NHS England and the integrated care boards are responsible for the allocation and distribution of Additional Roles Reimbursement Scheme (ARRS) funding to primary care networks (PCNs). This system is applied consistently across the National Health Service in England.

The PCN Additional Roles Reimbursement Sum is updated each year via updates to the Network Contract DES Contract Specification and supporting guidance, namely Chapter 10 of the specification and Chapter 7 of the guidance. The specification and the guidance are available at the following two links:

https://www.england.nhs.uk/wp-content/uploads/2026/03/network-contract-des-contract-specification-2026-27.pdf

https://www.england.nhs.uk/wp-content/uploads/2026/03/network-contract-des-part-b-guidance-non-clinical-26-27-2.pdf

For 2026/27, it equates to £27.668 and a PCN's maximum entitlement is calculated by multiplying the £27.668 ARRS Sum by the PCN Contractor Weighted Population as of 1 January 2026. PCNs can calculate their entitlement by using the General medical services and primary care network income ready reckoner from 1 April 2026, which is available at the following link:

https://www.england.nhs.uk/publication/general-medical-services-and-primary-care-network-income-ready-reckoner-from-1-april-2026/

The scheme is subject to annual review as part of the consultation on the GP Contract with professional representatives. NHS England works closely with the Department to implement any changes identified as part of this process.

In October 2024 the Government announced changes to the ARRS which allows PCNs to recruit general practitioners (GPs) through the scheme for 2024/25. Since October 2024 over 3,700 GPs have been recruited through the ARRS.

As part of the 2026/27 GP Contract, we are increasing flexibility of the scheme by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling PCNs to recruit a broader range of ARRS roles, where agreed with the commissioner.

NHS England and the integrated care boards are responsible for the allocation and distribution of Additional Roles Reimbursement Scheme (ARRS) funding to primary care networks (PCNs). This system is applied consistently across the National Health Service in England.

The PCN Additional Roles Reimbursement Sum is updated each year via updates to the Network Contract DES Contract Specification and supporting guidance, namely Chapter 10 of the specification and Chapter 7 of the guidance. The specification and the guidance are available at the following two links:

https://www.england.nhs.uk/wp-content/uploads/2026/03/network-contract-des-contract-specification-2026-27.pdf

https://www.england.nhs.uk/wp-content/uploads/2026/03/network-contract-des-part-b-guidance-non-clinical-26-27-2.pdf

For 2026/27, it equates to £27.668 and a PCN's maximum entitlement is calculated by multiplying the £27.668 ARRS Sum by the PCN Contractor Weighted Population as of 1 January 2026. PCNs can calculate their entitlement by using the General medical services and primary care network income ready reckoner from 1 April 2026, which is available at the following link:

https://www.england.nhs.uk/publication/general-medical-services-and-primary-care-network-income-ready-reckoner-from-1-april-2026/

The scheme is subject to annual review as part of the consultation on the GP Contract with professional representatives. NHS England works closely with the Department to implement any changes identified as part of this process.

In October 2024 the Government announced changes to the ARRS which allows PCNs to recruit general practitioners (GPs) through the scheme for 2024/25. Since October 2024 over 3,700 GPs have been recruited through the ARRS.

As part of the 2026/27 GP Contract, we are increasing flexibility of the scheme by removing the restriction that ARRS funding can only be used for recently qualified GPs, increasing the maximum reimbursement amount for GP roles to reflect experience, and enabling PCNs to recruit a broader range of ARRS roles, where agreed with the commissioner.

The Government recently announced a £340 million uplift to community pharmacy funding, a 10% increase, recognising the essential role pharmacies play in supporting patients and the wider National Health Service. As part of this, we are funding the rollout of NHS Independent Prescribing nationwide from Autumn 2026, building on the success of Pharmacy First and the Pharmacy Contraception Service to help pharmacists use their clinical skills and provide more on-the-spot care for common conditions.

Under the new contractual framework, pharmacists with an independent prescribing qualification, including those graduating from September 2026, will be able to assess patients and prescribe medicines directly. This rollout draws on learning from successful NHS pathfinder sites. In the Nottingham and Nottinghamshire Integrated Care Board, the pathfinder delivered 2,434 consultations up to 31 December 2025, of which 2,248, or 92.4%, were completed without onward referral and 1,424, or 58.5%, resulted in a pharmacist issuing a prescription, demonstrating its positive impact.

