New Practice-Level GP Reimbursement
£292 million repurposed from the PCN Capacity and Access Payment (CAP/CAIP) to a new practice-level scheme. Practices can use it to recruit new GPs or fund additional sessions from existing GPs to support same-day urgent access. The CASP and CAIP will be removed from the Network Contract DES.
ARRS GP Restrictions Removed
The restriction limiting ARRS GP recruitment to recently qualified GPs is lifted. PCNs can now recruit a wider range of GPs. Maximum reimbursement is increased to the top of the salaried GP pay range plus employment on-costs. PCNs may also recruit a broader range of ARRS roles where agreed with the commissioner.
Same-Day Urgent Access — Mandatory
Practices must deal with all clinically urgent requests on the same day. It is for the GP practice to determine which patients are clinically urgent. Data will be collected on % seen same day.
No "Call Back Tomorrow"
Practices must not ask patients to call back or make contact on another day. For non-urgent contacts, an appropriate response (confirming next steps) must be provided by the end of the next working day.
No Capping of Online Consultations
Online consultation systems must not cap the number of requests during core hours. Online access must operate with parity to telephone and walk-in — practices cannot restrict online submissions.
5 New Data Metrics Collected
Practices will be required to provide data on: (1) call wait 8–10am, (2) call wait during core hours, (3) % urgent seen same day, (4) % non-urgent seen within 1 week, (5) % non-urgent within 2 weeks. Not for performance management — for understanding demand.
Opening Times Must Be Displayed
Practices must display core hours and opening times for all modes of access (walk-in, telephone, online) on their website, practice leaflet and within premises.
ICB Support Engagement Required
Practices where unwarranted variation in contractor performance is identified must engage with ICB support — including where same-day urgent access requirements are not being met or where contractual breach is at risk.
| Indicator | Change | Thresholds | Points | Status |
|---|---|---|---|---|
| AF006 | Upper achievement threshold increased | Upper ↑ 90% → 95% | 12 pts | Amended |
| CD001 | New BP control indicator for patients ≤79 without frailty — combines & replaces CHD015, STIA014 BP indicators | 40–90% | 41 pts (reallocated) | New |
| CD002 | New BP control indicator for patients aged 80+ without frailty — combines & replaces CHD016, STIA015 BP indicators | 46–90% | 20 pts (reallocated) | New |
| CHOL003 | Points reduced for consistency with lipid lowering indicators | 70–95% (unchanged) | 38 → 20 pts ↓ | Amended |
| DM034 | Points increased — primary prevention statin use in diabetes | 50–90% (unchanged) | 4 → 8 pts ↑ | Points up |
| DM035 | Points increased — secondary prevention statin use in diabetes | 50–90% (unchanged) | 2 → 8 pts ↑ | Points up |
| DM037 | New annual diabetes care processes indicator — all 8 NICE-recommended care processes required. Replaces DM012. | 35–75% | 10 pts (reallocated) | New |
| HF009 | New 4-pillar therapy indicator for heart failure with reduced ejection fraction (HFrEF) — reflects updated NICE guidance. Replaces HF003 & HF006. | 20–50% | 12 pts (reallocated) | New |
| HYP010 (was HYP008) | Frailty cohort removed from indicator | 40–85% (unchanged) | 38 pts | Amended |
| HYP011 (was HYP009) | Frailty cohort removed from indicator | 40–85% (unchanged) | 14 pts | Amended |
| NDH003 (was NDH002) | Gestational diabetes patient cohort added; points increased | 50–90% (unchanged) | 18 → 20 pts ↑ | Points up |
| OB004 | New referral to weight management programmes indicator for adults living with obesity. Weight Management Enhanced Service retired. | 10–30% | 5 pts (new) | New |
| OB005 | New shared decision-making and pharmacotherapy (e.g. GLP-1) indicator for obesity | 50–80% | 13 pts (new) | New |
| STIA007 | Ticagrelor added to list of antiplatelet medications that count towards QOF achievement | 57–97% (unchanged) | 4 pts | Amended |
| VI001 | Addition of improvement threshold calculations (see below) | 89–96% + improvement 5–18pp | 18 pts | Amended |
| VI002 | MMRV vaccine added + improvement threshold calculations | 86–96% + improvement 5–23pp | 18 pts | Amended |
| VI003 | MMRV vaccine added + improvement threshold calculations | 81–96% + improvement 5–30pp | 18 pts | Amended |
Vaccination Improvement Thresholds
New dual-track approach for VI001–003: practices receive whichever is higher — points based on traditional achievement thresholds OR a sliding scale for improvement from 2-year baseline. Particularly benefits practices in deprived areas. Lower improvement threshold = 5 percentage points above baseline.
