This guidance sets out how commissioner allocations have been updated for the impact of the NHS pay awards and resident doctors (RDs) deal in 2026/27, as well as the impact on other areas of income and expenditure. It also advises how commissioners and providers should update contract values for relevant services and how integrated care boards (ICBs) and NHS trusts should reflect the impact of the pay awards and RDs deal on income and expenditure as part of in-year financial reporting.