‘More unrealistic expectations of unlimited same‑day urgent care’: Reactions to the 2026/27 GP contract

The new GP contract, coming into effect from April in England, has been announced. We will be featuring all the reaction to this news – from the BMA, to accountants, to grassroots GPs. This will be constantly updated. If you would like to send in your reaction, email [email protected]

Dr Katie Bramall, BMA GP committee England chair:

‘We expect the Government to frame this GP contract as a major win for patient access, but hard working family doctors will be deeply concerned about setting up even more unrealistic expectations of unlimited same‑day urgent care provision alongside potential barriers being put in place around specialist referrals, all while trying to keep practices open and prevent even more surgery closures.

‘Crucially – the BMA’s GP Committee for England has not had the opportunity to negotiate these contract changes directly with Government, instead being part of a group consultation – this has gone against the well‑established processes the profession has come to expect from successive Governments, even during our most tense periods of negotiation. It has been disappointing to see the new Labour administration break from this norm for no discernible benefit. Nevertheless, the committee will examine all the contract changes when it meets on Thursday and determines its next steps for the profession.’

Professor Professor Victoria Tzortziou Brown, chair of the Royal College of GPs:

‘While the College was involved in the formal consultation on the GP contract for the first time, it remains for the BMA to negotiate on the terms and conditions of the contract, and to assess whether the resources will be enough to deliver the ambitions set out in the new contract.  

‘The new contract contains some steps forward in tackling the workforce crisis in general practice, but we can and should go further to ensure general practice is ready to support ambitions to deliver more care close to home.   

‘The only way to boost access to general practice is by having more GPs on the ground to deliver the care that patients need and the contract indicates an intention to shift funding to allow practices to hire additional GPs or fund additional sessions.  

‘This is something the College has been calling for alongside the BMA and others, and we now need to make sure the details are right so that this results in more GPs on the frontline.  

‘The additional funding should also help address the nonsensical GP unemployment and underemployment issues the College has been highlighting over the last year. It’s good to see that these roles will be funded and delivered at practice level, allowing practices to take on the roles they need. However, we will also need to see continued, significant workforce investment beyond this funding if we are to bring patient to GP ratios – which are currently 15% higher than in 2015 – down to safer levels.  

‘GPs want to ensure that patients can access the care they need when they need it. We are seeing 46% of patients on the same day they book demonstrating the scale and responsiveness of current general practice activity. But we know that, despite not all appointments being urgent, some patients are still waiting too long for care. While long-overdue investment in the GP workforce is welcome, it will not solve our capacity issues overnight or guarantee an ability to meet ambitious access targets. It’s also important to remember that improving access is not just a question of faster appointments but also building the continuity and quality of care we know patients value.  

‘There are other important changes in the contract that will require careful consideration and implementation. Some of the QOF and vaccination changes appear logical but have potentially significant resource implications. We also need to be cautious of how Advice and Guidance is integrated into the GP contract and the implementation of a ‘single point of access’ for all specialist referrals. Our members have raised concerns over how its use varies across the country, how delays and potentially blocked referrals can jeopardise patient safety, and how it can push workload from secondary to primary care without clear resourcing, consistent clinical governance, or sufficient consideration of the downstream consequences for capacity and care quality.  

‘If care and activity are to be transferred from hospital settings into the community, this must be accompanied by fully costed pathway redesign, clear accountability, and funding that demonstrably follows the work. General practice cannot continue to absorb additional clinical responsibility without the resources required to deliver it safely. It is crucial that the funding matches workload and increases in line with these new processes.  

‘The College has been clear: in principle we support Government plans to shift care from hospital into the community where appropriate, but sufficient investment has to follow if GPs are going to be able to deliver safe, timely care close to home. We will continue to engage constructively with the Government and external stakeholders, sharing the insights of our members to advocate for implementation that is carefully managed, adequately resourced, and avoids unintended consequences for patient care or the sustainability of general practice.’

Dr Steve Taylor, GP co-lead for the Doctors’ Association UK (DAUK):

‘We welcome any increase in GP funding, but this is not bold enough.

‘The new GP contract merely tinkers around the edges of what is needed to genuinely bring back the family doctor, which was Labour’s manifesto pledge.

‘The funding increase for core general practice is only £85m, when adjusted for inflation, and will not go very far.

‘The lack of genuine core funding, combined with a lack of vision for what can be achieved, is incredibly disappointing given the Labour Government is nearly two years into its tenure.’

Dr Kath McCullough, special adviser on obesity at the Royal College of Physicians:

‘Committing to improving access to weight loss medications and to evidence-based weight management services in primary care is welcome. Obesity is a chronic, long-term condition, and we know that timely access to high quality support can prevent serious long-term illnesses such as type 2 diabetes, cardiovascular disease and certain cancers and other related complications.
 
