What this is telling you
The Single Activity Fee is the per-item fee that replaced the old bundle of professional fees. For most contractors it is the largest determinant of dispensing income after the medicine margin itself, which makes a six pence movement worth calculating rather than assuming.
The uplift is backdated to take effect from May 2026, with early advanced payments from June. So some of the value may already have reached you as a lump rather than as a visibly higher monthly rate, which is exactly the kind of thing that makes a year-on-year comparison confusing if nobody has separated it out.
The trap in the headline
The 2026/27 settlement is £3.636 billion, up £340 million on £3.296 billion — a 10.3% increase at sector level. That total now includes the Pharmacy First budget, integrated into the CPCF for the first time, where in 2025/26 it sat outside. Comparing it against the older £3.073 billion figure overstates the rise. A sector percentage is not your percentage: run your own volume through this and set it against your own cost increases.
What a sector total does and does not tell you
A settlement figure is the size of the pot, not the size of your share. It is distributed through a formula and a service mix, so two contractors dispensing the same volume can take materially different amounts out of the same increase depending on how much of their income is fee-per-item and how much is service-based.
The Single Activity Fee is the part you can model directly, because it is a flat rate per item and your item count is the one number every contractor knows. That is why this tool starts there rather than with the headline. Once you have the annual figure, the useful exercise is to set it against the cost increases landing in the same year — employer National Insurance at 15% above a £5,000 secondary threshold, the National Living Wage, and locum rates — rather than against last year's income.
The other reason a year-on-year comparison misleads
Because some of the value may already have reached you as a lump. The uplift is backdated to take effect from May 2026 with early advanced payments from June, so the money can appear as a one-off adjustment rather than as a visibly higher monthly rate. If nobody has separated the backdated element out, a monthly comparison shows a rise that is partly catch-up and a later month that looks like a fall when it is not.
The same applies in reverse to establishment payments. They were abolished in England but remain in Wales, so a Welsh contractor and an English one are not looking at the same income structure at all — and neither is a Scottish or Northern Irish contractor, who negotiate separately. Nothing on this page carries across a border unchanged.