The new GP funding pays a salary, not a locum invoice

Since 1 April 2026 a practice in England has had a pot of money it can spend on a GP, on condition the GP is employed. The 2026/27 contract moved £292 million out of the PCN Capacity and Access Payment into a practice-level GP reimbursement scheme, and NHS England has confirmed in writing that a locum can be paid from it only by signing a contract of employment. Meanwhile the only official monthly count of ad-hoc locum work in England shows more of it than a year ago, not less.

What the practice-level scheme funds

Each practice's entitlement is £4.57 multiplied by its adjusted practice population as at 1 January 2026. Claims run from 1 April 2026 to 31 March 2027 through CQRS Local, and the money stays in the core contract recurrently rather than going back to PCNs. On the BMA's figures of 63.2 million registered patients across 6,147 practices, the average list is a little over 10,000, which puts a typical entitlement near £47,000 for the year.

The legal basis is section 14A, inserted into the Statement of Financial Entitlements by the GMS SFE (Amendment) Directions 2026, signed on 30 April 2026 and in force from 1 May 2026 with effect from 1 April 2026. It reimburses the lower of actual cost or £152,900 a year for a new salaried GP, £155,698 with London weighting, and that ceiling covers salary plus employer National Insurance and pension contributions. Claims and declarations go in within three months of the end of the month claimed, so sessions worked in July 2026 stop being claimable on 31 October 2026.

Additionality rules apply. A GP funded as new must not have been a salaried GP at that practice in the previous 12 months, unless they were covering sickness, suspension, family leave or study leave, or are a retiree returning. An existing GP increasing their participation can go up to nine sessions a week, and practices with more than 3,500 patients per GP must contact their ICB first.

Where a locum sits in it

NHS England's supplementary guidance of 20 May 2026 deals with locums directly. A GP locum already working in the practice can be funded, but "they must hold an employment contract with the practice for the additional sessions", which in the scheme's own terms makes them a new salaried GP. An invoice does not qualify.

The BMA's GP committee for England asked for the scheme to cover short-term GP sickness absence, which would have pulled ordinary locum cover inside it. NHS England refused, on the basis that the employer currently meets that cost, though it did drop a fixed FTE baseline from the additionality test. As it stands, the money cannot be used to cover an absent GP.

The ARRS cap moved to the top of the salaried scale

The other pot changed shape in the same month. From April 2026 the salary element of the maximum ARRS reimbursement for a GP rose from £82,418 to £118,759, and to £120,921 for GPs in London. That is the top of the salaried GP pay range rather than the bottom of it. Adding proportionate employer on-costs gives the same annual equivalent maximum of £152,900, or £155,698 with London weighting.

Eligibility widened too. The restriction to GPs who completed CCT within the previous two years has gone, and any GP now qualifies provided they have not been substantively employed as a GP in a core network practice of that PCN at any point in the previous 12 months. ARRS GP funding continues in 2026/27, including the 2024/25 and 2025/26 cohorts, at £197 million for the full year. Going into the negotiations the BMA had called the roles "grossly underpaid" and asked for pay parity with practice-employed salaried GPs, a limit on how many practices an ARRS GP covers, and eligibility for all GPs. Two of the three landed.

The ad-hoc locum numbers went the other way

NHS England Digital counts GP ad-hoc locums every month in Annex B of the General Practice Workforce bulletin tables, an annex excluded from every headline GP figure since June 2021 and therefore rarely quoted.

Taking like-for-like non-provisional months from the release of 27 August 2026: ad-hoc locum FTE in England was 406.0 in April 2025 and 499.4 in April 2026, and 399.0 in May 2025 against 499.2 in May 2026. Headcount rose from 2,307 to 2,695 in April. The series peaked at 636.1 FTE in October 2025, the highest point in a published run going back to December 2017. June and July 2026 look lower, at 469.3 and 364.4 FTE, but both are provisional: the table notes say the latest two months are published in arrears and revised upward.

The separate GP Regular Locums role, which does sit inside the headline count, stood at 631.3 FTE in July 2026 against 568.0 a year earlier. Behind both sits the structural move the funding is designed around: GP partners fell from 21,655.0 FTE in September 2015 to 15,064.6 in July 2026 while salaried GPs rose from 6,859.7 to 13,091.6, and fully qualified GP numbers over that decade are down by 307 FTE in total.

The budget that still pays an invoice

Absence cover is the one line of practice funding that reimburses an invoice rather than a payslip. These are the England ceilings from 1 April 2026, as uplifted by the SFE Directions 2026 and the April amendment.

Reimbursement is the lower of the invoiced cost or the ceiling, and it is not scaled to the absent GP's working pattern. The practice claims within 14 days of the end of the month, and payment falls due 14 days later. Nothing is payable where the locum is a partner or shareholder in the contractor, or already employed by it. The SFE also assumes the practice's arrangement with you already covers the superannuation contributions payable for you as a locum practitioner, which matters when a practice treats your quoted rate as covering everything. The pension guide sets out where Form A and Form B fit.

What to ask before 31 October

When a practice mentions funding for extra sessions, establish which pot it means. The practice-level scheme and ARRS both require an employment contract and both look back 12 months at your history there. SFE absence cover takes an invoice, but only against a fixed weekly ceiling and only for a named category of leave.

If the work is absence cover, price with the ceiling in view: anything above it comes out of the practice's own money, which is a different conversation from one where reimbursement covers the whole invoice. If you are offered a short employed block under the practice-level scheme, check your last 12 months there against the additionality rule, and check the claim clock, because July 2026 sessions drop out of scope on 31 October 2026. Sessional keeps the shift log, the invoices and their automatic chasers and the Form A and Form B figures in one place for GP locums, and what an invoice needs to carry is in the invoicing guide.

One date to watch: NHS England Digital publishes workforce data to 30 September 2026 on 22 October 2026. If the ad-hoc annex repeats last year's October peak, the gap between what the funding rules encourage and what practices do will have widened again.

Sources

• Changes to the GP Contract in 2026/27 (NHS England, 24 February 2026, updated 4 March 2026)
• Supplementary information to support changes to the 2026/27 GP contract (NHS England, 20 May 2026, updated 3 July 2026)
• Primary Care Networks: Network Contract Directed Enhanced Service from April 2026 (NHS England, 26 March 2026)
• General Medical Services Statement of Financial Entitlements Directions 2026 (DHSC, signed 30 March 2026)
• General Medical Services Statement of Financial Entitlements (Amendment) Directions 2026 (DHSC, signed 30 April 2026)
• General Practice Workforce, 31 July 2026 (NHS England Digital, 27 August 2026)
• General Practice Workforce series, forthcoming publication dates (NHS England Digital, accessed 11 September 2026)
• Focus on the new 26/27 GP Employment Reimbursement Scheme (BMA GP committee England, 2 April 2026)
• Pressures in general practice data analysis (BMA, updated 28 August 2026)
• Four possible changes to salaried and locum GP work: 2026/7 contract (NASGP, Dr Clare Sieber, 12 January 2026)