‘Incentivising primary care practitioners to prescribe weight loss medications will go some way to further the access of patients to these medications but it is vital that clinicians across the health service are trained to understand which interventions are most appropriate and when. Weight loss jabs are one of a much broader suite of measures including weight management services and bariatric surgery.
 
‘The Government have announced £25m of funding to primary care services, however the government’s NHS 10 Year Health Plan committed to expand access to weight-loss interventions with £85m of funding.  We would be keen to see the details of how the remaining £60m will be spent and would encourage the government to publish a long-term obesity treatment strategy.
 
‘Medication alone will not be enough to make meaningful and lasting progress on tackling obesity. Clinical interventions must be complemented with broad, bold action from government to tackle the social and environmental drivers of obesity. It is vital that legislation and national and local policies enable people to lead healthy lives to reduce the impact of overweight and obesity on the individual, the health service and wider society.’

Andy Pow, adviser to the Association of Independent Specialist Medical Accountants (AISMA):

‘A cash uplift of 3.6% is unlikely to leave practices with a significant funding increase for the year ahead. 

‘The 2.5% pay assumption looks low, compared with a rise in the national minimum wage of 4.1% and the Agenda for Change staff pay increase of 3.3%. Consumer price inflation remains at 3% for other costs. As in previous years a further uplift may arise once the DDRB publishes its review.’

While practices will effectively tread water financially with the 3.6% cash uplift, AISMA accountants say the biggest potential problem highlighted in the letter is the shift of £292 million of existing Capacity and Access funding from PCN level to practice-based reimbursement for GP time.

‘This may appear a good thing at a headline level by expanding the number of reimbursed GP roles. However, the reality is that practices are already using this funding at practice level in an unrestricted way. Ringfencing the money is going to cause problems for practices.’ 

He added that PCNs and Federations currently using the Capacity and Access Payment at scale level will now need to re-think.

PCNs may also now need to re-structure to align with neighbourhood footprints, he said, paving the way for the new neighbourhood contracts. ‘However, the delay in releasing any details about the neighbourhood contracts will exacerbate the uncertainty around funding flows at both practice and PCN level.’

‘The changes announced today are unlikely to resolve any of the uncertainty in general practice coming out of the 10 year plan, nor provide it with any substantial uplift in funding to develop services.’

While welcoming the change to allow PCN ARRS funds to employ a wider number of GPs, Mr Pow said that without extra funding the current GP recruitment issue will remain unresolved

Dr Luisa Pettigrew, senior policy fellow at the Health Foundation:

‘The new GP contract includes some welcome commitments, including on prevention where there are greater incentives for improving vaccine uptake. However, once inflation is accounted for, the investment is modest given the scale of the task ahead and does not represent the shift in resources needed to deliver the government’s 10-Year Health Plan or address the deep-rooted challenges around access and continuity of care.

‘The commitment to ringfence existing funding to employ more GPs, now extended to include experienced GPs, is welcome. However, questions remain about how easy it will be for practices to access this funding – particularly those facing greatest pressures.

‘It’s right for patients with urgent needs to be seen as quickly as possible. But new requirements to deal with ‘clinically urgent’ patients on the day will depend on defining what counts as ‘urgent’ in a way that aligns with both clinical standards and patient expectations. And this needs to be balanced with the needs of other patients, particularly those requiring routine care for long term conditions.

‘Notably absent from today’s announcement is clarity on the government’s proposed ‘Neighbourhood’ provider contracts set out in the 10-Year Health Plan. Without this, the new GP contract leaves practices uncertain about the role they will be expected to play in new neighbourhood health services and will make it hard to plan effectively.’

Dr Becks Fisher, Nuffield Trust director of research and policy:

‘These measures to hire more GPs and to encourage same-day appointments for urgent patients are good moves – although the funding settlement is much more sparing than the big boost we saw this financial year.

‘We are currently in a frustrating situation where unemployed GPs are struggling to find work, as the public also struggle to get appointments. Public satisfaction with general practice rests heavily on patients having access to GPs. Letting the pot of money for extra staff finally apply to experienced doctors is a step in the right direction.

‘Allowing practices to clinically determine who needs a same-day appointment will avoid some of the problems with the cruder 48-hour target of previous governments, which tended to force a desperate 8am rush. This way, people who prefer to book something further out can still expect flexibility.

‘The 3.6% funding increase set out here means GP funding next year will rise more slowly than the DHSC day-to-day budget as a whole, which is growing by more than 4%. One of the likely reasons will be the trade deal with the USA to drive up medicine costs, with another being money held back in case other parts of the NHS overspend.

‘The Government put in substantially more general practice funding this year. But today’s announcement means that next year, unless there are additional in-year funding boosts, money will not be shifting towards GPs and their practices, despite the commitment to offer patients more of their care outside hospital.’