The Government recently announced a £340 million uplift to community pharmacy funding, a 10% increase, recognising the essential role pharmacies play in supporting patients and the wider National Health Service. As part of this, we are funding the rollout of NHS Independent Prescribing nationwide from Autumn 2026, building on the success of Pharmacy First and the Pharmacy Contraception Service to help pharmacists use their clinical skills and provide more on-the-spot care for common conditions.

Under the new contractual framework, pharmacists with an independent prescribing qualification, including those graduating from September 2026, will be able to assess patients and prescribe medicines directly. This rollout draws on learning from successful NHS pathfinder sites. In the Nottingham and Nottinghamshire Integrated Care Board, the pathfinder delivered 2,434 consultations up to 31 December 2025, of which 2,248, or 92.4%, were completed without onward referral and 1,424, or 58.5%, resulted in a pharmacist issuing a prescription, demonstrating its positive impact.

The Government recently announced a £340 million uplift to community pharmacy funding, a 10% increase, recognising the essential role pharmacies play in supporting patients and the wider National Health Service. As part of this, we are funding the rollout of NHS Independent Prescribing nationwide from Autumn 2026, building on the success of Pharmacy First and the Pharmacy Contraception Service to help pharmacists use their clinical skills and provide more on-the-spot care for common conditions.

Under the new contractual framework, pharmacists with an independent prescribing qualification, including those graduating from September 2026, will be able to assess patients and prescribe medicines directly. This rollout draws on learning from successful NHS pathfinder sites. In the Nottingham and Nottinghamshire Integrated Care Board, the pathfinder delivered 2,434 consultations up to 31 December 2025, of which 2,248, or 92.4%, were completed without onward referral and 1,424, or 58.5%, resulted in a pharmacist issuing a prescription, demonstrating its positive impact.

As part of the Government’s investment in digital channels, the NHS App currently provides patients with a National Health Service ‘front door’ through which they can access primary care services, including making appointments, ordering prescriptions, and viewing test results.

As set out in the 10-Year Health Plan, the NHS App will develop further to give patients greater control and choice over their healthcare, enabling them to see their whole health record and contribute to it in one place.

NHS England guidance sets out a digital-first approach to patient communications, with the NHS App increasingly used as the primary channel for patient communications, including for general practice (GP) services, followed by text messages and emails where appropriate. However, digital-first does not mean digital-only, and we will continue to communicate with patients in a way that is comfortable and convenient for them.

NHS England is linking local GP surgery communications with national NHS digital channels through NHS Notify, which includes messaging in the NHS App. NHS England does not currently mandate that all clinical systems utilise NHS Notify, but it is available for all suppliers to use, including those supporting GPs.

Pathways for managing patients with achalasia are set out in the NHS England Specialised Commissioning Paediatric Medicine: Gastroenterology, Hepatology and Nutrition Service Specification. The current specification was published in 2013/14, and there are no plans to update this specification at this time. The specification sets out that patients with achalasia should be managed within Specialist Paediatric Gastroenterology Centres under the care of an expert multidisciplinary team.

Patients with achalasia may also receive care from a specialist surgical team, within Specialised Surgery in Children services, to help manage their condition. The NHS England Specialised Surgery in Children service specification sets out standards for these services, and an updated specification is due for publication in 2026.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England. I refer the hon. member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

The MSF will drive improvements in the services that patients and their families receive at the end of life and will enable integrated care boards to address challenges in access, quality, and sustainability through the delivery of high-quality, personalised care. This will be aligned with the ambitions set out in the recently published 10-Year Health Plan.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

Integrated care boards (ICBs) are responsible for commissioning palliative care services to meet the reasonable needs of their population, which can include hospice services available within the ICB catchment. To support ICBs in this duty, NHS England has published statutory guidance and a service specification.

The Government is developing a Palliative Care and End of Life Care Modern Service Framework for England, due to be published in Spring 2026. I refer the hon. Member to the Written Ministerial Statement HCWS1087 I gave to the House on 24 November 2025.

Additionally, we are supporting the hospice sector with a £100 million capital funding boost for eligible adult and children’s hospices in England to ensure they have the best physical environment for care.   St Michael’s Hospice in Hereford is receiving £667,020 from this funding. We are also committing £80 million for children’s and young people’s hospices over the next three financial years, giving them stability to plan ahead and focus on what matters most, caring for their patients.

My Rt Hon. Friend, the Secretary of State for Health and Social Care, engages with Baroness Louise Casey regularly on a number of issues, including adult social care.

