The official voice for GPs in Leicester, Leicestershire and Rutland

The LLR ICB has shared the following guidance with LLR practices regarding the GP Reimbursement Scheme, but this might change if national guidance supersedes it .

We are writing to provide further clarification regarding the 2026/27 Practice-Level GP Reimbursement Scheme introduced as part of the 2026/27 GP Contract arrangements.

We recognise that the scheme represents a significant change to general practice workforce funding arrangements and has generated understandable questions from practices regarding eligibility, recruitment, sustainability, reimbursement arrangements, and operational expectations.

This communication is intended to provide a clear summary of the national guidance currently available and set out the local approach that will be applied by the ICB in administering the scheme. The scheme forms part of the national objective to increase substantive GP clinical capacity, improve patient access, support continuity of care, and strengthen workforce stability within general practice.

1. Purpose of the Scheme

The Practice-Level GP Reimbursement Scheme is intended to support additional patient-facing GP capacity aligned to the access and continuity objectives within the 2026/27 GP Contract.

The principal aims of the scheme are to:

• Increase substantive GP clinical time
• Improve same-day and routine patient access
• Support continuity of care
• Reduce unsustainable reliance on short-term staffing arrangements
• Support workforce retention and stability
• Provide practices with greater flexibility to respond to recruitment and workload pressures

The scheme should therefore be viewed primarily as a capacity-expansion and workforce-stabilisation mechanism intended to improve patient-facing GP provision

2. Eligible Organisations

Eligible organisations generally include:

• GMS practices
• PMS practices
• APMS practices participating in core contractual arrangements

Funding is available at practice level and claims do not need to be coordinated through Primary Care Networks (PCNs), although collaborative arrangements between practices may be agreed locally where appropriate.

Enhanced-access-only providers are not eligible to claim directly unless they also operate as a qualifying GP practice entity within the contractual definition

3. Funding Allocation and Reimbursement Limits

The national guidance states that each practice’s available funding allocation under the scheme will be calculated using the following formula:

• £4.57 multiplied by the practice adjusted population as at 1 January 2026

Reimbursement under the scheme is intended to provide salary support rather than complete employment cost recovery 

The nationally defined reimbursement limits are currently:

New Salaried GPs

• Reimbursement up to actual cost incurred, subject to a maximum annual reimbursement of:
  • £152,900
  • £155,698 where London weighting applies

Additional Sessions

• Reimbursement up to actual cost incurred, subject to a maximum hourly reimbursement of:
  • £90.61 per hour
  • £92.27 per hour where London weighting applies

Reimbursement may therefore not fully cover:

• Pension contributions
• Employer on-costs
• Indemnity costs
• Overheads
• Other indirect employment expenses

Practices should therefore consider affordability carefully when determining recruitment models and workforce expansion plans and further operational guidance regarding payment arrangements, reimbursement ceilings, claims processing and reconciliation arrangements will be issued separately

4. Additionality Requirements

The core principle underpinning the scheme is “additionality”

The scheme is intended to support additional patient-facing GP capacity rather than subsidise existing baseline workforce costs

Additional capacity may include:

• Recruitment of new salaried GPs
• Additional sessions from existing salaried GPs
• increased contracted GP hours
• Continuation of posts previously funded through the Capacity and Access Payment (CAP) or PCN Test Site programmes
• Conversion of long-term locum dependence into substantive salaried employment
• Arrangements which preserve patient-facing GP capacity that would otherwise be lost
   

Does the arrangement demonstrably increase or preserve patient-facing GP capacity above the agreed baseline position?

Evidence supporting claims may include:

• Payroll records
• Rota comparisons
• Workforce returns
• Contracted sessions
• Employment contracts
• Baseline establishment information

National guidance also confirms the following additionality rules:

• Newly recruited salaried GPs funded through the scheme must not have been employed by the practice as a salaried GP within the previous 12 months.
• Exceptions apply for maternity leave, adoption leave, paternity leave, neonatal care leave, shared parental leave, long-term sickness absence, suspension, or study leave cover
• Retired GPs returning to practice are exempt from the 12-month rule
• Existing salaried GPs may increase participation under the scheme up to a maximum of 9 sessions per week

The ICB recognises that practices operate within differing workforce, recruitment and population contexts. The scheme will therefore be applied consistently whilst retaining reasonable discretion to consider local workforce circumstances, provided all claims meet the nationally defined principles of additionality, transparency and demonstrable patient-facing GP capacity.