Beccy Baird, senior fellow at The King’s Fund:

‘It’s clear that prevention has been placed at the forefront of today’s new GP contract, with efforts to close the health inequalities gap a common thread running through plans to incentivise GPs to support improving childhood vaccination rates, roll out the national lung cancer screening programme, and expand obesity treatment across the country. The government also continues its emphasis on improving access for patients with both additional investment and existing money ringfenced for employing GPs. However, questions remain about how achievable these ambitions are without sustainable long-term planning for the right workforce make-up in general practice.

On the updated incentive scheme for childhood vaccination:

‘The government’s plan to give extra financial support to GP practices in areas with low childhood vaccination uptake is a crucial dose of support. As uptake tends to be lower in more deprived communities, an incentive scheme that rewards progress, rather than hitting absolute targets, helps ensure that practices serving these populations aren’t unfairly penalised or denied the funding they need to improve uptake.

‘The King’s Fund’s research shows that lower vaccine uptake is often driven by financial and practical barriers such as transport or digital exclusion, alongside safety concerns, cultural beliefs, mistrust and misinformation. Recognising and rewarding the GP practices that are working incredibly hard to overcome these obstacles through tailored, community-rooted approaches is a positive move toward narrowing the inequality gap in vaccination and children’s health.

On the introduction of obesity care and increased access to weight loss jabs:

‘With the country facing a major obesity crisis, it’s good to see the government put better and fairer access to the latest treatments for obesity on the agenda. It’s unclear whether these jabs will lead to lasting health improvements or risk widening inequalities while failing to tackle the root causes of obesity in our environment. A true prevention revolution will require government to show political bravery, introduce tougher regulation of junk-food companies and implement promised compulsory reporting of healthy food sales to hold the junk-food industry to account.

On mandating GPs to provide patient data for lung cancer screening:

‘Mandating GPs to provide patient data to support lung cancer screening is another positive step that brings to life commitments set out in the National Cancer Plan. Early diagnosis saves lives, and this change will help ensure more people benefit from timely screening and treatment. It is important that GPs are equipped with the resources they need to implement this change as patient data may need cleaning and standardising.

‘All of these initiatives are positive for people’s health, but there are still some thorny issues to be tackled ahead of the long-awaited 10 Year Workforce Plan, particularly the details of how general practice will be staffed in the long term to deliver this work. General practice requires a workforce model. If the government is serious about shifting care from hospitals into the community, and for GPs to be central to that vision, then it must take a more holistic, long‑term approach to building a resilient workforce capable of delivering the best quality of care to all patients across the country.’

Jacob Lant, chief executive of National Voices:

‘People want to know that when they reach out to their GP practice – whether their need is urgent or routine – they won’t be pushed into a frustrating loop of trying again another day. The final proposals take a positive step by requiring practices to give people clear next steps for non-urgent requests, while protecting same-day responses for clinically urgent needs. We also welcome continuity being treated as a core requirement for those who need it most, and a clearer commitment that data should be used to understand patient experience and inequalities – not just to count activity. The test now is implementation: ensuring reasonable adjustments, accessible routes, and meaningful patient-centred measures are built into guidance so these reforms genuinely reduce unequal access.’

Katie Collin, partner at specialist medical accountancy firm Ramsay Brown: 

‘I welcome the extra investment in the 2026/27 GP contract, but much of this additional cash either has complicated strings attached or repurposes other important pieces of the funding jigsaw.

‘The most concerning area for me is the scrapping of the PCN Capacity and Access Payment, which is being repurposed as a £292 million practice-level GP reimbursement scheme. On the face of it, this is fantastic, but payments in these schemes always end up running two to three months in arrears, causing major cash flow issues for practices. In these cases, the CAP has always been absolutely crucial, and removing that safety net now could be disastrous.

‘The expansion of the ARRS to include experienced GPs is a similar story — it’s a great move on the surface, but until we see the actual numbers, I’ll have to remain cautiously optimistic. In the past, ARRS funding hasn’t even covered the sessional rate for newly qualified GPs, so I would not be surprised if the same is true for more experienced doctors. In short, this change doesn’t necessarily mean that PCNs will be able to go out and hire the staff they want and need.

‘This contract also contains elements that will undoubtedly place more pressure on practices and increase their costs. The funding unveiled for childhood vaccinations is unlikely to cover all associated costs, forbidding practices from asking patients to call back later will require more administrative staff, and rules around assessing which patients are “clinically urgent” and treating them the same day will force partners to hire more locums.

‘From where I’m sitting, the extra £485 million of largely conditional funding won’t touch the sides. All in all, today’s news really concerns me, and I doubt it will have done much to quell GPs’ anxieties, either.