New GP contract: What PCN pharmacists need to know

The new GP contract for 2025/26 will see changes to the Additional Roles Reimbursement Scheme (ARRS) and Quality and Outcomes Framework (QOF).

While the full GP contract and primary care network (PCN) contract are yet to be published, some information has already been shared by NHS England and the British Medical Association (BMA).

The Pharmacist breaks down what we know so far, and what practice and PCN pharmacists need to know.

What will adding nurses and GPs to combined ARRS funding pot mean for pharmacists?

For 2025/26, there will not be a separate pot of funding for recruiting GPs through ARRS. Instead, there will be one pot of ARRS funding that PCNs can use for any role within the scheme, including pharmacists, GPs and, for the first time, practice nurses.

President of the Primary Care Association (PCPA) Dr Graham Stretch said he had noticed 'nervousness' among ARRS pharmacists worried their role might be at risk if a PCN chose to recruit a GP or nurse with that funding instead.

Dr Stretch advised pharmacists in that position: 'Make your presence felt, make sure that you're seen by the partners and by the clinical directors that [pharmacists] are such good value so they don't want to hire somebody else.'

In a recent survey by our sister titles Healthcare Leader and Pulse PCN, GPs ranked pharmacists as the most successful ARRS role.

And recent primary care workforce figures indicate that pharmacists continue to be the most hired ARRS role.

Will ARRS pharmacists see a pay increase from the GP contract uplift?

According to the BMA, the amount that each PCN can claim per ARRS clinical pharmacist working at band 7-8a will be uplifted to £66,972 in 2025/26.*

And for advanced practitioners working at band 8a, PCNs will be able to claim £73,334.

Meanwhile the reimbursable amount for pharmacy technicians will be uplifted to £43,352.

According to NHS England, these amounts are intended to be used towards the salaries and some on costs of these clinicians.

And Dr Stretch told The Pharmacist that it remained unclear whether practice pharmacists would see an uplift in their salaries, or whether these increases may be used to cover National Insurance Contribution rises.

He also noted that while the amount that could be claimed per role had increased, it was not yet clear whether there would be an uplift in the total amount of funding available through ARRS overall.

In previous years, when PCNs were allowed to spend more on staff salaries, they were not given any increase in overall funding to do so, which may impact how many or which ARRS staff they employ.

In a recent survey carried out by our sister title Pulse PCN, of 147 PCN respondents, some 55% said they had paid over 5% more than the ARRS allowances for their pharmacist, with 8% of those paying more than 20% above this.

Will the new GP contract change the work that PCN pharmacists do?

Other changes to the GP contract will see some QOF payment incentives removed, with the associated £100m in funding invested into the GP Global Sum, childhood immunisation payments and locum reimbursement rates.

Some of these QOF points will be redirected towards cardiovascular disease (CVD) prevention, with practices encouraged to reach higher thresholds across several indicators.

And on other QOF indicators, some technical changes have been made to reflect latest clinical practice.

With CVD thresholds increasing, Brendon Jiang, vice chair of the Royal Pharmaceutical Society (RPS) England Pharmacy Board, told The Pharmacist that general practice pharmacy teams had 'already played a key role in delivering against these indicators over the past year'.

'As thresholds increase, they will continue to support in identifying and optimising CVD prevention,' he added.

Read more from Mr Jiang on how pharmacists in his PCN are working with community heart failure nurses to upskill, improve patient care and tackle health inequalities.

*This article was updated on 27/03/25 to clarify the amount that each PCN can claim per ARRS clinical pharmacist working at band 7-8a will be uplifted to £66,972 in 2025/26.

