PCN Network Contract DES 2026/27 — What’s Changing?

PCN Network Contract DES
What’s changing from April 2026

A plain-English guide to the updated Network Contract Directed Enhanced Service specification for 2026/27, with role-specific explanations for everyone involved.

  • 📄 Based on NHS England publications of 26 March 2026
  • 🔄 DES effective from 1 April 2026
✅ Correct as of 27 March 2026

📎 Source: NHS England — Network Contract DES 2026/27 specification and guidance
⚠️ Note on the wider GP contract Some of these DES changes sit alongside wider proposed changes to the core GP contract for 2026/27. At the time of writing, the wider GP contract changes are still subject to negotiation between NHS England and GPC England. This guide covers the PCN DES changes as published. Where we reference the wider contract context, we flag that it is not yet confirmed.

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Show all ICB Commissioner PCN Clinical Director GP Partner Practice Manager ARRS Staff Member Interested Passer-by
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ARRS becomes more flexible for GP recruitment

The Additional Roles Reimbursement Scheme is no longer restricted to newly qualified GPs. Maximum reimbursement rates have increased significantly. A new “other” role category is added.

Previously, PCNs could only use ARRS funding to recruit GPs who had completed their Certificate of Completion of Training (CCT) within the last two years. That restriction has been removed. Any GP is now eligible, provided they haven’t been substantively employed at a core network practice within the PCN in the previous 12 months.

The maximum salary that can be reimbursed has risen from £82,418 to £118,759 (£120,921 in London), reflecting that PCNs can now recruit experienced GPs, not just newly qualified ones. With employer on-costs, the total maximum reimbursement is:

£152,900
Max reimbursement (outside London), salary + on-costs
£155,698
Max reimbursement (London), salary + on-costs
Element2025/262026/27
GP eligibilityCCT within last 2 years onlyAny GP (not employed in PCN practice in last 12 months)
Max salary reimbursement£82,418£118,759 (£120,921 London)
Employer on-costsNot explicitly includedIncluded in overall maximum
Broader rolesFixed role list onlyAdditional roles possible with commissioner agreement

ARRS funding continues into 2026/27, including £197 million for GP cohorts recruited during 2024/25 and 2025/26. A new “other non-direct patient care” role has also been added to the scheme.

Minimum role requirements have been updated for several ARRS roles: social prescribing link workers, physician associates, first contact physiotherapists, dietitians, podiatrists, occupational therapists, paramedics, and advanced nurse practitioners.

ICB CommissionerYou now have a role in approving the recruitment of “broader” ARRS roles beyond the standard list. You will need a clear process for PCNs to request this. The increased maximum reimbursement rates may also affect your financial planning for PCN allocations.
PCN Clinical DirectorThis is a significant opportunity. You can now recruit experienced GPs via ARRS, not just those fresh out of training. The 12-month rule means you cannot simply reclassify existing practice GPs under ARRS, but you can recruit GPs from outside your PCN’s practices. Consider your workforce plan and whether the new “other” role category could fill any gaps — but you will need commissioner sign-off for non-standard roles.
GP PartnerIf your PCN recruits an ARRS GP, they could now be a more experienced colleague rather than a newly qualified one. The higher reimbursement cap means the PCN can offer competitive salaries. The 12-month rule prevents your practice’s existing GPs from being shifted onto ARRS funding, but a GP from another PCN’s practice could be eligible.
Practice ManagerCheck the updated minimum role requirements for any ARRS staff you currently employ — several role specifications have changed (physios, paramedics, PAs, dietitians, OTs, podiatrists, ANPs, social prescribers). You’ll also want to note the new maximum reimbursement amounts for your claims. The professional registration number must now be included on the online portal.
ARRS Staff MemberYour role continues to be funded through ARRS. The minimum role requirements for several ARRS positions have been updated — check the specification annexes to see if your role’s requirements have changed. If you’re a GP employed via ARRS, the salary cap for your role has increased. The scheme now also includes a new “other non-direct patient care” role category.
Interested Passer-byGP surgeries work together in groups called Primary Care Networks (PCNs). The NHS funds these networks to hire extra staff — nurses, pharmacists, physiotherapists and now more GPs. This change means PCNs can hire more experienced GPs, not just those who recently qualified. The idea is to strengthen the GP workforce available to patients.
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💷

Capacity and Access Payment scrapped — money moves to practice level

The £292 million CAP (CASP and CAIP) is removed from the DES and repurposed into a new practice-level GP reimbursement scheme focused on same-day urgent access.

The Capacity and Access Payment — which had two components, the Capacity and Access Support Payment (CASP) and the Capacity and Access Improvement Payment (CAIP) — is being removed from the Network Contract DES entirely.

The £292 million is being redirected into a new practice-level GP reimbursement scheme. This will fund practices to recruit new GPs or buy additional sessions from existing GPs, specifically to strengthen clinically urgent same-day access.

GPs already employed through CAP funding will be eligible to transfer to the new scheme.

