The 2026/27 GP Contract makes clear that requests identified by practices as clinically urgent should be responded to on the same day. This builds on NHS England’s Medium Term Planning Framework, which set an expectation that urgent appointments should be delivered on the same day so that patients with urgent needs are prioritised.

We recognise that practices will need the right capacity and flexibility to deliver this. That is why we are investing an additional £601 million in general practices (GPs) in 2026/27, bringing total spend on the GP Contract to approximately £14 billion. This builds on the £1.1 billion increase in 2025/26, the largest uplift in over a decade. Since October 2024 we have recruited 2,000 more GPs. We now have the highest number of GPs by headcount since 2015. The 2026/27 contract also introduces a practice-level GP reimbursement scheme, backed by £292 million of ringfenced funding, to help practices recruit more GPs or expand sessions.

This will support practices to manage demand, improve access for patients, strengthen GP employment, and continue to improve patient satisfaction.

Same-day appointment levels have remained broadly steady. In May 2026, 44.9% of appointments were booked and attended on the same day, up 0.3% from April 2026 and 0.7% from May 2025. This represents approximately 13 million appointments taking place on the day of booking.

The Department and NHS England considered the potential risks, benefits, and wider impact of the policy changes as part of standard policy-development processes and Equalities Impact Assessments.

No immediate negative impacts have been identified from these policies. If any are identified at a later stage, the Department will consider and review them. The changes are intended to improve access to general practices (GPs), build workforce capacity, and strengthen prevention. They include measures to increase GP capacity, including a new practice-level GP reimbursement scheme and greater flexibility to recruit GPs through the Additional Roles Reimbursement Scheme.

We are routinely collecting data on workforce, patient access, and service use to inform the assessment of impacts.

Where a patient presents with a clinically urgent need, it is for the general practitioner to determine the appropriate course of action, and the patient should receive a clinically appropriate response on the same day. Where a request is ‘dealt with’, this does not always mean a same‑day appointment, but that the patient has received an appropriate clinical response. This could include advice, an appointment, including one that delivers continuity of care, or signposting to another suitable service, depending on the patient’s needs.

The Government recognises that continuity of care plays an important role in patient experience and outcomes, particularly for those with ongoing health challenges. As part of the 2026/27 contract, we have made it a core requirement for primary care networks to identify and prioritise cohorts for continuity of care using risk stratification tools as part of their core activities. This will make continuity a core expectation within primary care and support future work to embed more meaningful continuity models in subsequent contract reform.

The Department and NHS England considered the potential impacts of expanding Advice and Guidance (A&G) as part of the policy development process, including through clinical input, established governance arrangements, and equalities considerations. A&G is intended to support timely clinical decision‑making and ensure patients are directed to the most appropriate care. National guidance is in place to support its safe and consistent use, and the use of A&G does not change existing clinical accountability or patient safety arrangements.

The contract does not change the clinical threshold for referral to specialist care. General practitioners (GPs) should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

The 2026/27 GP Contract embeds the previous A&G enhanced service funding into core practice funding. Following near universal uptake of the A&G Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

General practices (GPs) are valued independent contractors who provide £14 billion worth of National Health Services. Every year we consult with the profession about what services GPs provide, and the money providers are entitled to in return under their contract, taking account of the cost of delivering services.

In early 2026, we concluded the 2026/27 GP Contract consultation. This year we expanded the consultation to engage with wider stakeholders, and these were the General Practitioners Committee England, the Royal College of General Practitioners, National Voices, the Institute of General Practice Management, Healthwatch England, NHS Confederation, now NHS Alliance following its merge with NHS Providers, and the National Association of Primary Care. The feedback we received from stakeholders across the system has been constructive and comprehensive, enabling us to refine proposals and address concerns while developing the final contract package.

We are investing £601 million in GPs in 2026/27, bringing the total spend on the GP Contract to £14 billion. This builds on last year’s £1.1 billion of investment. This uplift represents a 4.5% cash increase, or 2.2% real terms increase, and includes the Review Body on Doctors' and Dentists' Remuneration recommended pay increase of 3.5%.

