What changed in the PCN DES for 2026/27

Written by the Virtual Pharmacist clinical team

The 2026/27 contract year moved several things that shape how a Primary Care Network plans its medicines work. Some of the changes are structural, such as money leaving the network and reappearing at practice level. Others are additions to the specification that give the network new cohorts to find and follow up. This is a plain summary of what actually changed, with the figures NHS England has published, so a clinical director or PCN manager can see the year in one read.

For the evergreen version of how the Network Contract DES works and where medicines sit within it, see our companion guide on the Network Contract DES and PCN pharmacy. This page covers only what is different this year.

Money moved from the network to the practice

The largest structural change is the removal of the PCN-level Capacity and Access Payment from the Network Contract DES from 1 April 2026. NHS England confirms the Capacity and Access Payment, covering both the Capacity and Access Support Payment and the Capacity and Access Improvement Payment, has been removed from the DES, and that the £292 million involved has been repurposed into a new practice-level GP reimbursement scheme.

The practical effect is that a pot which previously arrived at network level, and which many networks used to fund shared capacity, now arrives at individual practices and is aimed at recruiting GPs or increasing sessions from GPs already in the practice. Networks that had built shared services on the assumption of network-level access money will find that assumption no longer holds.

We have written separately about where the Capacity and Access money went and what networks are doing in response.

ARRS opened up for GPs, with higher reimbursement

The restriction limiting ARRS funding to recently qualified GPs has been removed, so a wider range of GPs can be brought in through the scheme. The reimbursement figures moved with it.

• The salary element rises from £82,418 in 2025/26 to £118,759 in 2026/27, and £120,921 for GPs in London.
• Including proportionate employer on-costs, the maximum reimbursement amounts are £152,900 outside London and £155,698 with London weighting.

These figures apply to the GP role specifically. For how the wider scheme is sized and paid, see our ARRS funding guide.

The knock-on for medicines is worth thinking about. A network that uses a chunk of its allocation on GP sessions has less of it available for pharmacy capacity, and the medicines workload does not shrink to match. Networks that want both tend to plan the split deliberately at the start of the year rather than discovering it in month eight.

Continuity of care became a core expectation

The specification now includes the use of risk-stratification tools to identify and prioritise cohorts for continuity of care. Continuity moves from something a network might describe in a narrative to something it identifies, prioritises and can show.

For a medicines team this is familiar territory. The patients who benefit most from continuity are very often the same patients who appear on high-risk drug registers, on long repeat lists, or with recent discharge activity. A network that already runs structured medication reviews by risk cohort has most of the identification work in place; it is the same searches pointed at a different question.

Vaccination and screening expectations widened

Two additions are worth noting for anyone planning clinical capacity across the year.

• Care home residents. The specification covers identifying eligible care home residents and offering seasonal and routine vaccinations in line with national guidance. The Mandatory Network Agreement was also amended to allow collaborative delivery of the seasonal vaccination Enhanced Service under the DES.
• Screening. The cancer and screening expectations now cover referral quality, stronger safety-netting and clearer responsibilities for supporting eligible patients, alongside signposting through the NHS App.

Both create list-management and recall work. Both sit naturally with a pharmacy team that is already running searches and recall cycles for medicines purposes.

Neighbourhood boundaries come into view

Networks are asked to work with their integrated care board to align PCN lists with neighbourhood boundaries. NHS England is explicit that this is aimed at limited cases where current geography does not reflect local communities, and is not intended to disrupt networks whose boundaries already work.

For most networks this will be a conversation rather than a change. For the minority whose lists were drawn around historic practice groupings rather than population geography, it is worth knowing the direction of travel before the ICB opens the discussion.

Access expectations tightened at practice level

Alongside the network changes, practices now work to a requirement that patients identified as clinically urgent are dealt with the same day, and that non-urgent contacts receive an appropriate response by the end of the next core hours period. Online consultation systems are not to cap the number of requests during core hours. ICBs carry a target of 90% same-day access for clinically urgent patients by March 2027.

The medicines link here is direct and often underestimated. A large share of the contacts arriving through an online form are prescription queries, medication questions and requests that never needed a GP appointment. Networks that route those to a pharmacy team before they reach the appointment book tend to find the access numbers move without adding clinical sessions. We covered the mechanics of that in meeting the GP access target.

Reading the year as a whole

Three of this year’s changes point the same way. Continuity by risk cohort, wider vaccination and screening expectations, and tighter same-day access all reward a network that can find a defined group of patients, do something specific with them, and evidence it. That is search, recall and review work, and it is the work a pharmacy team is set up to do at volume.

The funding picture pulls the other way for networks. Money left the network for the practice, and the ARRS allocation now has a more expensive GP option competing for it. Networks that come out of this year well tend to be the ones that decided early what the network itself is for, and resourced that deliberately, rather than spreading the allocation thinly across everything.

If you want to talk through how the medicines share of your allocation is working this year, get in touch.

Figures and specification changes in this article are taken from NHS England’s published 2026/27 GP contract and Network Contract DES material, read in August 2026. Contract detail is updated during the year, so check the current NHS England publication before relying on a figure for planning.