How the GP reimbursement scheme and ARRS rules have loosened since 2023

Sep 30

5 min read

Updated: Oct 4

From 1 October, practices can claim for locum GP sessions through the £292m GP reimbursement scheme. GPonline reported it on 30 September, after an update to the GMS Statement of Financial Entitlements (SFE). Up to now, it was salaried GPs only.

This news prompted me to map back how ARRS funding and the ways GPs can be funded have changed since 2023. It's been interesting to look back and see how much the requirements have loosened.

If you're running a PCN, this blog summarises how you can now fund GP time, and what sits with the network and what sits with your practices.

Let's jump in!

Infographic on GP funding rules loosening since 2023, with three colored columns and summary boxes on ARRS, PCN, and reimbursement.

The capacity and access money

The capacity and access payment (CAP) went from a conditional PCN payment to no PCN payment at all in under four years.

October 2022. The scheme began as a monthly support payment to PCNs (Healthcare Leader).

2023/24. The payment was split. 70% was paid monthly on the adjusted population. The other 30%, the capacity and access improvement payment (CAIP), depended on performance. PCNs had to submit access improvement plans. The ICB then assessed whether they had met their targets across three areas: patient experience of contact, ease of access and demand management, and accuracy of recording in appointment books (Healthcare Leader).

2024/25. £46m from three retired IIF indicators was added, taking CAP to £292m. The 70/30 split stayed. The 70%, now called the capacity and access support payment (CASP), came with no reporting requirements. CAIP was paid on the clinical director's confirmation that all practices had put in place one or more of the three parts of the Modern General Practice Access Model (NHS England).

2025/26. The £204m CASP continued and stayed unconditional. The £87.6m CAIP moved from three domains to two: £58.4m for modern general practice access and £29.2m for population health management and continuity of care (Pulse).

2026/27. CAP, CASP and CAIP were removed from the PCN DES. The £292m was repurposed into a practice-level GP reimbursement scheme (NHS England).

GPs in ARRS

GPs entered ARRS in October 2024 as a narrow, ringfenced addition. By April 2026 any GP was eligible at full salaried rates.

October 2024. A ringfenced £82m pot was made available from October to March (Pulse). Only GPs who had gained their Certificate of Completion of Training (CCT) within the previous two years could be funded.

2025/26. The GP ringfence was removed, and GP funding joined the main ARRS pot. Practice nurses were added. There was no cap on numbers. The GP reimbursement rose by £9,305 to £82,418 plus on-costs, in line with the BMA salaried GP pay range (BMA). The two-year CCT rule stayed.

2026/27. The restriction to recently qualified GPs was removed. The salary element of the maximum reimbursement rose from £82,418 to £118,759, or £120,921 in London (NHS England). The ARRS total rose from £26.631 to £27.668 per adjusted population (THC Primary Care). PCNs can also recruit additional non-direct patient care roles where commissioners agree.

The 12-month rule hasn't changed, though. You still can't use ARRS to fund a GP who's been employed at one of your practices in the last year.

The practice-level GP reimbursement scheme

The scheme started narrowly in April 2026 and has been changed twice since.

April 2026. Each practice's entitlement is £4.57 multiplied by its adjusted population at 1 January 2026. Practices in the same PCN can transfer entitlements to each other. Practices can claim for a new salaried GP, or for extra sessions from an existing salaried GP, up to nine sessions a week.

The funding stays in the core GP contract beyond 2026/27 and will not return to PCNs (NHS England). Practices with more than 3,500 patients per GP must seek approval from NHS England to take part (Pulse).

Locums could be funded only if they took an employment contract with the practice for the additional sessions, which made them salaried GPs under the scheme. The Association of Independent Specialist Medical Accountants (AISMA) warned that limiting the scheme to salaried sessions would affect smaller, rural and coastal practices.

Mid 2026. A later SFE amendment corrected an error in the maximum hourly rate practices could claim (GPonline).

BMA, September 2026: Locums are now in. The SFE does not mention partners.

1st October 2026. "The SFE adds 'the increased participation of locums'. Locums' annualised sessions must have been under nine a week before the claim and can be increased to a maximum of nine. The maximum hourly rate for locums is £78.41 (£79.84 London). Practices can also now transfer entitlement to any practice, confirmed in writing to NHS England."

Where the BMA fits in

I wondered if the BMA were behind some of these changes, but this is what I found.

2024/25. During collective action, the BMA's GP committee told PCNs to hold off signing up to one part of CAIP, the "simpler online requests" part. That meant opening up e-consultations right through core hours (BMA). On that one, they were pushing back.

2025/26. This contract was negotiated with the BMA (Hill Dickinson). Adding GPs and practice nurses to ARRS, with no caps on numbers, was one of the headlines the BMA put out (BMA).

September 2026. The BMA has been in talks with the government about making the £292m scheme more flexible, so the money actually gets spent. That included claims for partners and locums (GPonline).

In summary, the routes for funding GPs

None of this is new, but it helps to see the routes for funding GPs in one place.

GPs new to the PCN can be funded through ARRS, at any stage of career.
GPs already working in the PCN's practices in the last 12 months go through the practice-level scheme, not ARRS. The same GP cannot be claimed under both.
Posts previously funded by CAP can move onto the practice-level scheme. Practices can transfer entitlements to each other, confirmed in writing to the ICB.
Practices that could not sustain a salaried post may now be able to use locum sessions.
Practices with more than 3,500 patients per GP need NHS England approval before claiming.

My take

The rules loosen when the money isn't being spent (overall nationally).

The locum change came after reports of slow take-up to the scheme, and unspent money is hard to defend, so the rules bend.

There's also a political agenda around growing the workforce and access, which explains the restrictions.

Looking back at how things have moved, I wouldn't be surprised if we saw some of these changes next.

Using the scheme to cover a GP who is off, which it can't be used for at the moment.
Dropping or easing the 3,500 patients per GP threshold.
Relaxing the ARRS 12-month rule, the one rule that hasn't moved.
Moving the money into the global sum, with no claims and no conditions.
Even more flexibility on which roles ARRS can fund.

We will watch this space!

On the podcast

Podcast poster for The Business of Healthcare: Making Neighbourhoods Work with Dr Niruban Ratnarajah, two portraits, Episode 385.

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About the Author

Tara Humphrey has supported over 300 primary care networks across England, providing interim PCN management, training, events and facilitation.

Tara also holds an MBA in Leadership and Management in Healthcare and has written over 300 blogs and hosted the Business of Healthcare Podcast, which has published over 370 episodes.