Classification: Official
Publication reference: PRN02483

To:  

• All GP practices in England
• Primary care networks:
  • clinical directors

cc. 

• Integrated care boards:
  • primary care leads
  • chief executive officers
  • chief medical officers
• NHS England regions:
  • regional directors
  • regional directors of commissioning
  • regional directors of primary care
  • regional primary care medical directors

Dear Colleagues                                                            

Variation to the Network Contract Directed Enhanced Service (DES) contract specification 2026/27

Explanatory note

NHS England has today published a variation to the Network contract directed enhanced service (DES) specification 2026/27 and Part B guidance, which take effect from 01 May 2026.

The updated specification introduces the following changes:

Local Variation Arrangements

1. The specification has been updated to enable ICBs to request local variations to the Network Contract DES (Network Contract DES LV). Network Contract DES LVs are limited to amendments to sections 7, 8 and 10.1 to 10.5 of the Network Contract DES Specification. This allows greater flexibility to tailor arrangements to local circumstances where existing local contractual routes may not be sufficient.

The changes could support ICBs that are developing neighbourhood services by using the Network Contract DES framework. These amendments are separate from the proposed Multi Neighbourhood Provider (MNP) and Single Neighbourhood Provider (SNP) Contracts, which will be subject to a separate DHSC and NHS England consultation.

Further Additional Roles Reimbursement Scheme (ARRS) flexibilities

2. From 1 May 2026 we have introduced additional flexibilities into the ARRS additionality rules. These changes allow GPs and Band 5 and Band 6 practice nurses who were funded either through the PCN Capacity and Access Payment (CAP) in 2025/26 or the PCN Test Sites Programme to transition into the ARRS, subject to funding availability.

3. The amendments to the Network Contract DES specification 2026/27, and Part B guidance: non-clinical – are highlighted in green within the documents.

Participation

4. Core Network Practices will automatically participate in this variation unless they follow the opt-out process in accordance with section 4.9.5 of the Network Contract DES specification. This means that PCNs with no changes to their membership or information do not need to submit any sign-up information to their commissioner to continue to participate. (To note – participating in this national variation does not automatically mean that Network Contract DES LVs can be made. ICBs will need to request permission to vary the Network Contract DES locally).

PCNs with changes must notify the commissioner within 30 calendar days of the publication of the Network Contract DES variation to seek approval of those changes. All participating practices must agree a variation to incorporate the specification into their contracts.

5. If a practice wishes to sign up to, or opt out of, the DES, it must inform its commissioner within 30 calendar days of the publication of the variation. The commissioner will work with the remaining practices in the PCN to consider the consequences, including whether the PCN remains viable.

6. Similarly, if a practice wishes to opt into the DES, it must inform its commissioner within 30 calendar days of the publication of the variation in accordance with the process set out in the Network Contract DES specification and guidance.