The Department and NHS England considered the potential impacts of expanding Advice and Guidance (A&G) as part of the policy development process, including through clinical input, established governance arrangements, and equalities considerations. A&G is intended to support timely clinical decision‑making and ensure patients are directed to the most appropriate care. National guidance is in place to support its safe and consistent use, and the use of A&G does not change existing clinical accountability or patient safety arrangements.

In 2025/26 we introduced an enhanced service for A&G with funding of up to £80 million made available nationally to support increased use of A&G in general practices (GPs). This was uplifted to £82 million in 2026/27.

The 2026/27 GP Contract embeds the previous A&G enhanced service funding into core practice funding. Following near universal uptake of the A&G Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

The contract does not change the clinical threshold for referral to specialist care. GPs should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

The Government is committed to improving access to general practices (GPs) by increasing capacity and making it easier for patients to contact their surgery. The changes made to online consultation systems in October 2024 are supporting greater parity across booking routes, reducing pressure on busy phone lines, and ensuring patients have a consistent and reliable way to request care.

The Office for National Statistics’ Health Insight Survey for May 2026 shows that 76.5% of patients reported it was easy to contact their GP, up from 60.9% in July 2024, an increase of nearly 16%

To support practices, we are investing an additional £601 million in GPs in 2026/27, bringing total spend on the GP Contract to approximately £14 billion. This builds on the £1.1 billion increase in 2025/26, the largest uplift in over a decade. Since October 2024 we have recruited 2,000 more GPs. We now have the highest number of GPs by headcount since 2015. The 2026/27 contract also introduces a practice-level GP reimbursement scheme, backed by £292 million, to help practices recruit more GPs or expand sessions

Data collected through General Practice Appointment Data provides insight into the volume of online consultation submissions received by practices. In May 2026, practices received 2.1 million more online consultation submissions than in May 2025, a 36.4% year-on-year increase. However, submissions were 7.2% lower than in April 2026, following a larger month-on-month decrease in April of 14.6%, equivalent to 1.5 million fewer submissions.

As a result, GPs have delivered 12.7 million additional appointments to patients compared with the previous year. This data is available at the following link:

https://digital.nhs.uk/data-and-information/publications/statistical/appointments-in-general-practice/may-2026

There are no current plans to review the list of prescription charge exemptions or the list of medical conditions that entitle someone to apply for a medical exemption certificate. The Government has not specifically assessed the impact on patient health outcomes for people with arrhythmogenic cardiomyopathy who may struggle to afford their prescribed medication.

Patients with certain medical conditions may be eligible for exemption from National Health Service prescription charges for another reason. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, and whether they are in receipt of certain benefits or a war pension.

Additionally, people on a low income can seek help under the NHS Low Income Scheme, and people who have to pay NHS prescription charges and need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs are available to purchase online from the NHS Business Services Authority or in-person at some pharmacies. The prescription charge in England is £9.90. A PPC costs £32.05 for three months or £114.50 for 12 months.

There are no current plans to review the list of prescription charge exemptions or the list of medical conditions that entitle someone to apply for a medical exemption certificate. The Government has not specifically assessed the impact on patient health outcomes for people with arrhythmogenic cardiomyopathy who may struggle to afford their prescribed medication.

Patients with certain medical conditions may be eligible for exemption from National Health Service prescription charges for another reason. Eligibility depends on the patient’s age, whether they are in qualifying full-time education, whether they are pregnant or have recently given birth, whether they have a qualifying medical condition, and whether they are in receipt of certain benefits or a war pension.

Additionally, people on a low income can seek help under the NHS Low Income Scheme, and people who have to pay NHS prescription charges and need many prescription items could save money with a prescription prepayment certificate (PPC). PPCs are available to purchase online from the NHS Business Services Authority or in-person at some pharmacies. The prescription charge in England is £9.90. A PPC costs £32.05 for three months or £114.50 for 12 months.

NHS England is committed to delivering high quality care and support for every person with dementia at every age, and central to this is the provision of personalised care.