5. Employment Models

Subject to scheme rules and evidence requirements, the following arrangements may be eligible:

• Substantive salaried GP appointments
• Fixed-term salaried contracts
• Additional sessions from existing salaried GPs
• Part-time appointments
• Shared posts across practices
• Approved locum-to-substantive employment transitions.

Practices may wish to consider phased recruitment models or conditional expansion arrangements given the current funding position beyond 2026/27

6. Locum Arrangements

Ad hoc locum expenditure is not reimbursable under the scheme

However, national guidance confirms that GPs currently working as locums within a practice may be supported where they enter into substantive employment arrangements with the practice for eligible additional sessions under the scheme

Any such arrangements must:

• Meet the additionality requirements
• Demonstrate workforce sustainability
• Provide evidence of increased or protected patient-facing GP capacity

The scheme is not intended to support routine short-term locum expenditure or general temporary absence cover arrangements

7. GP Partners

The National guidance does not provide for direct reimbursement of GP partners in the same manner as salaried GPs

However, practices may present proposals where:

• Additional partner clinical sessions demonstrably increase patient-facing capacity
• Partner-funded replacement arrangements preserve capacity that would otherwise be lost

Any such arrangements will be assessed against the core principles of:

• Additionality
• Transparency
• Workforce sustainability; and
• Demonstrable patient benefit

8. Existing Salaried GPs and Workforce Retention

The scheme is not intended to subsidise existing baseline workforce expenditure

However, practices may use the scheme to support:

• Additional sessions from existing salaried GPs
• Continuation of posts previously funded through CAP or Test Site arrangements
• Arrangements which preserve patient-facing GP capacity that would otherwise be lost

This may include:

• Expansion of existing salaried GP participation
• Conversion of long-term locum reliance into substantive employment
• Protection of access capacity at risk due to withdrawal of previous funding streams

9. Practices with High Patient-to-GP Ratios

Practices with more than 3,500 patients per GP are required under national guidance to contact the ICB prior to accessing funding under the scheme

This process is intended to support discussion regarding workforce planning and sustainable service delivery and is not intended to act as a barrier to accessing funding

10. Claims, Reporting and Assurance

Claims must be submitted and maintained through CQRS Local in accordance with national and local reporting requirements

Practices will be expected to:

• Maintain accurate workforce and sessional records
• Provide supporting evidence where requested
• Comply with audit and assurance processes
• Avoid duplicate funding claims for the same workforce costs
• Ensure claims remain accurate and up to date

The scheme cannot be used for:

• Duplicate reimbursement of existing funded workforce costs
• Separate routine GP absence cover arrangements

11. Outcomes and Evaluation

As public funding is being invested through the scheme, the ICB is required to demonstrate appropriate use of funds, value for money, and improvement in patient access outcomes, whilst keeping reporting requirements proportionate.

Measures used to evaluate the impact of the scheme are expected to include:

• Additional GP sessions delivered
• Improvement in same-day urgent access
• Reduction in waits for routine appointments
• Continuity of care indicators
• Patient experience measures
• Workforce stability metrics

Practices may therefore be asked to participate in proportionate reporting and contractual monitoring arrangements relating to workforce capacity and access performance

The ICB remains committed to minimising unnecessary administrative burden wherever possible.

12. Funding Sustainability and Future Years

National guidance confirms that funding for the scheme remains within core GP contract allocations beyond 2026/27 and will not transfer back to PCNs.

However, the operation, scope and value of the reimbursement scheme remain subject to:

• Future national funding settlements
• Annual contract negotiations
• NHS England commissioning decisions
• Wider affordability considerations

Funding is currently confirmed for the period:

• 1 April 2026 to 31 March 2027

Practices should therefore consider affordability and employment models carefully pending future national settlement and may wish to consider:

• Fixed-term recruitment models
• Phased recruitment
• Conditional workforce expansion
• Flexible employment arrangements

We recognise that workforce pressures vary significantly across practices and localities, and we will continue to work collaboratively with practices to support sustainable patient-facing GP capacity, continuity of care and improved patient access.

Further operational guidance and FAQs will follow as additional national clarification becomes available.