The healthcare sector is constantly shaped by changes in funding and fiscal policy, and GP practices often feel the impact most directly. This year is no exception.
The 2025 Autumn Budget introduced several measures that will influence how practices operate, while the government’s 10 Year Health Plan signals longer-term structural reform across the NHS. Together, these developments raise an important question: how can GP practices prepare for what lies ahead?
The Autumn Budget proved more favourable than many had anticipated, with relatively few direct changes affecting GP practices and partners.
Notably, there were no reforms to the pension regime, meaning GPs are unaffected both personally and as employers. In addition, despite prior speculation, National Insurance was not extended to partnerships or limited liability partnerships.
However, rising employment costs will present a challenge. From April, the National Living Wage (NLW) will increase by 4.1% to £12.71 per hour. For a full-time worker, this equates to an additional £900 annually, adding further financial pressure at a time when many practices are already operating under tight budgets.
There are also tax considerations with dividend tax rates rising by 2% from April for basic and higher-rate taxpayers. This may affect GP partners operating through limited companies, making it important to reassess whether this structure remains the most tax-efficient option. The additional rate remains unchanged.
Published last July, the NHS 10 Year Health Plan sets out a vision for significant transformation, particularly within primary care.
There are three major shifts:
1. Moving care into the community
The plan aims to bring services closer to patients’ homes, easing pressure on hospitals. However, success will depend on whether sufficient funding is allocated to build capacity in community settings rather than simply transferring existing demand.
2. Embracing digital transformation
A strong focus is placed on technology to improve patient care and streamline administrative processes. Moving away from outdated systems should enhance efficiency and support better outcomes.
3. Prioritising prevention over treatment
The strategy also emphasises prevention, encouraging early intervention and healthier lifestyles to reduce long-term demand on services.
GPs will play a central role in delivering this model. However, workforce challenges remain a significant concern. According to the British Medical Association (BMA), the number of GP partners has been declining since 2015, with a loss of over 6,300 full-time equivalent roles and a further 470 lost in the past year alone. With rising patient demand and an ageing population, this raises questions about how effectively these ambitions can be realised.
This year also brings a new approach to GP contract negotiations. For the first time, consultation extended beyond the BMA to include a broader group of stakeholders, such as practice managers and patient representatives.
The resulting contract includes a 3.6% cash uplift (1.4% in real terms), equivalent to £485 million and a £292 million shift from Primary Care Networks (PCNs) level funding into a practice-level reimbursement scheme.
While many PCNs already distribute such funding locally, this change will particularly benefit practices that previously did not receive direct allocations.
At PCN level, updates to the Additional Roles Reimbursement Scheme (ARRS) remove the restriction limiting funding to newly qualified GPs. Reimbursement caps have also been increased to reflect full salaried GP costs, including on-costs, offering greater flexibility to strengthen workforce capacity.
The contract also introduces new access requirements. Practices must now provide patients with an update on next steps by the end of the next working day and ensure same-day responses for clinically urgent cases. Importantly, responsibility for determining urgency will rest with a GP or suitably trained professional.
While the contract uplift offers some support, it remains modest in the context of rising costs. As a result, careful planning will be essential.
GP practices should focus on strengthening operational efficiency, reviewing internal processes, and ensuring workforce plans are fit for purpose. Financial resilience will also be key, which includes setting clear objectives, maintaining rolling budgets and cashflow forecasts, and regularly reviewing performance against these plans.
With changes coming into effect from April, early preparation will be critical. Practices that take a proactive approach will be best placed to adapt and continue delivering high-quality care.
Duncan & Toplis provides accounting and business services specifically designed for GP practices and partners, including payroll and pensions management, tax planning and financial forecasting. To find out more, contact Kay Botley or contact us.