⚠️ Subject to wider contract negotiationsThe new practice-level GP reimbursement scheme sits within the wider GP contract changes, which are still being negotiated between NHS England and GPC England. The removal of CAP from the DES is confirmed; the detailed mechanics of the replacement scheme may evolve.
ICB CommissionerThis shifts £292 million from PCN-level to practice-level funding, which changes how you will allocate and monitor this spend. You will need to understand the new scheme’s mechanics once confirmed to plan commissioner oversight.
PCN Clinical DirectorYou lose the CAP as a PCN-level funding stream. The money moves to individual practices rather than the network. This may affect how you coordinate PCN-wide workforce decisions.
GP PartnerThis could be good news for your practice directly — the funding comes to practice level, meaning you could use it to recruit a new GP or fund extra sessions from an existing GP. The focus is explicitly on same-day urgent access.
Practice ManagerExpect new administrative processes for claiming this funding once the scheme details are confirmed. You will need to understand the eligibility criteria and reporting requirements.
ARRS Staff MemberThis change does not directly affect ARRS roles — ARRS funding continues separately. However, the overall shape of funding in your PCN is shifting, with more money going directly to practices for GP recruitment.
Interested Passer-byPreviously, NHS funding for improving GP access went to networks of surgeries. Now, £292 million is going directly to individual GP surgeries, specifically so they can hire more GPs and see urgent patients on the same day.
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🔗

Continuity of care becomes a core PCN requirement

PCNs must now use risk-stratification tools to identify patients who most need continuity, embedding this as a formal expectation rather than an aspiration.

For the first time, the DES makes it a core requirement for PCNs to use risk-stratification tools to identify and prioritise cohorts of patients for continuity of care. This means identifying patients who would benefit most from seeing the same clinician consistently — typically those with complex or multiple long-term conditions.

This is described as laying the groundwork for future continuity models in subsequent contract reforms. It does not prescribe exactly how continuity must be delivered, but it does require that the identification and prioritisation work is done.

ICB CommissionerYou may need to support PCNs in accessing or implementing risk-stratification tools. Consider whether your ICB can provide standardised tools or guidance to ensure consistency across PCNs in your area.
PCN Clinical DirectorYou need to ensure your PCN has a risk-stratification approach in place. This could use your clinical system’s built-in tools, a population health management platform, or another method.
GP PartnerYou may be asked to ensure that identified patients are offered continuity — meaning they see the same GP or clinician where possible. In practice, many GPs already do this informally for their most complex patients. This formalises the expectation.
Practice ManagerYou may need to support the implementation of risk-stratification tools in your clinical system and ensure that the resulting patient lists are being used in appointment booking workflows.
ARRS Staff MemberIf you work with patients who have complex needs (e.g. as a clinical pharmacist, social prescriber, or paramedic), you may be part of the continuity model for identified cohorts. Your PCN Clinical Director should involve you in planning.
Interested Passer-by“Continuity of care” means seeing the same doctor or healthcare professional regularly. Research shows this leads to better outcomes, especially for people with ongoing health conditions. GP networks are now required to identify which patients need this most.
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💉

New vaccination requirements for care homes and collaborative delivery

PCNs must ensure care home residents are offered seasonal and routine vaccinations. Practices can now collaborate to deliver seasonal flu and COVID jabs under the DES.

Care home vaccinations: PCNs with aligned care homes must now ensure that eligible residents are identified and offered seasonal and routine vaccinations in line with national guidance. The PCN does not have to deliver the vaccinations itself — it could be done by the registered practice, another practice in the PCN, or through a subcontracting arrangement — but the PCN must ensure arrangements are in place.

Collaborative delivery: The Mandatory Network Agreement has been amended to remove the previous exclusion of adult influenza and COVID-19 vaccination from collaborative delivery. Practices within a PCN can now work together to deliver the seasonal vaccination Enhanced Service under the DES, if they wish.

ICB CommissionerYou should assure yourself that PCNs with aligned care homes have credible arrangements for offering vaccinations. The collaborative delivery change may lead to PCNs approaching you about delivering seasonal vaccinations at network level.
PCN Clinical DirectorIf your PCN has aligned care homes, confirm that arrangements are in place for all eligible residents to be offered vaccinations. The collaborative delivery change gives you a new option — practices can now pool their seasonal vaccination delivery.
GP PartnerIf your practice has patients in aligned care homes, expect to be involved in ensuring they are offered vaccinations. If your PCN decides to collaborate on seasonal vaccinations, this could mean delivering jabs for patients registered at other practices in the network.
Practice ManagerYou may need to produce or maintain lists of eligible care home residents for vaccination. If your PCN opts for collaborative seasonal vaccination delivery, there will be administrative implications around claiming, recording, and sharing patient information. Check the updated Mandatory Network Agreement.
ARRS Staff MemberIf you work in or visit care homes (e.g. as a clinical pharmacist or paramedic), you may be involved in identifying eligible residents or supporting vaccination delivery.
Interested Passer-byIf you have a relative in a care home, this change means the local GP network must now make sure care home residents are offered their vaccinations. The network doesn’t have to give the jabs itself, but it must make sure someone does.
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🔬

Cancer referrals, screening and safety-netting requirements clarified

Clearer expectations on referral quality against NICE NG12, electronic safety-netting, and proactive support for cancer and non-cancer screening uptake.

