The contract is the accounts

Most of a practice's income arrives under rules set out in the Statement of Financial Entitlements and the annual contract letter. Accounts that do not follow that structure describe the result without ever explaining it — which is why partners so often cannot say why their drawings changed.

Two denominators, one separate addition
The global sum is £130.07 per weighted patient from 1 April 2026, up from £123.34, applied to your Carr-Hill Contractor Weighted Population. The London Adjustment is £2.18 per registered patient with a Greater London Authority postcode and is a separate addition, not part of the £130.07. The out-of-hours opt-out deduction is 4.70% of Initial GSMP — £6.11 per weighted patient.

What you get

Worth knowingThe 2026/27 uplift is £485 million, total contract value £13,863 million: 3.6% cash, 1.4% real against the GDP deflator, with a 2.5% pay assumption embedded and expressly described as one to revisit. That assumption is not a commitment about what you will have to pay your own staff, and planning as though it were is how a practice budgets a shortfall into its own year.

Common questions

What should practice accounts separate out?

Core contract income, enhanced services, QOF, and PCN or ARRS money, kept apart from each other and from any private work. The reason is that they behave completely differently: the global sum moves with your weighted population, QOF moves with achievement, enhanced services move with what you have signed up to deliver, and PCN money frequently is not the practice's income at all — it flows through the network. Merged into a single turnover line, none of them can be managed or explained to a partner asking why drawings changed.

Why did our global sum move when the list did not?

Because the global sum is paid on your Contractor Weighted Population, not your registered list. The Carr-Hill formula weights for age, sex, morbidity, patient turnover and other factors, so a practice can gain patients and lose weighted population, or hold its list steady and see the weighted figure move underneath it. If nobody has ever shown you the weighted number alongside the raw one, that is usually where the confusion starts. It is worth tracking both over time, because a divergence between them is an early signal about how your population is changing — and it moves income before anyone notices the demographics.

What is the 2026/27 contract worth?

The uplift is £485 million, taking the total estimated contract value to £13,863 million — 3.6% in cash terms and 1.4% in real terms against the GDP deflator. Embedded in it is a 2.5% pay assumption, expressly described as one to revisit in light of the pay review bodies' recommendations. That last point matters for planning: the pay assumption inside the settlement is not a commitment about what you will actually have to pay your staff. If the pay review bodies land above it, the difference comes out of the practice rather than out of the contract, and that is a risk worth modelling before it arrives.

When do partners find out what they actually earned?

Later than they should, in most practices. Superannuation is certified up to two years after the year it relates to, and tax follows the accounts rather than the drawings. We aim to give partners a reliable profit and reserve figure during the year instead, so drawings can be set against something real. The alternative is the pattern most practices know well: a good year, generous drawings, and a January that undoes both. The fix is not complicated — it is a reserve set as profit arises rather than a calculation done afterwards — but it has to be started at the beginning of a year to work properly.