General Practitioners: Contracts

The contract does not change the clinical threshold for referral to specialist care. General practitioners (GPs) should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement. This reflects longstanding planned care referral practice and does not alter existing legal or professional accountability frameworks for GPs. The Department and NHS England assessed the potential impacts of the changes made regarding A&G as part of the equalities assessments, as part of the policy-development process.

In early 2026, we concluded the 2026/27 GP Contract consultation. This year, we expanded the consultation to engage with wider stakeholders across GPs and patient voice organisations. These were the General Practitioners Committee England, the Royal College of General Practitioners, National Voices, the Institute of General Practice Management, Healthwatch England, NHS Confederation, now the NHS Alliance following its merge with NHS Providers, and the National Association of Primary Care. The feedback we received from stakeholders across the system has been constructive and comprehensive, enabling us to refine proposals and address concerns while developing the final contract package.

The 2026/27 GP Contract embeds the previous Advice and Guidance enhanced service funding into core practice funding. Following near universal uptake of the Advice and Guidance Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.