BMA Backs GP Contract Reform: A Turning Point for General Practice in England?
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The British Medical Association (BMA) has formally backed proposed reforms to the national GP contract for 2025/26, marking what many in the profession describe as a critical step towards stabilising and rebuilding general practice in England after years of financial strain.
Following an emergency meeting on 28 February 2025, members of the BMA’s General Practitioners Committee (GPC) for England accepted proposals that include an £889 million uplift in funding for the General Medical Services (GMS) contract. Combined with a £433 million investment announced in autumn 2024, the reforms represent a 7.2% cash increase in contract funding for the coming year.
While the agreement has been cautiously welcomed as “a crucial step towards recovery,” the BMA has made clear that its support is conditional. The association is demanding a full renegotiation of the national GP contract during the current Parliament, warning that without long-term reform, the crisis in general practice will persist.
At Parachute Law, we examine what these reforms mean in practice, why they matter legally and financially, and what lies ahead for GP practices, patients, and the wider NHS.
Why GP Contract Reform Was Urgently Needed
General practice is often described as the “front door” of the NHS, yet it has faced prolonged underinvestment over the past decade. Rising patient demand, increasing complexity of care, workforce shortages, and escalating operational costs have left many practices financially vulnerable.
According to professional bodies, years of erosion in the real-terms value of GP contracts have contributed to:
Practice closures and mergers
Reduced appointment availability
Recruitment and retention challenges
Increased pressure on hospitals and emergency services
Against this backdrop, the threat of collective action by GPs in 2024 underscored the depth of dissatisfaction within the profession. The acceptance of the 2025/26 proposals signals a tentative truce—but not an end to wider concerns.
The £889 Million Funding Uplift: What’s Included?
The centrepiece of the reform package is the £889m uplift to the GMS contract, described by the BMA as the first meaningful increase in many years. This funding is intended to address both immediate pressures and structural weaknesses within the system.
Meeting Rising Practice Costs
A significant portion of the uplift is designed to help practices cope with unavoidable cost increases, including:
Staff salaries and recruitment costs
Premises and infrastructure expenses
Inflationary pressures
Growth in patient list sizes
For many practices, these costs have outpaced funding increases, forcing difficult decisions about staffing levels and service provision.
ARRS Expansion: Supporting Workforce Capacity
One of the most notable reforms concerns the Additional Roles Reimbursement Scheme (ARRS), which funds non-GP clinical and support roles within Primary Care Networks (PCNs).
Key changes include:
Newly qualified GPs (within their first two years) now eligible under ARRS
Practice nurses brought into the consolidated ARRS framework
Removal of the cap on the number of GPs that can be employed through ARRS
From a workforce and employment law perspective, this expansion is significant. It gives practices greater flexibility to recruit clinicians while reducing financial risk. It also acknowledges that supporting early-career GPs is essential to long-term retention.
However, some commentators caution that ARRS should complement—not replace—direct investment in traditional GP roles, particularly in smaller or rural practices.
Additional Payments for Vaccinations and Advice & Guidance
The reforms also include targeted investments to reflect the realities of frontline clinical work.
Childhood Vaccinations
The Item of Service (IoS) fee for routine childhood vaccinations will increase, recognising both the workload and public health importance of maintaining high immunisation coverage.
Advice and Guidance Funding
An additional £80 million, on top of the £889m uplift, will compensate practices for making advice and guidance requests to hospital specialists.
This funding acknowledges the growing expectation that GPs act as care coordinators—seeking specialist input to avoid unnecessary referrals while ensuring patients receive appropriate treatment.
Legally and operationally, this move aligns incentives with NHS policy goals: reducing pressure on secondary care while supporting safe, well-documented clinical decision-making in primary care.
Conditional Support: The Demand for Long-Term Reform
While GPC England has agreed in principle to the 2025/26 contract changes, its endorsement comes with a clear condition: a commitment from the Government to renegotiate the national GP contract within this Parliament.
Written confirmation of this commitment must be provided ahead of the Special LMC Conference on 19 March 2025, allowing the ongoing dispute—running since March 2024—to be formally paused.
This condition reflects a broader concern: that short-term funding injections, while welcome, cannot undo over a decade of structural underfunding.
A Pause, Not an End, to the Dispute
In March 2024, GPs rejected the proposed 2024/25 GMS contract, later voting in favour of collective action. The acceptance of the new proposals follows two months of intense negotiations between the BMA, the Government, and NHS England.
While the agreement brings the formal dispute to a close for now, the BMA has urged GPs to remain “organised and united,” particularly ahead of the Government’s upcoming three-year comprehensive spending review.
This signals that industrial relations in primary care remain fragile and heavily dependent on future political decisions.
What This Means for Patients
For patients, the reforms aim to stabilise access to general practice by:
Supporting workforce recruitment and retention
Reducing financial pressures that drive practice closures
Improving coordination between primary and secondary care
If successful, the changes could help protect appointment availability and continuity of care—both of which have been under strain.
However, patient groups and clinicians alike stress that meaningful improvements will depend on sustained investment, not one-off settlements.
Legal and Policy Implications
From a legal and governance perspective, the reforms raise several important considerations:
Contractual certainty: Practices need predictable funding models to plan staffing and premises commitments
Workforce regulation: Expanding ARRS roles requires clear professional accountability and indemnity frameworks
Public law accountability: The Government’s commitment to renegotiation may carry political—but not strictly legal—enforceability
These issues will shape how confidently practices can invest in long-term capacity.
A “Turning Point” — With Caveats
GPC England chair Katie Bramall-Stainer described the reforms as a turning point after 15 years of contract erosion, but emphasised that this is only the beginning.
Her message reflects a broader consensus: this deal may stop the bleeding, but it will not, by itself, heal the system.
Whether the reforms mark a genuine reset or merely a temporary reprieve will depend on what happens next—particularly whether the Government delivers on its promise of a new national contract within the current Parliament.
Conclusion: A Fragile but Significant Step Forward
The BMA’s decision to back GP contract reform represents a rare moment of alignment between the profession and Government after a prolonged period of tension. The funding uplift, workforce support, and targeted investments address some of the most acute pressures facing general practice.
Yet the agreement is best understood as a foundation, not a solution. Without long-term contractual reform and sustained political commitment, the underlying challenges facing general practice will remain.
At Parachute Law, we continue to monitor developments in healthcare policy, public sector contracts, and workforce reform. For GP practices, commissioners, and healthcare professionals navigating contractual and regulatory change, understanding both the legal framework and the policy direction will be essential in the years ahead.
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