The Well Pathway for Dementia highlights that services need to be integrated, commissioned, monitored, and aligned with the National Institute for Health and Care Excellence’s (NICE) standards for each component of the pathway. It makes it clear that the needs, wishes, and preferences of each individual, including those with young onset dementia, should be taken into account when planning and providing their care.

The provision of dementia health care services is the responsibility of local integrated care boards (ICBs). NHS England would expect ICBs to commission services based on local population needs, taking account of NICE’s guidelines. It is the responsibility of ICBs to work within their geographical area to offer services that meet the needs of their population.

Funding for general practice (GP) is agreed annually through consultation on the GP Contract, which considers wider cost pressures facing practices as part of the overall settlement. These funding decisions are informed by a range of factors, including independent recommendations from the Review Body on Doctors’ and Dentists’ Remuneration, where relevant, as well as affordability considerations. However, the GP Contract does not provide for automatic reimbursement of individual cost increases, including changes to National Insurance contributions or the National Minimum Wage.

In this context, we have uplifted the GP Contract by £601 million for 2026/27. This builds on last year’s £1.1 billion of investment, taking the two-year increase to £1.7 billion, or 13.8% in cash terms and 8.1% in real terms. Through consultation with stakeholders, we set these uplifts and changes to the contract with regard to the pressures faced by businesses. This includes the costs associated with the Government’s agreement to implement review body recommendations, including a 3.5% pay rise for GPs.

Local authorities must identify young carers, including those caring for older siblings and relatives, who may need support and assess their needs when requested. We strongly support the No Wrong Doors for Young Carers Memorandum of Understanding, which promotes collaboration across children’s and adults’ services, health partners, and schools. We strongly encourage local authorities to sign up to it.

NHS England is supporting the identification of young carers through general practice guidance and improved data sharing. NHS England is also leading a cross-Government project, co-produced with young carers and voluntary, community, and social enterprise partners, to improve identification, strengthen support pathways, and join up services across education, health, and local organisations.

I chair a regular cross-Government meeting with ministers from the Department for Work and Pensions, the Department for Business and Trade, and the Department for Education, to consider how best to provide unpaid carers and young carers with the recognition and support they deserve. The Government is preparing a cross-Government action plan for unpaid carers which we plan to publish later this year. This will include actions to strengthen further the support that is provided to young carers.

Care agencies who carry out a regulated activity must be registered by the Care Quality Commission (CQC) and are expected to comply with relevant regulations. Where a care agency does not carry out a regulated activity but supplies workers to a regulated care provider, the legal duty to comply with CQC regulations sits with the registered provider using the agency and the registered manager.

Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 sets out that it is the responsibility of the regulated provider to ensure robust and safe recruitment practices are in place, and to make sure that all staff, including agency staff, are suitably experienced, competent, and able to carry out their role. Further information on Regulation 19 is available at the following link:

https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-19

Registered providers are also expected to comply with Regulation 18: Staffing, which sets out a provider’s responsibility to deploy enough suitably qualified, competent, and experienced staff. Further information on Regulation 18 is available at the following link:

https://www.cqc.org.uk/guidance-regulation/providers/regulations-service-providers-and-managers/health-social-care-act/regulation-18

The CQC can assess compliance with these regulations through assessment and monitoring activity. Where a breach of regulation or non-compliance is identified, the CQC can take regulatory action.

An Enhanced Disclosure and Barring Service (DBS) check must be undertaken prior to the recruitment of all care workers. In line with the CQC guidance for DBS checks, staff working with vulnerable adults can only start work before a DBS certificate is received if they have had a DBS Adult First Check, are appropriately supervised, and do not escort people away from the premises unless accompanied by someone with a DBS check.

The Government is committed to ensuring the general practice nursing workforce is sustainable, supported and valued for the work they do.

The Government looks to the independent pay review bodies for a pay recommendation for National Health Service staff, including both contractor and salaried general practitioners (GPs). They consider a range of evidence from organisations including the Government, the NHS and trade unions to reach their recommendations.