QOF changes for 2025/26

Income protected indicators, retired from 2025/26

CAN001	The contractor establishes and maintains a register of all cancer patients defined as a ‘register of patients with a diagnosis of cancer excluding non-melanotic skin cancers diagnosed on or after 1 April 2003
CAN004	The percentage of patients with cancer, diagnosed within the preceding 24 months, who have a patient Cancer Care Review using a structured template recorded as occurring within 12 months of the date of diagnosis
CAN005	The percentage of patients with cancer, diagnosed within the preceding 12 months, who have had the opportunity for a discussion and informed of the support available from primary care, within 3 months of diagnosis
CKD005	The contractor establishes and maintains a register of patients aged 18 or over with CKD with classification of categories G3a to G5 (previously stage 3 to 5)
CHD001	The contractor establishes and maintains a register of patients with coronary heart disease
HF001	The contractor establishes and maintains a register of patients with heart failure
HYP001	The contractor establishes and maintains a register of patients with established hypertension
PAD001	The contractor establishes and maintains a register of patients with peripheral arterial disease
STIA001	The contractor establishes and maintains a register of patients with stroke or TIA
DEM001	The contractor establishes and maintains a register of patients diagnosed with dementia
DM017	The contractor establishes and maintains a register of all patients aged 17 or over with diabetes mellitus, which specifies the type of diabetes where a diagnosis has been confirmed
EP001	The contractor establishes and maintains a register of patients aged 18 or over receiving drug treatment for epilepsy
LD004	The contractor establishes and maintains a register of patients with learning disabilities
DEP004	The percentage of patients aged 18 or over with a new diagnosis of depression in the preceding 1 April to 31 March, who have been reviewed not earlier than 10 days after and not later than 56 days after the date of diagnosis
MH001	The contractor establishes and maintains a register of patients with schizophrenia, bipolar affective disorder and other psychoses and other patients on lithium therapy
MH021	Percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who received all six elements of the Physical Health Check for people with Severe Mental Illness
OB003	The contractor establishes and maintains a register of patients aged 18 years or over living with obesity, appropriately adjusted for ethnicity in line with NICE guidelines – either with a BMI ≥30 in the preceding 12 months, or a BMI greater than or equal to 27.5 kg/m2 recorded in the preceding 12 months for patients with a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background
OST004	The contractor establishes and maintains a register of patients: Aged 50 or over and who have not attained the age of 75 with a record of a fragility fracture on or after 1 April 2012 and a diagnosis of osteoporosis confirmed on DXA scan, and Aged 75 or over with a record of a fragility fracture on or after 1 April 2014 and a diagnosis of osteoporosis
PC001	The contractor establishes and maintains a register of all patients in need of palliative care/support irrespective of age
AF001	The contractor establishes and maintains a register of patients with atrial fibrillation
AST005	The contractor establishes and maintains a register of patients with asthma aged 6 years or over, excluding patients with asthma who have been prescribed no asthma related drugs in the preceding 12 months
AST008	The percentage of patients with asthma on the register aged 19 or under, in whom there is a record of either personal smoking status or exposure to second-hand smoke in the preceding 12 months
COPD014	The percentage of patients with COPD and Medical Research Council (MRC) dyspnoea scale ≥3 at any time in the preceding 12 months, with a subsequent record of referral to a pulmonary rehabilitation programme (excluding those who have previously attended a pulmonary rehabilitation programme)
COPD015	The contractor establishes and maintains a register of: patients with a clinical diagnosis of COPD before 1 April 2023 and patients with a clinical diagnosis of COPD on or after 1 April 2021 whose diagnosis has been confirmed by a quality assured post bronchodilator spirometry FEV1/FVC ratio below 0.7 between 3 months before and 6 months after diagnosis (or if newly registered at the practice in the preceding 12 months a record of an FEV1/FVC ratio below 0.7 recorded within 6 months of registration) and patients with a clinical diagnosis of COPD on or after 1 April 2023 who are unable to undertake spirometry
RA001	The contractor establishes and maintains a register of patients aged 16 or over with rheumatoid arthritis
SMOK005	The percentage of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 12 months
QI modules	QI x 6

CVD prevention indicators (2025/26 QOF points and thresholds)

		2024/25 scheme			2025/26 scheme
ID	Description	Lower threshold	Upper threshold	QOF points	Lower threshold	Upper threshold	QOF points
CHOL003	Percentage of patients on the QOF Coronary Heart Disease (CHD), Peripheral Arterial Disease (PAD), Stroke/ Transient Ischaemic Attack (TIA) or Chronic Kidney Disease (CKD) Register who are currently prescribed a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy	70%	95%	14	70%	95%	38
CHOL004	Percentage of patients on the QOF Coronary Heart Disease (CHD), Peripheral Arterial Disease (PAD), or Stroke/Transient Ischaemic Attack (TIA) Register, with the most recent cholesterol measurement in the preceding 12 months, showing as ≤ 2.0 mmol/L if it was an LDL (Low-density Lipoprotein) cholesterol reading or ≤ 2.6 mmol/L if it was a non-HDL (High-density Lipoprotein) cholesterol reading. For multiple readings on the latest date the LDL reading takes priority.	20%	35%	16	20%	50%	44
HYP008	The percentage of patients aged 79 years or under with hypertension in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less (or equivalent home blood pressure reading)	40%	77%	14	40%	85%	38
HYP009	The percentage of patients aged 80 years or over, with hypertension, in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less, (or equivalent home blood pressure reading)	40%	80%	5	40%	85%	14
STIA014	The percentage of patients aged 79 years or under, with a history of stroke or TIA, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less (or equivalent home blood pressure reading)	40%	73%	3	40%	90%	8
STIA015	The percentage of patients aged 80 years or over, with a history of stroke or TIA, in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less, (or equivalent home blood pressure reading)	46%	86%	2	46%	90%	6
CHD015	The percentage of patients aged 79 years or under, with coronary heart disease, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less, (or equivalent home blood pressure reading)	40%	77%	12	40%	90%	33
CHD016	The percentage of patients aged 80 years or over, with coronary heart disease, in whom the last blood pressure reading (measured in the preceding 12 months) is 150/90 mmHg or less, (or equivalent home blood pressure reading)	46%	86%	5	46%	90%	14
DM036*	The percentage of patients with diabetes, on the register, aged 79 years and under without moderate or severe frailty in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less (or equivalent home blood pressure reading)	38%	78%	10	38%	90%	27