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 planned introduction of an online contractual access requirement from 1 October 2025; final details of this have not been agreed and are subject to further negotiation prior to this planned implementation date.
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 needed to confirm all PCN member practices had this access in place before 31st March 2025. Many practices consciously delayed implementing this, because of, in the LMCs view, well-founded concerns about overwhelming clinical capacity and undermining the practices ability to implement the BMAs Safe Working Guidance. It was also the case that the payment arrangements written into the PCN DES (in particular Para 10.4 A 6 (c) and (d)) meant that provided the PCN CD could make such a declaration prior to March-end 2025, the full years payment would be made. It should be noted ICBs are entitled to undertake a post payment verification process to confirm compliance.
CAIP is a PCN payment, although, once received, practices can devolve funding directly to practices in accordance with any arrangements in 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 on-line requirement wording within the 2025/26 PCN DES, and also the same contractual payment arrangement, meaning that the full years payment will be available providing compliance occurs within all PCN member practices by March-end 2026. The equivalent wording reads:
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.
Unlike 2024/25, there is however the uncertainty of what arrangements may be in place from 1st October 2025: these are for practices, whereas the PCN DES CAIP arrangements require the collective agreement of all PCN member practices and any payment is made to the PCN.
A preliminary view is that the CAIP provisions are more demanding than the October 2025 Contract will be, since the latter is expected to distinguish between urgent and non-urgent clinical conditions (notwithstanding the challenges associated with that process) whereas the CAIP does not do so.
The LMC therefore advises practices and PCNs that if they have concerns about the CAIP online consultation requirements, particularly in terms of workload, they can now switch this to a less than full core hours implementation, even if they were compliant during the end of 2024/25. There is still a contractual requirement to offer on-line consultations in the Core Contract. The CAIP funding can be paid for the full 2025/26 financial year providing, based on the PCN DES 2025/26 wording, compliance by all member practices occurs by March-end 2025. This advice stands even if by the end of 2024/25 the PCN was compliant with the CAIP online consultation component, since this is a new annual contractual year
There is obviously no rquirement 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.