The BMA has revealed its asks for the next GP contract in England, which includes a requirement for practices to sign declaration letters to confirm pay uplifts have been given to salaried GPs.
The GP Committee England (GPCE) has also proposed replacing the ARRS with a ‘practice level funding scheme’ to ‘support practices to hire more GPs’.
The union has published three papers outlining its proposals for the 2026/27 contract that were presented to the Government in a meeting last week. These include:
- Introducing a clause to GMS/PMS/APMS contracts that requires practices to ‘sign declaration letters’ confirming they have passed on the annual pay uplift to their employed GPs following Review Body on Doctors’ and Dentists’ Remuneration (DDRB) recommendations ‘or risk a potential enquiry’; and for the uplifts to be ‘fully funded and ringfenced’ and to specifically include all employer on costs on top of the percentage pay award offered. This would apply only to salaried GPs, not to all practice staff.
- Replacing the GP element of ARRS with a practice ‘GP Employment Support Scheme (GPESS)’ to allow surgeries to independently recruit and retain GPs and that has funding allocated directly to each practice based on size and recruitment issues.
- Increasing the Global Sum payment per weighted patient by £50 extra per patient per year, from £123.34 to £173.34, in 2026/27.
- Introducing a ‘Partnership Premium Scheme for GPs’ in England, designed to incentivise GPs to ‘take up and remain’ in partnership roles within practices.
- Replacing the existing ‘patchwork of regional LESs’ in relation to safeguarding with a ‘comprehensive nationally agreed DES’.
- Item of Service payments for vaccinations to be increased to £13.48 to take account for their lost value since 2018/19.
- Consider expanding the GP locum reimbursement scheme – which allows practices to recoup locum costs when a GP is on parental or sickness leave – to non-GPs, such as practice nurses, to improve the parental leave benefits for this group of staff. This would ensure parity of parental leave benefits with other sectors of the NHS.
- Development of a GP premises funding scheme and system reimbursements for property costs. This would involve a commitment to joint working to develop a new, costed and funded approach to GP premises as part of GP contract reform.
The overhauled contract consultation process is currently underway.
Instead of GP contract negotiations with the BMA’s GP committee, the Government is currently ‘consulting’ it alongside a wider group of stakeholders, including the Institute of General Practice Management (IGPM) and patient groups.
In a message to GPs on Friday, GPC England deputy chair Dr Samira Anane said: ‘We submitted several high-level papers and counter proposals from our perspective under a series of themes, and in a departure from usual practice, we have published our contract proposals.
‘These proposals build on our historical contract asks around the need to restore resourcing levels for general practice and the GP unemployment crisis, and complement several key publications developed to support the profession and practices, working towards hope, safety and stability.’
On the proposed DDRB pay award pay uplift declaration for practices, the document said that this already happens in Wales. Since 2021, the GMS contract in Wales has required practices to sign declaration letters that confirm they have passed on any DDRB uplift agreed by Government for that financial year to their salaried GPs and to practice staff. If the uplift is not passed on, practices risk having the funding for the staff pay award clawed back.
Expanding this to England would ‘promote good practice, compliance with the salaried GP model contract’ and fairness in pay across general practice, said the document.
The new practice-level funding scheme would replace the existing PCN GP element of the ARRS, allowing practices to ‘independently recruit and retain GPs’ to provide direct patient care at a practice level, the GPCE said.
The documents added: ‘The ultimate goal is to improve access to general practice, strengthen job stability for GPs, and enhance continuity of care for patients.
‘The scheme would support NHS practices to hire and retain GPs more easily, with funding allocated directly to each practice based on practice size and recruitment issues.’
Funding for the scheme could be via a reimbursement mechanism, providing a clear, transparent use of those funds that offers direct benefits to patients and practices alike, the documents said.
‘Funding could be drawn from other areas of the PCN contract, such as repatriating all or part of the capacity and access improvement payment (CAIP), or £1.7 billion of annual ARRS funding for use at practice level, re-orientating that money to directly support the provision of general practice services to the public,’ the GPCE added.
And the Partnership Premium Scheme would be open to qualified GPs who join a partnership or remain in a partnership role within NHS GP practices in England, allowing them to receive an annual payment of £1,150 per clinical session (for up to a maximum of eight sessions per week), and increasing to £1,316 per session for those with over 16 years’ experience (up to a maximum of eight sessions per week).
