This resouce page looks to outline the contractual position and LMCs advice to practices and PCNs in relation to the CAIP funding for 2025/26.
Colleagues should also note the introduction of the online contractual access requirements from 1 October 2025. These regulations apply at practice level and are separate from the PCN DES arrangements described below.
The CAIP funding for Primary Care Networks (PCNs) under the PCN Directed Enhanced Service (DES) in 2024/25 was contingent on compliance with three independent components, one of which was that the online consultation [OC] was:
“available for patients to make administrative and clinical requests at least during core hours”.
PCN Clinical Directors were required to confirm that all PCN member practices had this access in place before 31 March 2025. Many practices consciously delayed implementing this because of, in the LMC’s view, well founded concerns about overwhelming clinical capacity and undermining the practice’s ability to implement BMA Safe Working Guidance. It was also the case that the payment arrangements written into the PCN DES, in particular paragraph 10.4A.6(c) and (d), meant that provided the PCN CD could make such a declaration prior to March end 2025, the full year’s payment would be made. ICBs are entitled to undertake post payment verification to confirm compliance.
CAIP is a PCN payment. Once received, practices may devolve funding in accordance with the terms of their Network Agreement.
The PCN DES is an annually updated contractual agreement; although there is a provision stating unchanged PCNs do not have to routinely provide full details of their membership and other arrangement, PCN DES participation is an annual decision and other contractual elements do not roll over.
NHS England have included the same online requirement wording within the 2025/26 PCN DES, together with the same contractual payment mechanism. The full year’s payment will therefore be available provided compliance across all PCN member practices occurs by March end 2026. The relevant wording states:
c) the amount will be paid in instalments if there is one or more full months in the period between the date of payment (as set out in section 10.4A.6(b)) and 1 April 2026. The number of instalments will equal the number of full months in this period and the amount due to the PCN will be equally split between instalments;
d) if there is no full month in the period between the date of payment (as set out in section 10.4A.6(c)) and 1 April 2026, the amount due to the PCN will be paid in full on the date of payment;
The LMC has written to all ICBs (NHS Sussex, Surrey Heartlands, SW London and Frimley) confirming this advice is being sent to practices, without this contractual position described above being challenged.
CAIP access requirement and October 2025 regulations
The CAIP requirement relates specifically to availability for online consultation for both clinical and administrative requests at least during core hours. This wording derives from Annex B, Section 11 of the PCN DES.
This requirement should not be confused with the separate online consultation regulations introduced from 1 October 2025. The October regulations apply at practice level and include additional provisions, for example in relation to handling urgent clinical requests and response arrangements. CAIP is a PCN DES payment and does not replicate all of those elements.
In our view, where a practice is compliant with the post 1 October 2025 regulations, it is likely also to be compliant with the CAIP access requirement. However, we are aware that commissioners may interpret “availability for clinical requests” strictly where online consultation systems distinguish between different types of request, for example separating “health problem” and “routine or administrative” forms.
PCN Clinical Directors should ensure they are confident that all member practices are compliant before confirming eligibility for payment. Where there is doubt, practices or PCNs may wish to seek written clarification from their ICB as to the specific element of Annex B they consider not to be met.
Unlike 2024/25, there is the additional complexity that the October 2025 regulations apply to individual practices, whereas CAIP remains a PCN level payment dependent on collective compliance.
The LMC therefore advises practices and PCNs that if they have concerns about the CAIP online consultation requirement, particularly in terms of workload, they may adjust arrangements during the year. The CAIP funding can still be paid for the full 2025/26 financial year provided compliance across all member practices occurs by March end 2026. This advice stands even if the PCN was compliant during 2024/25, as this is a new contractual year.
There remains a contractual requirement within the core GMS contract to offer online consultation.
There is no requirement to reduce online consultation availability if practices believe it does not adversely affect working arrangements.
There is obviously no requirement to do this if practices believe the on-line consultation process does not adversely affect working arrangements.
LMC recommendation
We suggest matters are reviewed prior to October, since at that point it will be clear what arrangements in relation to online consultations are being implemented from October2025. The PCN DES is not scheduled to change during 2025/26.