PCN ARRS and Capacity and Access Payment

Relating to the GP Contract for 2026/27

We wished 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.  

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, can be seen here.  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 2026/27 Agenda for Change (AfC) uplift is 3.3%.  Most GP practice staff are not on AfC 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.

Information:

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 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 we 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 Capacity and Access Payments within the PCN DES. This comprises:

  • the Capacity and Access Support Payment (CASP), paid monthly as a fixed sum of £3.208 multiplied by the PCN’s adjusted population
  • the Capacity and Access Improvement Payment (CAIP), worth up to £1.375 multiplied by the PCN’s adjusted population

CAIP is contingent on achieving two targets:

  • delivery of “modern general practice” access
  • risk stratification to support continuity of care

In practice, many PCNs have sought to meet the access requirement in full based on the Regulations, which require PCN Clinical Directors to declare compliance across all member practices. Commissioners may then undertake verification after this declaration.

PCNs have varied in how CAP funding has been used, particularly CASP, which had no specific performance requirements. PCN DES guidance set out a range of potential uses for this funding.

With the withdrawal of CAP funding in 2026 to 2027, the LMC recommends that PCNs and practices review current CASP and CAIP-related spending. This should include:

  • reviewing ARRS GP claims and any additional local funding used to support those roles, in light of the revised ARRS salary arrangements
  • noting that CAIP funding may still be received after March 2026 if a declaration is made in that month

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. This is particularly relevant given that full details of that scheme were not published alongside 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. 

There are a number of PCN responsibilities that will now be included within the PCN DES specification directly including:

  • risk stratification of patient cohorts for continuity of care
  • aligning of cancer referral arrangements amongst PCN member practices
  • alignment of PCNs in relation to neighbourhoods – although it is stated this is: “not intended to signal widespread reconfiguration of PCNs”

There are also drafted responsibilities for PCNs in relations to vaccination of care home residents and the LMC has written to all practices regarding this issue as it appears to create a substantial risk and workload for PCNs based on the individual decision of one or more member practices in relation to the seasonal vaccination programmes. Colleagues are advised to await clarification of this issue before responding to ICB requests (unfortunately sometimes couched as demands) in relation to this issue.

Read more about the Seasonal Vaccination Arrangements for Patients in Aligned Care Homes