What the Government's new approach to GP contract negotiations for 2026/27 means for GPs

Summary: The government has set out a different approach to negotiating the GP contract for 2026/27. For the first time in the NHS era it has signalled it will broaden who is consulted — diluting the British Medical Association’s (BMA) position as the sole negotiating partner — and involve a wider group of stakeholders (including practice managers and patient representatives). The move has already prompted concern among GP leaders about the risk of changes being imposed rather than agreed.

What exactly has changed?

Historically, the BMA (via GPC England) has been the government’s main negotiating counterpart for the national GP contract. The government now says it will engage a broader set of representative organisations during the 2026/27 negotiation cycle — explicitly inviting other bodies (such as the Royal College of GPs, NHS Confederation, practice manager organisations and patient groups) to input into terms and conditions. This represents a marked shift away from the traditional single-negotiator model.

Official NHS documentation for the 2026/27 contract has also been published as part of planning for next year, indicating the contract will set national terms for 2026/27 and that stakeholders will be engaged in the process. That guidance sits alongside policy announcements about access targets and other operational expectations.

Why GPs are worried

Leading GP bodies and the BMA have expressed concern that widening the negotiating table could be used to reduce the BMA’s influence and, in the worst case, create a pathway to the government imposing contractual terms. Several reports and GP leaders have warned that this departure from a single recognised negotiating partner risks eroding mutual trust and could mean changes are forced upon practices rather than reached by agreement.

Who else is being invited to the table?

• Royal College of GPs (RCGP) and other professional colleges.
• Practice management groups — the Institute of General Practice Management (IGPM) has been invited to play a role. This is the first time practice managers have been given such a formal seat at the negotiation table.
• NHS Confederation, Integrated Care Board (ICB) representatives, and patient groups.

What this could mean in practice

Short-term practical impacts GP practices should consider:

• Changes to access expectations: Government and NHS planning documents reference strengthened requirements around how patients access services (including online booking throughout working hours and targets for face-to-face access). Practices may see operational expectations clarified or tightened for 2026/27.
• More voices on contract detail: With practice managers and ICBs involved, elements of the contract that touch on workforce modelling, IT, and local system working may be shaped differently than under a single-negotiator model.
• Risk of imposition: If an agreed settlement cannot be reached, ministers have signalled they may be prepared to press forward with changes — a prospect that has alarmed GP leaders.

What GPs and practice teams should do now

We recommend practical steps to protect your practice and influence outcomes:

1. Stay informed through your LMC and GPC: Local Medical Committees and GPC England will lead on professional responses — keep up to date with their updates and guidance.
2. Engage locally: Make sure your practice manager and partners have read any ICB or local consultation material and make your practice’s view known via LMC routes. The new process gives practice managers a stronger voice — use it.
3. Respond to consultations: If the government or NHS England issues formal consultation documents, submit evidence-based responses highlighting operational realities (workforce, appointment demand, continuity of care).
4. Plan operationally: Consider the operational implications of likely changes (for example extended online access expectations or revised access targets) and identify systems or staffing adjustments you might need to make.
5. Document risks and patient impact: Collect local data on appointment types, demand spikes, and continuity harms — concrete evidence is persuasive in negotiations and consultations.

How MedMatch can help

At MedMatch we work with practices across England and can:

• Help you model workforce implications for different contract scenarios;
• Provide locum and permanent staffing options quickly if operational changes require additional cover;
• Share anonymised benchmarking data to support LMC/GPC submissions.

Bottom line

The government’s announcement marks a notable shift in how GP contract negotiations will be handled for 2026/27. Broadening the consultation group offers opportunities for wider input (including practice managers and patients), but it also raises real concerns about the prospect of imposed changes if consensus cannot be reached. GPs and practice teams should monitor developments closely, engage through their LMCs and professional bodies, prepare practical evidence on how changes would affect patient care, and be ready to adjust operational plans if new contract terms emerge.

Sources: government and NHS guidance, recent coverage in Pulse, GP Online, Management in Practice and NHS England contract documents.