The commission is independent, and Baroness Casey has the autonomy to define her own engagement plans, including with ministers, based on what she believes is most appropriate for the commission’s work.

We have launched an independent commission into adult social care, chaired by Baroness Casey. The Commission's Terms of Reference are sufficiently broad to enable Baroness Casey to define its remit to independently consider how to build a social care system fit for the future. This includes considering professional registration if the Commission sees fit.

There is also work underway to improve professional recognition and workforce mobility.

In April 2025, the Department published the expanded and revised Care Workforce Pathway, including a new enhanced care worker role category. These pathway role categories will guide workers in building their careers in adult social care by signposting training and development opportunities, highlighting routes for progression, and giving proper recognition to the highly skilled, complex care and support they provide. Additionally, the Learning and Development Support Scheme, backed this financial year by up to £12 million, funds learning and development opportunities, including learning outcomes outlined in the Care Workforce Pathway. Overall, this work is essential for raising the status of adult social care as a career and recognising the vital work that care professionals do.

The Government and the National Health Service are working with local authorities and adult social care providers to help keep people well and independent for as long as possible, and to provide alternatives to hospital and care home admissions.

We have set out priorities for the NHS and local authorities to begin to move to a neighbourhood health service that delivers more care closer to home and that better supports people with complex needs. We are asking local systems to systematically implement six core components of neighbourhood health, which will help people stay healthy and independent for longer and reduce unnecessary time spent in hospital. This includes integrated intermediate care services to prevent an avoidable hospital admission or as part of hospital discharge planning.

NHS Operational Planning Guidance for 2025/26 sets an objective to deliver a minimum 10% reduction in the use of mental health inpatient care for people with a learning disability and autistic people. There is funding in NHS integrated care board baselines this financial year to improve community support provision and reduce reliance on inpatient care for people with a learning disability and autistic people, in line with the NHS Operational Planning Guidance.

The Mental Health Bill was introduced in the House of Lords on 6 November 2024. Through our proposed reforms to the Mental Health Act, we want to ensure that people with a learning disability and autistic people get the support they need in the community, improve care, and prevent admission to hospitals.

The Government and the National Health Service are working with local authorities and adult social care providers to help keep people well and independent for as long as possible, and to provide alternatives to hospital and care home admissions.

We have set out priorities for the NHS and local authorities to begin to move to a neighbourhood health service that delivers more care closer to home and that better supports people with complex needs. We are asking local systems to systematically implement six core components of neighbourhood health, which will help people stay healthy and independent for longer and reduce unnecessary time spent in hospital. This includes integrated intermediate care services to prevent an avoidable hospital admission or as part of hospital discharge planning.

NHS Operational Planning Guidance for 2025/26 sets an objective to deliver a minimum 10% reduction in the use of mental health inpatient care for people with a learning disability and autistic people. There is funding in NHS integrated care board baselines this financial year to improve community support provision and reduce reliance on inpatient care for people with a learning disability and autistic people, in line with the NHS Operational Planning Guidance.

The Mental Health Bill was introduced in the House of Lords on 6 November 2024. Through our proposed reforms to the Mental Health Act, we want to ensure that people with a learning disability and autistic people get the support they need in the community, improve care, and prevent admission to hospitals.

As part of the 10-Year Health Plan, Neighbourhood Health Centres will co-locate National Health Service, local authority and voluntary sector services, to help create an offer that meets population need holistically. Examples of this include providing debt advice and employment support services.

We support making the best use of the range of skills held by dental teams so that they work to their full scope of practice. This enables clinicians to deliver more complex care and reduce delays for patients.

The General Dental Council’s (GDC) Scope of Practice guidance sets out the areas in which dental professionals have the knowledge, skills, and experience to practise safely and effectively in the best interests of patients. NHS England’s guidance of January 2023 further sets out that dental therapists and dental hygienists can open and close National Health Service courses of treatment and provide direct access to NHS care within the GDC’s guidance.

We are holding a roundtable with dental care professionals on 10 July 2025 where we will listen to feedback about the implementation of recent reforms to increase the scope of practice for dental therapists and hygienists, and the potential for making better use of their skills in future.

The Government is determined to ensure that general practitioners (GPs) are able to spend more time doing what they do best, spending time with their patients.

That’s why, in October 2024, we invested £82 million into the Additional Roles Reimbursement Scheme to support the recruitment of 1,700 newly qualified GPs across England, helping to increase appointment availability and improve care for thousands of patients.

