Source: Practice Index 7.8.25
NHS England has confirmed a rise in the global sum for GP practices in England, increasing payments from £121.79 to £123.34 per weighted patient. This uplift is designed to implement the 4% pay increase recommended by the Doctors and Dentists Review Body (DDRB) for GP Partners, salaried GPs and practice staff.
In a letter to ICBs, NHS England said crucially, the funding will be backdated to 1st April 2025 and is due to reach practices in the August PCSE payment runs. While the announcement brings welcome clarity – after all, it was a badly kept secret that the increase was coming – Practice Managers now face the practical task of applying uplifts, managing claims and reconciling payments, all while keeping an eye on tight budgets.
What’s included in the uplift?
At the start of the 2025/26 financial year, GP contract funding had already factored in a 2.8% pay rise. Following the DDRB recommendation, the Government has agreed to increase this to a full 4%, implemented via a rise in the global sum and associated reimbursement schemes.
The figures include:
- A £1.55 increase to the global sum per patient, taking it to £123.34
- An additional £99 million added to contract funding for pay uplifts and backdating
- Out of Hours (OOH) deduction remaining at 4.75%, equating to £5.86 per patient
All practices paid under the GMS contract, and PMS practices receiving global sum-equivalent payments, will see these adjustments applied.
When asked what they thought about the uplift, a Practice Manager said, “It’s positive that this has been confirmed, but the timing isn’t ideal. We’ve had to manage staff pay expectations since April without knowing when the funding would land. Why it couldn’t have happened earlier in the year – we’ve all expected it to come – only Wes Streeting seems to know!
“We also have the problem that the uplift won’t cover the full cost of the pay rise, which of course the team now expects given they’ve read about it. I’m stating the obvious, but it’s such a difficult time for practices. I’ve never known a time like it in all my years as a Practice Manager.”
In a message to GPs, NHS England said this increase to practice funding “enables the 4% pay uplift with backdated payments to be passed on to salaried and contractor GPs” and pay uplifts for other practice staff.
“NHS England expects general practice contractors to implement pay rises to other practice staff in line with the uplift in funding they are receiving,” it added.
Locum reimbursement and neonatal leave
As part of the changes, NHS England has agreed to uplift Locum reimbursement maximum entitlements by 4%, backdated to 1st April 2025. Practices will also be able to claim reimbursement for GPs absent due to neonatal leave, a new provision effective from 6th April 2025.
A Practice Manager in Kent told us, “Including neonatal leave is a really welcome change. Previously, we had a GP who needed extended time off after a complicated birth and the system just didn’t provide for that.”
ARRS and enhanced access
PCNs will also see uplifts to their funding streams:
- The Additional Roles Reimbursement Scheme (ARRS) funding pot will increase by £14 million, raising the total to £1.71 billion for 2025/26
- An extra £6.1 million has been allocated to enhanced access services, with PCNs receiving updated entitlements
Payments for PCNs will be backdated and adjusted as part of the August payment cycles.
Practice management
For Practice Managers, this uplift comes with a checklist of actions to ensure the funding is applied correctly.
For example, practices are expected to implement the 4% pay uplift for salaried GPs and practice staff. This involves:
- Reviewing salary records back to 1st April 2025
- Calculating and processing backdated pay once uplifted funds arrive
- Managing communications with staff, many of whom will have been awaiting confirmation for several months
A Practice Manager in the North West said: “We’ll need to work fast to ensure the backpay is processed for September payrolls. Staff understand the delay hasn’t been our fault, but it’s still a delicate conversation.”
Reconciliation of contract changes
ICBs have been instructed to update contracts and flow through the increased funding as soon as possible. Practice Managers will need to:
- Review contract documentation for accuracy
- Check payment adjustments for global sum uplifts and Locum reimbursement claims
- Ensure any neonatal leave absences since April are covered by the new reimbursement provisions
Budget planning and cashflow
A Practice Manager from Yorkshire added that although the uplift is targeted at pay, wider operational costs continue to rise without additional cover. Practices will need to adjust their cashflow forecasts with the understanding that the uplift does not account for utilities, indemnity or infrastructure pressures.
“An uplift for pay is essential, but our other costs are still going up,” they said. “We have to balance this uplift carefully because it doesn’t give us breathing space elsewhere.”
While this uplift addresses immediate pay pressures, the outlook beyond this year is less certain. The Health Secretary has confirmed that there will be no additional funding for pay uplifts in 2026/27 (unless pressure from the likes of the BMA results in another Government U-turn), raising concerns about future sustainability.
A Practice Manager from London summed it up: “I think we have to accept that this is our lot for now. We need to adjust our cashflow and budget plans accordingly, with the understanding that no further pay-related uplifts are planned for next year. It’s a cycle of firefighting, year after year.”
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