The GP contract could have been a lot worse

Editor Sofia Lind is under no illusions that the 2026/27 GP contract will save general practice – but she argues ‘stakeholders’ seem to have protected practices from far more grim possibilities.

The new GP contract unveiled this week means practices will from April need to have ‘dealt with’ clinically urgent patient requests on the same day. And those practices who are deemed by their ICB to have failed at this, will be contractually obliged to ‘engage with’ performance management.

But what does dealt with mean? In one ominous section of NHS England’s contract letter the wording is instead ‘see’. With any hope, further guidance is afoot to clarify this contractual stipulation before 1 April comes around.

Meanwhile, practices can now defer responses to non-clinically urgent patient request to the end of the following working day. This will most certainly be a relief at 6.29pm, but crucially: GP practices have not been allowed to relax the 1 October obligation to keep online consultation tools open until close of core hours.

This had been a key endeavour of GP leaders – to allow a capping of consultations to protect patient safety and stop taking GPs away from face-to-face appointments, as has been shown to be happening as a result of the policy.

But in the Government’s closing letter to the BMA’s GP Committee there are clues that it could have been a lot worse. It talks about maintaining an ‘ambition’ for 90% of patients to be seen on the same day, but says it has scrapped an idea of an ‘Access Incentive Scheme’ which seems to have been aimed at mandating this absurd task.

And although there is no chance this contract – which does not meaningfully uplift funding – will solve the issues of general practice as a whole, another small win for the GPC will have been to allow GP recruitment at practice level, at its direct request.

Yesterday, one LMC wrote to the BMA to ask for the GPC England executive to resign because they have been sidelined from negotiations – that were this this time around replaced by a stakeholder consultation. In fact, the GPC is voting on the contract today, but it is entirely meaningless as the contract amendments are already signed off by ministers.

But it does appear, from the Government’s letter to the GPC, that regardless of the change from negotiation to consultation it has listened to feedback. It is also entirely possible that the introduction of other stakeholders – and I suspect especially the RCGP, with its focus on patient continuity of care – helped to thwart the Access Incentive Scheme.

The GPC will be desperate to a return to the narrative of being the negotiating partner, because if not its entire position becomes questionable. Some LMCs –  Pulse has learned – have already decided this is the case and are considering pulling their levies.

Whatever happens, I hope no babies are thrown out with the bathwater, and GPs continue to have meaningful representation in discussions with Government. Or there will be much worse to come than this contract.

Sofia Lind is editor of Pulse. Find her at [email protected] or on LinkedIn 

Read all of our coverage of the 2026/27 contract here.

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