We delivered the biggest boost to GP funding in years, an £889 million uplift, with GPs now receiving a growing share of National Health Service resources. We have also announced that over £100 million of funding will be used to unlock new capacity in over 1,000 GP surgeries, which will enable more appointments.

We have launched a Red Tape Challenge, and scrapped unnecessary targets in our new GP Contract, to cut down on bureaucracy and free up time to spend with patients.

Mental health support teams cover school pupils and further education learners, including those up to the age of 18 years old.

They work directly with school and college staff, alongside National Health Services, to provide professional advice, easing the pressure on school staff and allowing them to help young people get the right support and stay in education.

The immigration White Paper, Restoring Control over the Immigration System, was collectively agreed across Government, and is available at the following link:

https://assets.publishing.service.gov.uk/media/6821f334ced319d02c906103/restoring-control-over-the-immigration-system-web-optimised.pdf

In the technical annex, published alongside the White Paper, the Home Office has estimated an annual reduction of approximately 7,000 main applicants as a result of ending overseas recruitment for care workers and senior care workers. This is based on their internal management information for entry visas granted covering the period March 2024 to February 2025. This estimate reflects that there was a drop in visa grants of more than 90% compared with the 12 months ending in March 2024, when more than 83,000 entry visas were granted to care workers and senior care workers. The analysis in the technical annex will be refined and included within the relevant impact assessments accompanying the rule changes, as appropriate. The technical annex is available at the following link:

https://assets.publishing.service.gov.uk/media/6821b49bdb6463b14cd8189c/restoring-control-over-the-immigration-system-technical-annex.pdf

As set out in the immigration White Paper, visa extensions and in-country switching for those already in the country and with working rights will be permitted for a transition period until 2028. This will be kept under review.

DHSC are providing up to £12.5m to regional partnerships in 2025/26 to respond to unethical international recruitment practices in the adult social care sector. This includes supporting international recruits impacted by sponsor licence revocations to find alternative employment.

Care workers are essential to those who draw on care and support, helping them to maintain their quality of life, independence, and connection to the things that matter to them. In England, as per the Care Act 2014, it is the responsibility of local government to develop a market that delivers a wide range of sustainable, high-quality care and support services, that will be available to their communities. English local authorities have responsibility under the Care Act 2014 to meet social care needs, and statutory guidance directs them to ensure there is sufficient workforce in adult social care.

The Department continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool, and intelligence from key sector partners.

The immigration White Paper, Restoring Control over the Immigration System, was collectively agreed across Government, and is available at the following link:

https://assets.publishing.service.gov.uk/media/6821f334ced319d02c906103/restoring-control-over-the-immigration-system-web-optimised.pdf

In the technical annex, published alongside the White Paper, the Home Office has estimated an annual reduction of approximately 7,000 main applicants as a result of ending overseas recruitment for care workers and senior care workers. This is based on their internal management information for entry visas granted covering the period March 2024 to February 2025. This estimate reflects that there was a drop in visa grants of more than 90% compared with the 12 months ending in March 2024, when more than 83,000 entry visas were granted to care workers and senior care workers. The analysis in the technical annex will be refined and included within the relevant impact assessments accompanying the rule changes, as appropriate. The technical annex is available at the following link:

https://assets.publishing.service.gov.uk/media/6821b49bdb6463b14cd8189c/restoring-control-over-the-immigration-system-technical-annex.pdf

As set out in the immigration White Paper, visa extensions and in-country switching for those already in the country and with working rights will be permitted for a transition period until 2028. This will be kept under review.

DHSC are providing up to £12.5m to regional partnerships in 2025/26 to respond to unethical international recruitment practices in the adult social care sector. This includes supporting international recruits impacted by sponsor licence revocations to find alternative employment.

Care workers are essential to those who draw on care and support, helping them to maintain their quality of life, independence, and connection to the things that matter to them. In England, as per the Care Act 2014, it is the responsibility of local government to develop a market that delivers a wide range of sustainable, high-quality care and support services, that will be available to their communities. English local authorities have responsibility under the Care Act 2014 to meet social care needs, and statutory guidance directs them to ensure there is sufficient workforce in adult social care.

The Department continues to monitor adult social care workforce capacity, bringing together national data sets from Skills for Care’s monthly tracking data, the Capacity Tracker tool, and intelligence from key sector partners.