Childhood vaccination uptake remains below the level recommended by the World Health Organization to prevent outbreaks of measles and other infectious diseases. Recent years have seen thousands of confirmed measles cases in England, increasing pressure on local health services and families where preventable illness spreads.
The Department of Health and Social Care, led by the Rt Hon Wes Streeting MP, announced changes to the 2026/27 GP contract to strengthen vaccination delivery. The reforms include improvement incentives for practices in low-uptake communities, updated childhood vaccination incentives aligned to the national schedule, and additional support to follow up with families of unvaccinated children.
New GP Contract Measures to Increase Vaccination Uptake
The government said the updated GP contract for 2026/27 will embed vaccination delivery more firmly into general practice, with added support intended to protect more children from life-threatening infectious diseases. The Department of Health and Social Care said the changes are designed to help practices reinvest in outreach and follow-up activity where coverage is lowest.
The contract reforms include new improvement incentives, which are intended to recognise practices making progress in increasing vaccination uptake rather than focusing only on absolute thresholds. Ministers said this approach is aimed at supporting more communities to raise coverage and reduce the risk of outbreaks.
- Improvement incentives for practices raising uptake in low-vaccination communities
- Support for outreach and follow-up with families of unvaccinated children
- Childhood vaccination incentives aligned with the national vaccine schedule
Targeting Communities with Low Immunisation Rates
The Department of Health and Social Care said the current system rewards only practices that meet high vaccination-rate targets, which can leave some areas without additional resources even when improving year on year. Ministers said practices serving communities with lower uptake are often those that need the most support to strengthen delivery.
Under the changes, improvement payments are expected to help practices that are making progress to access resources they can reinvest locally. The department said this is intended to help reduce health inequalities linked to where children live.
Recent Outbreaks Highlight Urgency
The government pointed to the current measles outbreak in Enfield, where dozens of unvaccinated children have contracted measles and some have been hospitalised. Ministers said reducing the risk and number of outbreaks is a key aim of the contract changes.
The department also said the UK has lost its World Health Organization measles elimination status after more than 2,900 measles cases were confirmed in England in 2024, the highest levels recorded in decades. It added that childhood vaccination rates remain below the 95% uptake level recommended by the World Health Organization to prevent measles outbreaks, and are falling.
Additional Support for GP Practices
The Department of Health and Social Care said the new improvement incentives are intended to provide additional resources so practices can strengthen outreach and follow up with families of unvaccinated children. Ministers said this work is designed to help protect children who are currently missing out on vaccinations.
The government said embedding vaccination delivery into the GP contract is expected to increase uptake in high-risk communities, helping to stop outbreaks before they start. The updated contract will also match childhood vaccination incentives for GPs with the latest national vaccine schedule.
Expansion of Childhood Vaccination Programme
The NHS vaccination programme was expanded on 1 January to include chickenpox, also known as varicella, for the first time. GP practices started offering children a combined measles, mumps, rubella and varicella vaccine at 12 months and 18 months of age.
The government said GP quality indicators will be updated to include delivery of the combined MMRV vaccine, with the aim of removing unnecessary complexity for practices. Ministers said this will ensure practices are fairly rewarded as the MMRV vaccine is rolled out.
Childhood vaccination updates in the contract
| Combined vaccine | Practices will offer the MMRV vaccine at 12 months and 18 months of age, adding chickenpox protection to measles, mumps and rubella. |
| Quality indicators | GP quality indicators will be updated to include delivery of the MMRV vaccine. |
| Incentives alignment | Childhood vaccination incentives will be matched with the latest national vaccine schedule. |
Wider Contract Changes Beyond Children
The Department of Health and Social Care said the GP contract changes will also affect other vaccination programmes, including requirements for Primary Care Networks to identify care home residents with overdue or outstanding routine vaccinations. The contract will also allow greater flexibility in how practices collaborate to deliver flu and COVID-19 vaccines.
From April, the government said the RSV vaccination programme will extend to all adults aged 80 and over and all residents in care homes for older adults, in addition to existing cohorts. GP practices will be required to offer RSV vaccination to eligible patients as an essential service.
- Primary Care Networks to identify care home residents with overdue routine vaccinations
- Greater flexibility for practices collaborating on flu and COVID-19 vaccination delivery
- RSV vaccination extension to adults aged 80+ and care home residents from April
Vaccination delivery requirements for other groups
| Care home residents | Primary Care Networks will be required to identify residents with overdue or outstanding routine vaccinations. |
| Flu and COVID-19 | The contract will allow greater flexibility in how practices collaborate to deliver flu and COVID-19 vaccines. |
| RSV programme | From April, the RSV programme will extend to all adults aged 80+ and all residents in care homes for older adults, with GPs required to offer RSV vaccination as an essential service. |
Pilot Support for Hard-to-Reach Families
The Department of Health and Social Care said a new £2 million pilot will support health visitors to reach families facing barriers to vaccination. The department said the pilot is intended to help ensure more children are protected.
Ministers presented the pilot as part of the wider effort to improve uptake in communities where coverage is lowest. The government said these actions are designed to help protect children and reduce preventable illness.
Expected Impact on Public Health Outcomes
The government said the reforms are intended to increase vaccination uptake in high-risk communities and reduce the likelihood of outbreaks, keeping children out of hospital. Ministers said the shift toward recognising improvement is designed to support practices working in areas with high levels of unmet need.
The Department of Health and Social Care said the package aims to reduce inequalities in vaccination coverage by enabling practices to reinvest in local outreach and follow-up. The department said this is expected to support healthier starts for children and strengthen protection against serious, preventable disease.
Stakeholder Comments
Ministerial Comments
Wes Streeting, Secretary of State for Health and Social Care said;
“Vaccinations are safe and they save lives. The return of diseases we thought we’d defeated, with children in hospital as a result, is entirely preventable.”
“With our investment and modernisation in general practice, GPs will be backed to protect children and prevent the risk of further outbreaks like we’ve seen Enfield.”
“These improvement payments will give GPs the resources they need to help parents to protect children who are currently missing out and reduce health inequalities that leave some babies at far greater risk than others simply because of where they live.”
Ruth Rankine, Director of the Primary Care Network and Neighbourhood Lead at the NHS Confederation and NHS Providers, said;
“Primary care leaders welcome this announcement and see it as a fair and supportive approach for general practice, particularly for those working in communities with high levels of unmet need.”
“We are particularly supportive of recognising meaningful improvement rather than relying solely on absolute thresholds. This is a more realistic and constructive way to encourage progress, given the very real challenges many practices face.”
To Summarize
The Department of Health and Social Care said the 2026/27 GP contract will strengthen how vaccinations are delivered through general practice, with added support aimed at areas where uptake is lowest.
Ministers said new improvement incentives and updated measures linked to the national vaccine schedule are intended to help practices increase coverage over time. The government said the reforms aim to reduce outbreaks and protect more children and vulnerable groups from preventable infectious disease.
Sources: Department of Health and Social Care and The Rt Hon Wes Streeting MP.
Prepared by Ivan Alexander Golden, Founder of THX News, an independent news organisation delivering timely insights from global official sources. Combines AI-analysed research with human-edited accuracy and context.
