The Premises Costs Directions (PCDs) are regulations setting out how improvement of practice premises can be covered by premises improvement grants from the National Health Service, and how general practice (GP) contractors can apply for capital grants via the Utilisation and Modernisation Fund (UMF). UMF funding can support the improvement of practice premises’ lighting, ventilation, and heating installations, including the replacement of other forms of heating by central heating, except where improvements are designed solely to reduce the environmental impact of premises, such as the installation of solar energy systems or the replacement windows, doors, or facades, unless the contractor can satisfy NHS England, acting reasonably, that those improvements provide a net financial benefit to the health service.

The PCDs were reviewed and updated in 2024, with the revised directions allowing commissioners to make larger investments in GPs in a more flexible way and to seek to provide contractors with some reassurance about their premises liabilities.

In 2025/26 we committed to investing £102 million to upgrade GP surgeries across England, through the UMF. We are continuing this by providing £200 million over the next four years, in addition to up to £200 million to support 40 to 50 neighbourhood health centres this Parliament through the refurbishment of existing buildings.

The Premises Costs Directions (PCDs) are regulations setting out how improvement of practice premises can be covered by premises improvement grants from the National Health Service, and how general practice (GP) contractors can apply for capital grants via the Utilisation and Modernisation Fund (UMF). UMF funding can support the improvement of practice premises’ lighting, ventilation, and heating installations, including the replacement of other forms of heating by central heating, except where improvements are designed solely to reduce the environmental impact of premises, such as the installation of solar energy systems or the replacement windows, doors, or facades, unless the contractor can satisfy NHS England, acting reasonably, that those improvements provide a net financial benefit to the health service.

The PCDs were reviewed and updated in 2024, with the revised directions allowing commissioners to make larger investments in GPs in a more flexible way and to seek to provide contractors with some reassurance about their premises liabilities.

In 2025/26 we committed to investing £102 million to upgrade GP surgeries across England, through the UMF. We are continuing this by providing £200 million over the next four years, in addition to up to £200 million to support 40 to 50 neighbourhood health centres this Parliament through the refurbishment of existing buildings.

The Premises Costs Directions (PCDs) are regulations setting out how improvement of practice premises can be covered by premises improvement grants from the National Health Service, and how general practice (GP) contractors can apply for capital grants via the Utilisation and Modernisation Fund (UMF). UMF funding can support the improvement of practice premises’ lighting, ventilation, and heating installations, including the replacement of other forms of heating by central heating, except where improvements are designed solely to reduce the environmental impact of premises, such as the installation of solar energy systems or the replacement windows, doors, or facades, unless the contractor can satisfy NHS England, acting reasonably, that those improvements provide a net financial benefit to the health service.

The PCDs were reviewed and updated in 2024, with the revised directions allowing commissioners to make larger investments in GPs in a more flexible way and to seek to provide contractors with some reassurance about their premises liabilities.

In 2025/26 we committed to investing £102 million to upgrade GP surgeries across England, through the UMF. We are continuing this by providing £200 million over the next four years, in addition to up to £200 million to support 40 to 50 neighbourhood health centres this Parliament through the refurbishment of existing buildings.

The Department and NHS England considered the potential impacts of expanding Advice and Guidance (A&G) as part of the policy development process, including through clinical input, established governance arrangements, and equalities considerations. A&G is intended to support timely clinical decision‑making and ensure patients are directed to the most appropriate care. National guidance is in place to support its safe and consistent use, and the use of A&G does not change existing clinical accountability or patient safety arrangements.

The contract does not change the clinical threshold for referral to specialist care. General practitioner (GPs) should continue to make a clinical decision to refer for specialist care where that is in the patient’s best interests, and to request specialist advice where it is needed. GPs retain responsibility for referral decisions, and this model supports, and does not replace, clinical judgement.

The 2026/27 GP Contract embeds the previous A&G enhanced service funding into core practice funding. Following near universal uptake of the A&G Enhanced Service in 2025/26, the focus for 2026/27 is on stability and simplicity. Embedding the specialist advice model within the core contract recognises its role in routine clinical practice, removes annual signups, and provides more predictable funding while supporting consistent patient pathways.

Under Part 9, regulation 67 of the NHS (Pharmaceutical and Local Pharmaceutical Services) Regulations 2013, pharmacy owners must give notice before permanently closing premises. Contractors providing at least 40 core opening hours a week must give a minimum of three months’ notice. Boots pharmacy at Wellington Medical Centre complied with this requirement by notifying the NHS Somerset Integrated Care Board of its intended closure. On the date set out in that notice, the pharmacy may close and the premises are removed from the National Health Service pharmaceutical list. The Department keeps these processes under review and regularly engages with Community Pharmacy England and other relevant bodies on any changes that may be needed.

No assessments have been made on the operation, transparency, and application of the overseas visitor charging regulations with respect to maternity services and no guidance has been issued to National Health Service trusts on the application, proportionality, or consideration of maternity care previously received overseas, when calculating charges.

Individuals who are not ordinarily resident in the United Kingdom may be charged for some NHS services, however, maternity care is considered immediately necessary or urgent care and so must never be delayed because a patient cannot pay. As the NHS is a residency-based system and having British nationality does not mean someone is automatically considered ordinarily resident, no differentiated approach has been considered.

The Department is working closely with NHS England to ensure the overseas visitor charging regulations are applied fairly and consistently across all NHS trusts.

The Department and NHS England assessed the potential impacts of the proposed changes to the GP Contract for 2026/27 throughout the policy-development process, including Equality Impact Assessments, which consider the impact of policy changes against protected characteristics, in line with the public sector equality duty. We are routinely collecting data on workforce, patient access, and service use to inform assessment of impacts.

The Department undertook a programme of consultation and engagement ahead of the publication of the 2026/27 GP Contract Regulations, which concluded in early 2026. The Department expanded the consultation to engage with a wider range of primary care stakeholders, including the British Medical Association’s General Practitioners Committee England, the Royal College of General Practitioners, National Voices, the Institute of General Practice Management, Healthwatch England, the NHS Confederation, now the NHS Alliance following its merger with NHS Providers, and the National Association of Primary Care. This engagement provided in‑depth feedback and ensured that the views of both the profession and patients were reflected in the development of the proposals.