The most significant digital access development is that, from 1 October 2025, practices will be required to ensure patients can submit  requests online throughout core hours (8.00am to 6.30pm). This applies to routine, non-urgent requests, and aligns with NHS England’s position that digital contact routes should offer the same availability as traditional ones. 

This isn’t a standalone obligation — it is embedded in the first of two improvement areas within the Capacity and Access Improvement Payment (CAIP): 

• Supporting Modern General Practice Access, which covers online consultations, digital telephony, appropriate triage, and timely contact resolution. 

This part of CAIP is worth two-thirds of the funding — around £45,850 for a typical 50,000-patient PCN. It reflects a strong policy steer: digital access is no longer a supplementary option — it is part of the baseline service offer. 

For systems suppliers the challenge lies in how to filter urgent requests. Meanwhile for PCNs and Digital & Transformation Leads, this brings several considerations: 

• Are current online consultation platforms configured for full-day availability? 
• Is there an agreed process across the PCN for how requests are handled and triaged? 
• How is digital demand monitored and matched with appropriate clinical or administrative capacity? 

This is not simply a switch to leave forms open — it is a service redesign task that will require both digital and operational leadership. 

The 2025/26 Capacity and Access Improvement Payment retains the same structure as last year, but with two key differences: 

1. The number of improvement domains is reduced from three to two. 
2. A new focus is introduced: continuity of care via risk stratification. 

Each PCN can earn up to £1.375 per adjusted patient (~£68,750 for a 50k PCN) by delivering: 

• Modern access (online consultations, digital telephony, triage and navigation) 
• Continuity (using population health tools to identify patients who benefit from continuity and ensuring this is in place)

The access domain includes online request availability, but also requires practices to have systems for triage, timely contact, and responsiveness. The continuity domain introduces a new operational challenge: demonstrating how the PCN is identifying and supporting patients who need consistency in their care team. 

From a transformation standpoint, this reinforces the importance of: 

• Consistent processes across practices within a PCN 
• Operational data to track and evidence performance 
• Proactive engagement with practices on implementation and monitoring 

The Additional Roles Reimbursement Scheme (ARRS) continues in its current form, but with increased flexibility: 

• PCNs can now employ GPs, “new to practice” and experienced nurses under ARRS, within defined parameters 
• Reimbursement caps have increased for certain roles, including GPs (now £82,418 salary plus on-costs) 

PCNs must still submit workforce plans by 31 October 2025, but local ICBs will determine the format — a change from previous years. 

For PCNs investing in transformation capacity, this could be an opportunity to: 

• Expand digital or operational leadership roles using ARRS funding 
• Realign ARRS posts (e.g. care coordinators, social prescribers) to support continuity of care work 
• Increase focus on embedding additional roles into day-to-day general practice operations 

This is particularly relevant for PCNs preparing for the continuity improvement requirement. 

The DES maintains expectations around shared appointment books, record access, and interoperability — especially in the context of Enhanced Access services. 

PCNs must ensure: 

• Appointments are visible and bookable across the network 
• Staff working across sites (e.g. in ARRS roles) can access and contribute to patient records 
• Unused appointment slots are made available to NHS 111 

These requirements aren’t new, but they remain a foundational enabler for equitable and timely access — and a continued area of focus for many networks where interoperability remains variable.

Digital and transformation leads should ensure local systems support: 

• Inter-practice booking for enhanced access sessions 
• Role-based record access (e.g. via GP Connect or shared care record infrastructure) 
• Reliable and consistent coding for appointment types, continuity flags, and access outcomes 

While the 2025/26 DES does not introduce new service requirements, it does: 

• Consolidate the focus on digital access 
• Reframe continuity as a shared, proactive responsibility 
• Reinforce the importance of infrastructure that enables both 

At the same time, the broader GP contract introduces updated expectations around patient experience, QOF simplification, and access tracking, with most of these changes relying on digital capability and operational maturity. 

The direction is clear: practices and PCNs are expected to be digitally enabled, data-literate, and operationally integrated — and transformation leads remain central to making that a reality. 

The 2025/26 GP contract and PCN DES reflect a maturing policy landscape. There are fewer new requirements, but clearer expectations. The ask is not about launching new initiatives — it’s about embedding previous improvements and ensuring consistency and accountability across networks. 

For digital and transformation leads, this is an opportunity to: 

• Consolidate core digital access systems and make them sustainable 
• Build a stronger baseline of data and performance metrics 
• Refocus transformation resource on care continuity, not just access 

We will be hosting a webinar at the end of April exploring these changes and their practical implications for PCNs and transformation teams. If you would like to attend, register here. We are also offering PCNs a free one-to-one session to review your PCN’s Digital Maturity Index data and discuss support options for 2025/26 delivery — just get in touch to arrange a time through the booking links here.