This year will be no different, as the 2025 Autumn Budget brought announcements that will affect GP practices across the country and the Government's 10-Year Health Plan is set to reform healthcare and create a new model of care.

Kay Botley, head of healthcare, Duncan & Toplis, asks what can GP practices expect this year and how can they prepare for upcoming changes?

The effects of the Autumn Budget

November's Autumn Budget was kinder than expected, with just a few changes that have a direct impact on GP practices and partners.

There were no changes to the pension regime, meaning GPs are unaffected as individuals and as employers. What's more, there was also no change in National Insurance (NI) for partnerships, despite lots of speculation prior that NI contributions would be extended to partnerships and LLPs.

However, GP practices will be affected by the increase to the National Living Wage (NLW), which rises by 4.1% to £12.71 per hour from April. This increases the gross annual earnings of a full-time worker on the NLW by £900, placing increasing cost pressures on GP practices at a time when funding already presents challenges.

The uplift in dividend tax rates, which will increase by 2% from April, will also impact any partners who are basic or higher rate tax payers and hold limited companies that they extract dividends from. It is important to review whether a limited company is still the most efficient way to be structured when any changes have been implemented. The additional rate of dividend tax remains the same.

The NHS 10-Year Health Plan: What does it mean for GPs?

Published in July last year, the 10-Year Health Plan outlines significant proposed changes for the NHS, with a particular focus on developments within primary care.

There are three core transitions that the plan is centred on:

1. Decentralising care from hospitals to the community

The proposal brings care closer to patients' homes and alleviates pressures on acute hospital services. For this to be effective, it will be key to ensure there is enough funding within new contracts to facilitate building capacity and establish neighbourhood health centres, rather than simply transferring existing pressures.

2. Digital transformation

The plan places strong emphasis on leveraging technology to enhance patient care and streamline administrative processes. By moving away from outdated analogue systems, the plan aims to make the healthcare system more efficient and improve patient outcomes.

3. From sickness to prevention

The plan also aims to shift from a system focused on treating sickness to one that prioritises prevention, encouraging healthier lifestyles and early intervention.

The role of GPs will be central in delivering this sustainable, patient-centred healthcare system. However, according to the BMA, the GP partner workforce has been shrinking since 2015, with the loss of 6,397 full-time equivalent (FTE) GP partners during this time, and a loss of 470 FTE GP partners in the last year alone. So, with declining GP numbers, increasing patients and people living longer but with long-term conditions, it is difficult to see how this new system of care will be delivered effectively.

Changes to the GP contract in 2026/27

The Government took a different approach to negotiating the GP contract for 2026/2027. Instead of the BMA being the sole negotiating partner, the Government broadened its consultation to include a wider group of stakeholders - including practice managers and patient representatives.

Now published, the contract includes a 3.6% cash uplift (1.4% in real terms) to the core GP contract - equating to £485m. What's more, funds from the PCN-level Capacity and Access Payment have been repurposed to a practice-level reimbursement scheme, worth £292m. A lot of PCNs already distribute this money to practices, but this will impact practices positively where they do not.

At PCN level, the restriction on use of Additional Roles Reimbursement Schemes for only newly qualified GPs has been removed and reimbursement caps adjusted to reflect full salaried GP rates, plus on-costs. This provides the opportunity to strengthen GP workforce capacity.

The contract also introduces requirements to support timely access to GP services. This means practices can no longer ask patients to make contact another day and should instead provide patients with an update on the next steps to their query by the end of the next working day. For clinically urgent patients, practices should provide a same-day response - and the autonomy to determine the urgency of a request will now rest with a GP or appropriately trained professional.

The contract uplift is modest when compared to continuing rising costs and so it is essential practices have robust strategies and a workforce plan in place. The changes will come into effect from April, so it is essential to ensure your practice is being run as efficiently as possible to adapt to these changes. Consider the operational implications of the changes and identify what processes, systems and staffing adjustments need to be made.

In addition, practices need to ensure they have robust plans in place. Discuss and agree your goals for the year ahead, prepare rolling budgets and cashflow forecasts, and make sure these are monitored, evaluated and acted upon where necessary.

Duncan & Toplis provides accounting and business services specifically designed for GP practices and partners, including payroll and pensions management, tax planning and financial forecasting.