The DES now includes more explicit requirements around cancer:

Referral quality: PCNs should review their referral quality against NICE Guideline NG12 (suspected cancer: recognition and referral).

Safety-netting: Strengthened expectations including the use of electronic safety-netting tools to track patients referred on suspected cancer pathways.

Screening uptake: Clearer responsibilities for proactively identifying and supporting eligible patients to engage with cancer and non-cancer screening programmes.

The IIF indicator CAN04 has also been amended to reflect technical changes to NICE guidance.

ICB CommissionerThese changes give you clearer levers to monitor PCN performance on cancer referrals and screening. The amended IIF indicator CAN04 provides a measurable metric.
PCN Clinical DirectorReview your PCN’s cancer referral pathways against NICE NG12. Ensure you have an electronic safety-netting system in place. Consider how your PCN proactively identifies patients eligible for screening.
GP PartnerBe confident that your referrals align with NG12, that you have a reliable system for tracking patients on suspected cancer pathways, and that you are actively encouraging eligible patients to attend screening.
Practice ManagerCheck that your practice has electronic safety-netting processes in place for cancer referrals. You may need to run searches to identify eligible patients who haven’t engaged with screening.
ARRS Staff MemberIf you are a clinical pharmacist, care coordinator, or social prescriber, you may be asked to support screening uptake work — for example, contacting eligible patients.
Interested Passer-byYour GP network is now more explicitly required to make sure cancer referrals are high quality, that no one falls through the cracks, and that eligible patients are encouraged to attend screening.
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📊

General Practice Staff Survey is now mandatory

All practices and PCNs must participate and share staff contact details with their ICB so personalised survey links can be issued.

The Network Contract DES now requires that practices and PCNs participate in the General Practice Staff Survey. This includes sharing staff contact details with their ICB so that personalised survey links can be issued to individual staff members.

ICB CommissionerYou will need a process for receiving staff contact details from practices and issuing personalised survey links. Consider data protection implications.
PCN Clinical DirectorMake sure all practices in your network are aware this is now mandatory.
GP PartnerYour practice must participate and share staff contact details with the ICB. This is a contractual requirement.
Practice ManagerYou will likely be responsible for compiling and sharing staff contact details with your ICB. Ensure staff are informed and that your privacy notice covers this.
ARRS Staff MemberYou should expect to receive a personalised link to the General Practice Staff Survey.
Interested Passer-byThe NHS now requires all GP surgery staff to take part in a staff survey, designed to understand working conditions and staffing issues in general practice.
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🗺️

PCN and neighbourhood boundary alignment

PCNs must work with their ICB to better align their geography with neighbourhood boundaries — but only where current arrangements clearly don’t reflect local communities.

The DES now requires PCNs to work with their ICB to achieve greater alignment between the PCN registered list and neighbourhood boundaries.

This is limited in scope. NHS England explicitly states this is not intended to signal widespread reconfiguration. It is designed as a pragmatic safety net for cases where PCN geography clearly does not reflect local communities.

ICB CommissionerThis gives you a mechanism to address PCN boundaries that don’t align with your defined neighbourhoods, but it is explicitly a limited tool.
PCN Clinical DirectorIf your PCN’s geography broadly matches your neighbourhood, this is unlikely to affect you. If there is a known mismatch, expect your ICB to initiate a conversation.
GP PartnerUnless your PCN has an unusual geographical arrangement, this should not affect your practice.
Practice ManagerNo immediate action unless your ICB initiates a conversation about boundary alignment.
Interested Passer-byGP surgeries are grouped into networks based on geography. This change allows those groupings to be adjusted where needed.
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📋

Participation, opt-out and key dates

Existing PCNs are automatically enrolled. Key deadline: 30 April 2026 for any changes, opt-ins, or opt-outs.

  • 26 March 2026
    Updated DES specification and guidance published
  • 1 April 2026
    Updated DES takes effect
  • 30 April 2026
    Deadline for: notifying commissioner of PCN membership changes; opting out; opting in

Practices already signed up in 2025/26 automatically participate in the 2026/27 DES. No action is needed unless there are changes to PCN membership or practice information.

If a practice opts out, the commissioner will work with remaining practices to consider whether the PCN remains viable.

ICB CommissionerMonitor for any opt-out notifications by 30 April. If a practice opts out, assess viability of the remaining PCN.
PCN Clinical DirectorIf your PCN membership is unchanged, no action is needed. Membership changes must be notified by 30 April.
GP PartnerYou are automatically enrolled for 2026/27 unless you actively opt out by 30 April.
Practice ManagerDiary 30 April 2026. If there are changes to your PCN membership or practice details, notify the commissioner by that date.
ARRS Staff MemberIf your practice remains in the DES (automatic unless they opt out), your ARRS funding continues.
Interested Passer-byAlmost all GP surgeries participate in this contract. They are automatically signed up unless they actively choose to leave.
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✅ Correct as of 27 March 2026
Based on NHS England publications dated 26 March 2026. This is an independent summary, not an official NHS England document.
Source: NHS England — Network Contract DES 2026/27
Produced by Ankit AI
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