The Network Contract DES has entered another year of substantial change. The 2026/27 contract year builds on the structural overhaul introduced in 2025/26, which merged the ARRS budget, removed role caps and expanded the workforce scope. It also added further refinements that affect how PCNs plan and deliver against contract requirements. The current Network DES represents both a continuation of that direction and the last full year before the framework is expected to be replaced by local provider contracts.
Alongside the funding structure, the contract year keeps its focus on structured medication reviews, cardiovascular disease prevention and enhanced access. These are three of the priorities that have defined the DES since its inception. What’s changed is how those priorities interact with the wider service reforms now under review, and how PCNs need to demonstrate delivery against them.
Key takeaways
- ARRS funding continues under the single £1.7 billion pot introduced in 2025/26, with no individual role caps for 2026/27.
- The joint DES review carried through 2025/26 is expected to reshape the framework from 2027/28, with local provider contracts replacing the current DES model.
- Structured medication reviews remain a core delivery requirement, alongside cardiovascular disease prevention and enhanced access as sustained contract priorities.
- The ARRS workforce scope now includes GPs, practice nurses, pharmacists and pharmacy technicians alongside the earlier ARRS roles, all funded from the single budget.
- Networks are expected to demonstrate DES delivery through workforce plans, clinical activity data and outcome reporting to Integrated Care Boards.
The 2026/27 funding structure
The single ARRS budget introduced in 2025/26 continues into the 2026/27 contract year through the NHS England Network Contract DES specification, giving each PCN a defined allocation from a national pot of around £1.7 billion. Networks continue to have full discretion over how the allocation is spent across the covered roles, with no individual role caps applied.
Read More: Choosing an E Cigarette: A Straightforward Guide for Adult Smokers
That structure changes the operational question networks need to answer. In earlier ARRS years, clinical directors were often working to fill defined role slots against a set allowance for each. The current allocation asks a different question: given the clinical priorities of the network, what form should the pharmacy team, GP capacity, wider clinical workforce and coordination roles take when they all draw from the same budget.
ARRS workforce scope this contract year
Roles included in the current ARRS list
The covered roles for 2026/27 remain those brought in progressively during the earlier ARRS years, plus the additions from the 2024/25 and 2025/26 contract rounds. NHS Digital primary care workforce data tracks how the workforce has grown across each. The roles PCNs can fund from the current allocation include:
- Clinical roles: clinical pharmacists, pharmacy technicians, physician associates, paramedics, first contact physiotherapists, mental health practitioners, nursing associates, dietitians and podiatrists.
- Coordination and community roles: care coordinators, health and wellbeing coaches as well as social prescribing link workers.
- Recent contract additions: newly qualified GPs (introduced October 2024) and practice nurses (introduced April 2025).
How the single budget affects hiring decisions
The removal of role caps and the merger of the GP and main ARRS pots changed the strategic character of workforce planning. Networks now trade off pharmacist capacity against GP capacity, physiotherapy against nursing associate cover, and long-standing ARRS roles against the newer additions, all from the same allocation. That is a sharper set of decisions than the earlier ARRS years asked for, and it makes the workforce plan submitted to the ICB the primary vehicle by which the network signals how it intends to deliver against the DES.
What’s carrying through unchanged
Alongside the structural changes, several DES elements carry through into 2026/27 without material revision. Structured medication reviews remain one of the most visible parts of the contract, with the priority cohorts unchanged: care home residents, patients on ten or more regular medicines, those living with severe frailty and patients on medicines linked to safety incidents. Cardiovascular disease prevention continues as a sustained priority, worked through the same QOF indicators.
The Enhanced Access requirement also carries through from earlier contract years without material revision. PCNs continue to offer additional appointments outside core hours, delivered through coordination across member practices, with the operating hours framework unchanged and the same expectation of a mix of face-to-face, telephone and digital access. Coordination across member practices, shared rota planning, agreed clinical scope for each session and consistent documentation between the practices involved remain among the more time-consuming parts of running the DES.
The DES review and successor arrangements
The joint review of ARRS and the wider Network Contract DES carried through 2025/26 is the most consequential piece of context for the current year. Sector commentary, including NHS Confederation analysis, points to an expected replacement of the current DES by local provider contracts from around 2027/28, with commissioning likely to move to Integrated Care Boards under new local arrangements. The current 2026/27 year is likely to be the last full year of the DES in its current form.
For PCNs, that transition raises practical questions well before it lands. How workforce plans will map onto the successor arrangements is uncertain, and there is no guarantee that existing ARRS commitments will carry across the change. The outcome measures networks currently report against are also likely to change to fit the new contract structure. Preparing for those questions during 2026/27 is a more useful use of clinical director time than assuming the framework will hold its current form indefinitely.
Reviewing PCN capacity against 2026/27 priorities
A network entering the second half of 2026/27 has a specific window to review whether its ARRS workforce is deployed against the DES priorities that carry through to the successor framework. Workforce plans that reflect strong evidence of clinical impact tend to sustain better than those built around headcount targets, and that difference becomes more consequential when the contract structure changes.
Read More: The Science Behind the Expanding Role of Quality Beta-Alanine in Modern Health and Performance
Working with an experienced provider can help match pharmacy and wider ARRS capacity to the DES priorities most relevant to the network, and prepare the workforce structure for the transition to local provider contracts.