The independent review body on Doctors’ and Dentists’ Remuneration (DDRB) recommended an uplift of 4% to the pay ranges for salaried GPs, and to GP contractor pay. As with the previous year, we accepted the DDRB’s pay recommendation. We provided an increase to core funding for practices to allow this 4% pay uplift, on top of the provisional 2.8% uplift already provided, to be passed on to salaried and contractor GPs. The additional funding also allows for pay uplifts for other salaried general practice staff, including nurses. We expect GP contractors to implement pay rises to other practice staff in line with the uplift in funding they have received.

As self-employed contractors to the NHS, it is up to general practices how they distribute pay and benefits to general practice nurses and other staff. General practice contractual arrangements do not place any specific obligations on practices regarding general practice nurse terms and conditions.

We are investing an additional £1.1 billion in general practice to reinforce the front door of the NHS, bringing total spend on the GP Contract to £13.4 billion in 2025/26, representing the biggest cash increase in over a decade. The 8.9% boost to the GP contract in 2025/26 is greater than the 5.8% growth to the NHS budget overall.

The Department recognises the value that social prescribing can play in supporting people’s health and wellbeing. This includes activities such as the creative arts, as well as cultural activities.

The 2025/26 GP Contract has been updated to give patients the right to access help electronically, including requesting appointments, throughout the duration of core practice hours.

All practices in England are required to offer online and video consultation tools, secure electronic communication methods, and online facilities to provide and update personal information.

Practices are required to offer patients an appropriate response on the day they contact the practice, or the next day if they contact the practice in the afternoon, according to the urgency of their clinical needs and other circumstances. An appropriate response could, for example, involve inviting the patient to an appointment, providing appropriate advice or care by another method, signposting to the patient to appropriate services, or communicating with the patient to request more information.

From 2026/27, we want to fundamentally improve the way we fund councils and direct funding to where it is most needed through the first multi-year settlement in 10 years. This will provide greater long-term certainty for local authorities and will enable local government to focus on its priorities, delivering for residents and providing vital front-line services that people rely on every day.

The proposed 2025/26 NHS Payment Scheme does not remove a patient’s right to choose. The Government is committed to patients having the right to choose their provider when referred to consultant-led treatment, or to a mental health professional, for their first appointment as an outpatient.

Local authorities are required to undertake a pharmaceutical needs assessment every three years, to assess whether their population is adequately served, and keep these assessments under review. These assessments inform integrated care boards (ICBs) when reviewing applications from prospective National Health Service pharmacy contactors. In addition, ICBs have powers to direct and fund pharmacies to open for longer than their core contractual hours if there is an unmet need. Patients can also choose to access medicines and pharmacy services through any of the over 400 NHS online pharmacies that are contractually required to deliver prescription medicines free of charge to patients.

The 10-Year Health Plan will describe a shared vision for the health and care system in 2035, drawing directly from the extensive engagement underway with the public, patients, and staff. It will set out how the National Health Service will deliver the shift from sickness to prevention, which will be one of the central tenets of the plan. This includes a working group focused on the preventative healthcare model for the future.

We have announced a proposed £889 million uplift for general practices (GPs) in 2025/26 and set out the proposed areas of reform which will help us to deliver on our commitments. This is the largest uplift to GP funding since the beginning of the five-year framework and means that we are reversing the recent trend, with a rising share of total NHS resources going to GPs.

To shift care from sickness to prevention, the Government has also proposed providing financial incentives to reward GPs who go above and beyond to prevent the most common killers, like heart disease, for the next contract year. This is subject to the contract consultation currently underway with the General Practitioners Committee England.

We have already started hiring an extra 1,000 GPs into the NHS and uplifted a monthly payment to practices by 7.4%. We will also be resuming our consultation with Community Pharmacy England regarding funding arrangements.

The most common reason children aged five to nine are admitted to hospital is for tooth decay. We will work with local authorities and the NHS to introduce supervised tooth brushing for children aged between three and five years old in the most deprived communities. These programmes are proven to reduce tooth decay and to boost good practices at home.

Integrated care boards have delegated responsibility for planning and commissioning healthcare services to meet the reasonable needs of the people for whom they are responsible. In South Derbyshire, our Regional Director of Public Health is working with local government and the Joined Up Care Derbyshire Integrated Care System to support the shift to prevention.