I am writing to all colleagues to highlight the planned changes in PCN ARRS and Capacity and Access arrangements for 2026/27, in order that PCN and practice colleagues can prepare for these changes. At this point not all details are available, but these issues will also be covered in the planned GP Contract webinars.
In terms of ARRS arrangements, following the widely expressed concerns about restricting GP engagement via this Scheme to GP colleagues within two years of certification, this restriction is now lifted. Any GP can be engaged within this scheme. In addition, the upper claimable salary (which also includes commensurate on costs) will rise significantly within the BMA salaried GP pay range.
At this point colleagues should note a key point that will be reiterated in contract discussions. The underlying pay assumption, used by the Government when in its submission the Doctors and Dentists Pay Review Body (DDRB) for 2026/27, is 2.5%. This has thus been used in the current NHS England calculations for those elements of the Contract based on “pay”, which includes, Global Sum, ARRS reimbursement and, for example, the Enhanced Access Service within the PCN DES.
In addition, the announced – and accepted – 2026/27 Agenda for Change (AfC) uplift is 3.3%. Most GP practice staff are not on Agenda for Change pay scales, but this may affect some ARRS engaged staff. This creates a cost pressure over and above the £43 million already added to the ARRS pool which has risen from £1,711million to £1,754 million from 2025/26 to 2026/27. This additional uplift has not yet been added, nor has the currently unknown 2026/27 DDRB recommendation.
Colleagues will also note that the DDRB recommendation is ultimately decided by Government. As a comparison, the effect of the DDRB and AfC uplift in 2025/26 added a further £122 million to that years Contract value.
For these reasons the current figures are provisional.
In terms of planning for next year, colleagues can therefore anticipate an increase in claimable salary (including on-costs) for GPs engaged in the ARRS programme, and the LMC is aware many PCNs/practices have been supplementing such salaries by other non-ARRS income.
In terms of the new Practice based Reimbursement Scheme, this is not part of the ARRS allocation. At present no details in terms of how this will operate are known, beyond the ringfenced funding of £292 million (see below) and that it is exclusively for recruiting GPs. NHS England have said they wish it to be administratively simple, which is, as colleagues will appreciate, not necessarily reassuring. The scheme is set to operate from 01 April, but I appreciate that if full details are not available within the Statement of Financial Entitlements (SFE) until after that date, colleagues may well be cautious in commencing recruitment until full details are known.
The £292 million is being transferred from the Capacity and Access Payments within the PCN DES, comprising the Capacity and Access Support Payment (CASP), paid monthly as a fixed sum of £3.208 multiplied by the PCNs Adjusted Population, and the Capacity and Access Improvement Payment (CAIP). This payment of up to £1.375 multiplied by the PCNs Adjusted Population is contingent on achieving two targets, one relating to risk stratification to support continuity of care, and the second supporting “modern general practice” access. PCNs have sought to achieve the latter in it’s entirety based on the Regulations which require PCN CDs to declare compliance by all member practices. Commissioners are entitled to undertake verification subsequent to this declaration.
It is clear PCNs vary in how they have used CAP (and particularly CASP funding) since the latter had no specific performance indicators. The PCN DES Para B Guidance Para 11.2.1 lists a number of potential uses for this funding. Given the withdrawal of this funding in 2026/27, the LMC recommends PCN/practices review current CASP/CAIP related spending (noting the CAIP funding may be received after March 2026 if a declaration of compliance is made in that month). PCN/practices should also review the current claims associated with ARRS recruited GPs, together with any supplementary funding provided from other sources by the PCN/practices, given the changed salary arrangements for ARRS recruited GPs in 2026/27 – noting these haven’t (as above) been finally confirmed but will definitely be higher than the 2025/26 claimable pay rates.
There has been some criticism of this contractual change, in that funding previously directly available to PCNs/practices (via CASP) or contingently available (via CAIP) with relatively flexible usage is now transferred to a GP practice GP-reimbursement Scheme, particularly as details of the latter have not been concurrently published with the Contract announcement. Clearly one aim is to facilitate GP employment given the concerns within the whole profession about under- and un- employment. The lifting of the two-year post-certification limit within the ARRS rules underpinned the same aim.
Additionally, GPC England were concerned that such funding should be ringfenced for practice use, rather than risk any veering towards a transfer of PCN funding to support Neighbourhood provider models.
Obviously, as soon as further information is available, the LMC will circulate this to all practices.
Dr Julius Parker, Chief Executive