Investment in general practice to increase by 1.4% next year under current plans

ICB funding for general practice is set to slow to barely 1.4% next year, NHS England’s current plans for allocations reveal – a level GP leaders warn amounts to a real-terms cut that will further erode practices’ ability to meet demand.

New NHS England allocation projections show the primary medical care budget will rise by just 1.41% in 2026/27 (£185m), and 1.35% in 2027/28 (£180m). The primary medical care allocation, which funds GP services in England, currently stands at £13.1bn.

In contrast, the uplift from 2024/25 to the current financial year was 9.94% in real terms, with spending per patient rising by 7.4%.

However, the Department of Health and Social Care says this doesn’t take into account increases in staff pay and the new GP contract, which are still to be decided.

ICB allocations for ‘core services’ increased by 4.13% between 2024/25 and 2025/26, and are projected to rise by only 2.72% and 2.92% over the next two years.

This budget covers funding for core general practice services commissioned under the GP contract -including global sum payments to practices, funding for premises, IT, dispensing fees, out-of-hours services, and other essential and additional services. It does not cover local enhanced services (LES) that are funded from other parts of ICB budgets.

DHSC said some adjustments – including pay and other cost growth – have not yet been included and will be added once the 2026/27 GP contract is agreed. It also said the 9.94% on-year figure reflected the transfer of existing funding streams such as ARRS into ICB allocations.

However, a primary care expert warned that the projected uplifts remain concerning.

Professor Azeem Majeed, a GP and head of the Department of Primary Care and Public Health at Imperial College London, said: ‘Even allowing for DHSC’s clarification that some of the earlier increases were affected by technical adjustments (such as transferring existing funding streams into the primary care envelope), the projected uplifts of around 1.4% for the next two years are still very low given the pressures facing NHS general practice in England.’

He warned that increases at this level would ‘not allow adequate expansion of capacity and risk further erosion of the ability of practices to meet rising demand’ amid growing contacts, greater clinical complexity and higher administrative load.

‘Without sustained real-terms investment, general practice will struggle to recruit and retain staff, maintain timely access, and continue the shift toward more proactive, personalised care that the NHS rightly aspires to,’ he added.

‘Expectations of what general practice can deliver therefore need to be realistic. If the ambition is for general practice to play a central role in areas such as prevention, continuity of care and the management of long-term conditions, then funding must reflect that.’

A BMA spokesperson labelled the forecasts ‘deeply concerning’, telling Pulse: ‘the projected increases of only 1.41% in 2026/27 and 1.35% in 2027/28 signals a real term cut in funding, by all major measures of inflation including CPI’.

They added: ‘Before factoring in rising cost pressures, let alone the impact of next week’s Budget, this will mean cuts to practices and cuts to patient services as they struggle to absorb rising pay, premises costs, registered list growth and inflation.

‘It means ICBs will have no room to fund recruitment, transformation or innovation. Locally commissioned services will freeze at best, making it less likely practices will even agree to deliver local services if they run at an unaffordable loss.

‘GPCE will need to engage NHSE and DHSC to urgently protect funding for vital LES and PCN-led services, and to safeguard ARRS and other workforce investments.’

A Department of Health and Social Care spokesperson said: ‘This is categorically untrue. The years referenced are not directly comparable. Final funding depends on contract negotiations, not planning allocations.

‘The real terms increases being quoted for 2025/26 are factually inaccurate.’

The Government and NHS England have currently paused all negotiations with the BMA’s GP Committee for England amid the ongoing dispute over 1 October contract changes.