NHS Agenda for Change
GP nurses' 3.5% rise comes with no duty on the practice to pay it
The general practice minister says GP contracts place no obligation on practices over nurse pay — and 34% of practice nurses got no rise for 2025/26.
3.5% GP contract pay uplift from 1 April 2026
The pay element of the general practice contract in England rose by 3.5% on 1 April 2026, and the government says it expects practices to pass that on to the nurses they employ. Five months later, a written answer set out why they need not. The general practice minister, Dame Diana Johnson, put it plainly on 8 September 2026: “GP contractual arrangements do not place any specific obligations on practices with regard to GP nurse terms and conditions.”
So the uplift is funded, recommended and expected. It is not owed.
Why the money can arrive and the rise not
A practice nurse is employed by the practice, not by the NHS. The uplift does not arrive as a line item for nursing pay. It arrives as an increase in the global sum — the payment a practice receives per weighted patient — which went from £123.34 to £130.07 on 1 April 2026, a rise of £6.73. Funding for the Additional Roles Reimbursement Scheme was increased alongside it.
The money enables the 3.5%. Enabling is not requiring, and the practice decides what happens next. The BMA’s own guidance for GPs tells practices they “may also consider” an equivalent uplift for non-GP staff.
This is where the two figures cross over.
| Who you are | 2026/27 uplift | Guaranteed? |
|---|---|---|
| Nurse on Agenda for Change in a hospital or community trust, England | 3.3% | Yes — national terms, paid from April 2026 |
| Salaried nurse employed by a GP practice, England | 3.5% recommended | No — the practice decides |
The lower number is the certain one.
What the record shows
This is not a hypothetical. More than a third of practice nurses — 34% — received no pay rise at all for 2025/26, on a survey of almost 900 nursing staff in general practice. The year before, the Royal College of Nursing surveyed its members directly employed in English practices and found three in 10 had received nothing for 2024/25, and that fewer than one in five — 18.9% — had received the full 6% uplift the Department of Health and Social Care had funded.
Practice nurse pay is set practice by practice, which is why the college is campaigning for terms at least equivalent to Agenda for Change. It is now asking practice nurses directly whether the 3.5% appeared. That survey closes at the end of September 2026.
What to check
Compare a March 2026 payslip with an April one. If the hourly rate or the annual salary is unchanged, the uplift did not reach you, and nothing in the contract says it had to — which is why the question has to be put to the practice rather than to the NHS.
If your practice says it follows Agenda for Change, the figures are checkable: our NHS pay scales show every band for 2026/27, and nurse salary shows what a band 5 and a band 6 are paid now.
Where these figures come from
- Minister reiterates nurse pay is up to GP practices to decide — Nursing in Practice
- RCN investigating whether practice nurses have received 2026/27 pay rise — Nursing in Practice
- GP nursing pay: what the DDRB announcement means for you — Royal College of Nursing
- Westminster government announces Agenda for Change pay award in England — Royal College of Nursing
- DDRB Uplift 2026/27 – FAQs — British Medical Association
Every figure traces to a dated document — the line this section is named after. If one here is wrong, tell us and it gets fixed publicly. Work out your own figures.