NHS General Practice 2026: Contract Dispute, LMC Conference and a New Health Secretary

Its been a big week for the NHS!

 

What is happening at LMC Conference

 

As I write this, the UK LMC Conference is underway in Belfast, running 13 to 15 May 2026. This is the primary policy-making forum for Local Medical Committees representing NHS GPs across the UK.

 

The agenda this year includes voting on plans for taking GPs outside the NHS entirely, a motion against unlimited same-day access, and a debate on the mixed public and private model of general practice in the Republic of Ireland.

 

My friend and colleague Dr Hussain Gandhi is there, and his takeaways from the floor make for sobering reading.

 

The debate around Motion 16  states that current GP contracts are failing patients and practices alike, that general practice within the NHS is no longer financially viable, and that a move towards a hybrid NHS and private GP service is the only option for the future.

 

It calls for contracts that permit GPs to provide private services to their NHS patients where those services are not contractually available. It calls for a strategy for exiting GMS contracts. And it directs GPC UK to ballot the profession on a Plan B, including a means-tested subscription model similar to those currently being offered by NHS dentists.

 

The motion passed. But Supporters called it a survival strategy, not a choice. Opponents raised serious concerns about health inequalities and what it means for what general practice fundamentally is. Scottish delegates pointed to meaningful core funding as having allowed a different path north of the border, though whether that is replicable in England is a question nobody could answer cleanly.

 

 

The GP contract dispute

 

The GP contract dispute is the backdrop to everything being debated in Belfast this week.

 

The 2026/27 GMS contract was imposed in April 2026 after 98.9% of GPs voted to reject it. GPC England entered collective action from 1 May 2026. The initial focus is on data sharing agreements.

 

There is no stated end point. The action is designed to escalate each month if negotiations do not progress.

 

 

What this means for Primary Care Networks

 

Primary Care Networks are now seven years old. They were created in 2019 as the building blocks of a more integrated, neighbourhood-based NHS.

 

The neighbourhood provider contracts signalled in the 10 Year Health Plan will not arrive until 2027/28 at the earliest, delayed at least a year from what was indicated.

 

Some commentators have described 2026/27 as a transition year for PCNs, with the DES providing an operational framework while the longer-term neighbourhood structures are developed. The government’s own language talks of stabilisation and baseline-setting. Nobody is officially calling it another transition year. But that is what it is, in my view.

 

And PCN leaders who have been building steadily, some for all seven years, will be asking a reasonable question: how many transition years are there?

Earlier this year, I wrote that there was a gap between vision and infrastructure. That gap has not closed. If anything, it has widened.

 

 

A change at the top

 

On 14 May 2026, Wes Streeting resigned as Health Secretary. He has been replaced by James Murray, the former Chief Secretary to the Treasury. Whoever walks into that role inherits a full in-tray immediately.

 

Also published on 14 May, NHS England data shows the waiting list has fallen to 7.11 million, its lowest in three and a half years, with 65.3% of patients seen within 18 weeks in March 2026.

Streeting cited this in his resignation letter as evidence the plan was working. 

 

The Nuffield Trust published analysis on 14 May on what the incoming Health Secretary will inherit beyond the waiting list figures: a new dental contract to settle, a workforce plan to finalise, and the Baroness Casey Commission on adult social care still in progress, with phase one recommendations due later this year.

 

That commission was set up to build the case for a National Care Service and to make medium-term recommendations for reforming adult social care in England. It sits directly alongside the neighbourhood health agenda. You cannot build a functioning neighbourhood health model without also answering the social care question.

 

The King’s Speech on 13 May 2026 outlined plans to abolish NHS England entirely, pulling its functions directly into the Department of Health and Social Care and giving the Secretary of State direct operational control over the health service.

 

The NHS Modernisation Bill is one of the most significant structural changes to how the NHS is led in recent years. James Murray will not just be managing a department. He will be managing a restructure.

 

 

Primary care is being asked to build neighbourhood health in a period of sustained political uncertainty, with a contract that has been imposed rather than negotiated, and collective action now underway that is aimed specifically at the infrastructure the neighbourhood model depends on.

 

 

The view from the ground

 

In conversations with PCN leaders and practice managers, I hear genuine will to make this work. People believe in what neighbourhood health could be. That has not gone away.

 

But will and resource are not the same thing. And right now, the resource question remains unanswered. Many PCNs are already questioning the point of all their effort, and that is a reasonable response to the situation they are in.

 

More turbulence is coming. The wholesale renegotiation of the GMS contract, which the BMA has made a condition of ending the current dispute, could create further uncertainty for PCNs that are already trying to plan and build in difficult conditions.

 

What happens to the 10 Year Health Plan? What happens to the neighbourhood health agenda? What happens to primary care? What happens to the GP contract? Who will be the next Prime Minister?

 

Right now, nobody knows. And that is where we are.