Ministers will use the 2026/27 GP contract to raise vaccination uptake in communities at greatest risk of outbreaks. The Department of Health and Social Care says improvement-based payments will recognise practices that increase coverage even if they have not yet met absolute thresholds, aiming to reduce admissions and prevent clusters such as the current measles incident in Enfield, where around 50 cases have been confirmed and children have been hospitalised.
Under the current system, only practices that already hit high uptake targets qualify for additional incentive payments. Surgeries serving areas with historically low coverage-often those needing the most outreach-can miss out on funding even when year‑on‑year progress is strong. Government points to more than 2,900 measles cases in England in 2024 and the loss of World Health Organization measles elimination status, with overall childhood coverage still below the WHO’s 95 per cent threshold to prevent outbreaks.
The new improvement incentives are designed to close that gap. Payments will reward measurable progress and allow practices to reinvest in call‑and‑recall, outreach sessions and follow‑up with families whose children are not yet fully protected. Officials position this as a targeted tool to reduce health inequalities, recognising that postcode and deprivation continue to shape exposure to preventable disease.
The contract will align incentives with the national schedule, including the combined measles, mumps, rubella and varicella (MMRV) vaccine. Since 1 January, practices have been offering MMRV at 12 months and 18 months; GP quality indicators will be updated so delivery is counted consistently and rewarded fairly, removing duplicated steps and administrative complexity for clinicians.
Government confirms that vaccination delivery will be embedded within the GP contract rather than treated as an add‑on. The aim is to lift uptake in high‑risk communities and cut the likelihood of outbreaks before they start, keeping children out of hospital and easing pressure on urgent and emergency care.
Primary Care Networks will be required to identify care home residents who are overdue or missing routine vaccinations. The contract will also allow greater flexibility for practices to collaborate on seasonal programmes such as influenza and COVID‑19, enabling shared clinics and staffing where this is judged to be the most efficient model locally.
From April, the respiratory syncytial virus (RSV) programme will extend to all adults aged 80 and over and to all residents in care homes for older adults, alongside existing cohorts. GP practices must offer RSV vaccination as an essential service, building the offer into routine recall systems and care home outreach so eligible patients are proactively contacted.
The NHS’s vaccination offer was expanded on 1 January to include chickenpox (varicella) for the first time, delivered through the combined MMRV vaccine. Incorporating MMRV into quality indicators is intended to ensure practices are fairly rewarded as the schedule evolves and to simplify recording, stock planning and clinical governance.
Health leaders have welcomed the direction of travel. The NHS Confederation’s primary care lead, Ruth Rankine, described the package as fair and supportive for practices working in communities with high unmet need, arguing that recognising meaningful improvement rather than relying solely on absolute thresholds is a more realistic way to encourage progress amid workforce pressures and vaccine hesitancy.
Ministers frame the reforms as prevention-led. The Health and Social Care Secretary, Wes Streeting, said vaccines are safe and save lives, and linked the package to wider investment and modernisation in general practice to protect children and reduce avoidable hospitalisations.
For practices, the operational focus will centre on data quality, workforce and communications. Improvement funding can support extended call‑and‑recall, translated materials and targeted clinics for families facing barriers, while commissioners will expect clear evidence that coverage is rising towards the 95 per cent WHO benchmark over 2026/27.
In parallel, a new £2 million pilot will fund health visitors to reach families who face the greatest barriers to vaccination. Government expects closer coordination between health visiting, PCNs and general practice to close persistent gaps in coverage and narrow inequalities linked to geography and deprivation.