Register Rule Changes
Asthma register: now includes patients from age 5. COPD register: business rules amended to address potential under- and over-recording identified by audit. Review your registers before April.
Obesity — New QOF & ES Retired
Two new obesity indicators (OB004 & OB005) introduced covering referrals to weight management and shared decision-making on pharmacotherapy. The Weight Management Enhanced Service is retired. Net 18 new points worth ~£25m nationally.
RSV Programme Expansion
RSV vaccination extended to all adults aged 80+ and all care home residents (older adults). SFE updated to reflect this. Practices receive an Item of Service fee per vaccination administered.
PCN Care Home Vaccination Duty
PCNs must ensure eligible care home residents are identified and offered seasonal and routine vaccinations. PCNs are not necessarily responsible for delivery — but must ensure arrangements are in place (via registered practice or subcontracting).
Seasonal Vaccination Collaboration Enabled
The existing exclusion of flu and COVID-19 from collaborative delivery under the Network Contract DES is removed. Practices wishing to collaborate on seasonal vaccination delivery may now do so.
Advice & Guidance — Embedded
A&G Enhanced Service funding is embedded into core practice funding. Practices must use A&G prior to or in place of planned care referrals where clinically appropriate. The A&G Enhanced Service is retired.
Cancer Requirements Strengthened
Network DES updated with clearer expectations: reviewing referral quality against NICE NG12, strengthening safety netting (including electronic tools), and proactive identification of patients eligible for cancer/non-cancer screening.
Continuity of Care — Core Requirement
PCNs must now use risk stratification tools to identify and prioritise cohorts for continuity of care as a core activity. This embeds continuity as a core expectation within primary care.
Online Registration — Mandatory
All patient registrations must use the national online registration system. Paper form data must be entered into the online system. Practices must ensure boundary changes via the digital catchment tool are ICB-approved.
GP Staff Survey Extended
The General Practice Staff Survey is extended to all practice and PCN staff. Practices and PCNs must share staff contact details with their ICB so personalised survey links can be issued.
Dedicated Pharmacy Email Required
Practices must have a dedicated, monitored email address for pharmacy communications (where GP Connect is unavailable). Existing practice emails can be used — no new address required. Must be shared with the Directory of Services.
Patient Pharmacy Choice
When a new (non-repeat) prescription is issued, practices must reconfirm the patient's nominated pharmacy. Referral and triage tools for community pharmacy services must offer patients full choice of providers.
Lung Cancer Screening — Data Sharing
Practices must share data with the Lung Cancer Screening Programme to support its operation. This is a new contractual requirement in the core practice contract.
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1Review triage & telephony processes for same-day urgent access Ensure clinically urgent patients can be identified and seen same day. Update call handling so patients are never asked to call back tomorrow.
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2Check online consultation system settings Confirm your system does not cap online consultation requests during core hours. Contact your supplier if capping is in place.
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3Update clinical searches and templates for QOF changes Retire old indicators (CHD015/016, DM012, HF003/006, HYP008/009, NDH002, STIA014/015). Set up searches for CD001, CD002, DM037, HF009, OB004, OB005. Update asthma register (age 5+) and review COPD register accuracy.
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4Plan for new obesity indicators (OB004 & OB005) Weight Management Enhanced Service is retired. Practices will need to code referrals to structured weight management programmes and pharmacotherapy discussions to claim OB004/OB005 points.
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5Review childhood vaccination registers and consider improvement thresholds Calculate your 2-year baseline for VI001–003. Practices not meeting achievement thresholds can now earn points through improvement. MMRV coding should be in place for VI002/VI003.
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6Confirm RSV vaccination processes and SFE claims RSV extended to all adults aged 80+ and care home residents. Ensure IOS claims process is in place.
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7Understand the new GP reimbursement scheme mechanics £292m available practice-level to recruit or increase GP sessions. Watch for updated specifications from NHS England in coming weeks. CAP/CAIP will be removed from the Network DES.
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8Ensure A&G is embedded into referral pathways The A&G Enhanced Service is retired; funding moves into core. Practices are contractually required to use A&G before planned care referrals where clinically appropriate.
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9Update practice website/leaflet with opening times for all access modes Core hours must be displayed for walk-in, telephone and online access on your website, practice leaflet and within premises.
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10Confirm a monitored pharmacy email address and share with DoS Existing email can be used. Must be shared with the Directory of Services. No new address required if an existing one is suitable.