UK Government Overhauls GP Contract Negotiations, Diluting BMA's Exclusive Role

Significant Shift in Negotiation Process

The UK Government is implementing a major overhaul of the General Practitioner (GP) contract negotiation process in England, effectively ending the British Medical Association's (BMA) exclusive role. This change, set to commence with the 2026/27 contract, will see a broader range of stakeholders consulted, a departure from the BMA's sole negotiating position held since the inception of the National Health Service (NHS).

NHS England's primary care director, Dr. Amanda Doyle, confirmed that consultations for the 2026/27 General Medical Services (GMS) contract will involve not only the BMA GP Committee England (GPCE) but also other groups. These additional stakeholders will include the Royal College of General Practitioners (RCGP), the National Association of Primary Care (NAPC), Healthwatch England, National Voices, and the NHS Confederation. The stated aim of this change is to foster a more constructive process and incorporate a wider array of voices, including those of patients.

Context and Recent Contract Agreements

This decision follows a period of tension and negotiation between the BMA and the government. The BMA GPCE had previously entered into a dispute with NHS England over the 2024/25 contract changes, which were largely rejected by GPs. However, in late February and early March 2025, the BMA conditionally accepted revisions to the 2025/26 national GP practice and Primary Care Network (PCN) contracts.

The 2025/26 agreement included a significant £889 million funding uplift to the GMS contract, alongside an additional £433 million invested in autumn 2024, resulting in a 7.2% increase in contract funding. Key changes in this contract also involved enhancements to the Additional Roles Reimbursement Scheme (ARRS), now including GPs and practice nurses, and the removal of caps on the number of GPs that can be employed through the scheme. The BMA's acceptance of these terms was contingent on a written commitment from the government to fully renegotiate a new national contract within the current Parliament.

BMA's Response and Future Implications

While the BMA GPCE paused collective action following the 2025/26 agreement, its chair, Dr. Katie Bramall-Stainer, emphasized that the proposed changes were a 'crucial step towards recovery' but stressed the necessity of long-term negotiations for meaningful reform and vital investment. Health Secretary Wes Streeting has reaffirmed the government's commitment to working with the GPCE to secure a new substantive GP contract within the current parliament.

However, recent BMA surveys indicate ongoing concerns among GPs. A November 2025 survey of over 1,300 practices revealed that contract changes, particularly those mandating online access for routine requests from October 1, 2025, have negatively impacted patient care and staff. The survey found that 73% of responding practices had to alter their working methods, and 42% reported a reduction in face-to-face appointments. The BMA continues to campaign for improvements to the 2025/26 contract and is preparing for the renegotiation of the GMS contract for future years.