The Neighbourhood Health Framework was published jointly by the Department of Health and Social Care and NHS England on 17 March 2026, setting out how care in England will be reorganised around local populations of roughly 30,000 to 50,000 people over the next three years. For GP practices, it signals the most significant change to how primary care is commissioned and contracted since Primary Care Networks (PCNs) were introduced in 2019, though for most practices in the short term it changes how services are planned locally rather than the core GP contract itself.
We act for GP partnerships, PCNs and healthcare businesses across London and the South East, and we are already fielding questions from practice managers and partners trying to work out what is confirmed, what is still under consultation, and what they actually need to do in 2026/27. This post sets out the framework itself, in plain terms, direct from the primary source. We cover the specific implications for PCNs in a companion post, Do PCNs Have a Future Under the Neighbourhood Health Framework?
What the Neighbourhood Health Framework Actually Is
The framework is a policy paper, not legislation and not a new contract in itself. It is published on GOV.UK under the Department of Health and Social Care and sits within the government’s 10 Year Health Plan for England. Its stated purpose is to define neighbourhood health, set out the challenges neighbourhood health and care services should address, establish metrics for success, and define the roles of integrated care boards (ICBs), local authorities, health and wellbeing boards and other partners in delivering it.
The framework organises reform around three agendas:
- Improving routine access to general practice and wider primary care, including new national GP access targets
- Strengthening proactive, preventative care for people with complex needs through integrated neighbourhood teams (INTs)
- Providing better alternatives to hospital-based care, including urgent community response, virtual wards and intermediate care capacity
A “neighbourhood” is not a new statutory body. It is a defined population footprint, agreed locally between the ICB, local authorities and health and wellbeing boards, around which integrated neighbourhood teams and, in time, new contracts will be organised. In many areas, the existing PCN footprint already maps reasonably well onto this population size, which is one reason PCNs feature so heavily in how this reform is expected to play out in practice.
Key Dates: What Has Actually Been Confirmed
Given how fast this topic is moving, precision on dates matters more than usual. The table below sets out what is confirmed against the primary sources, as at 28 July 2026.
| Date | Milestone | Status |
|---|---|---|
| 17 March 2026 | Neighbourhood Health Framework and “Fit for the future: towards population health delivery models” published by DHSC and NHS England | Confirmed, published |
| 18 March 2026 | NHS England covering letter to ICB and provider chief executives on next steps | Confirmed, published |
| 2026/27 financial year | Stage 1: ICBs and health and wellbeing boards deliver minimum foundational actions (neighbourhood footprints, INT plans, Better Care Fund alignment, data-sharing arrangements) | Confirmed, in progress |
| 16 July 2026 | NHS England opens consultation on proposed Multi-Neighbourhood Provider (MNP) and Single Neighbourhood Provider (SNP) contracting models | Confirmed, live consultation |
| 10 September 2026 | MNP/SNP consultation closes | Confirmed deadline; outcome and further consultation on firmer proposals still to follow |
| By March 2027 | Target: 90% of clinically urgent patients seen same-day by their GP practice team; interim RTT trajectory of 70%; ED four-hour performance trajectory of 82% | Confirmed national target in framework, not yet achieved |
| From April 2027 | Stage 2 begins: ICBs and health and wellbeing boards required to develop locally owned neighbourhood health plans for 2027/28 onwards | Confirmed direction, detail still to be worked through locally |
| By March 2029 | Targets: RTT standard of 92%; ED four-hour performance of 85%; 10% reduction in non-elective admissions for priority cohorts, among other metrics | Confirmed national target |
| By 2030 | 120 of the planned 250 Neighbourhood Health Centres (NHCs) delivered | Confirmed ambition, wave 1 pipeline focused on repurposed NHS estate in areas of highest deprivation |
| By 2035 | 250 Neighbourhood Health Centres delivered nationally | Confirmed ambition |
What is not yet confirmed is equally important. The precise design of the new SNP and MNP contracts, how PCNs might transition into SNPs, and how funding will flow between ICBs, integrated health organisations and neighbourhood providers are all still subject to consultation and further guidance. Anyone telling you these details are settled is getting ahead of the primary source.
New Ways of Contracting: SNPs, MNPs and IHOs
The framework introduces three new population-based contracting models, sitting alongside (not replacing) the existing GP contract. Crucially, the framework and the subsequent NHS England consultation are explicit that General Medical Services (GMS), Personal Medical Services (PMS) and Alternative Provider Medical Services (APMS) contracts, the contracts that actually govern how most GP practices are paid and regulated, will continue to be determined nationally and commissioned locally. The Neighbourhood Health Framework does not, on its own, change your GMS or PMS contract.
| Model | Typical population size | What it does | Who can hold it |
|---|---|---|---|
| Single Neighbourhood Provider (SNP) | Around 50,000 (working assumption, not mandated) | Delivers enhanced primary medical services through integrated neighbourhood teams within one neighbourhood, building on the existing PCN DES | Any legal entity meeting eligibility criteria, including a lead GP practice acting for a consortium |
| Multi-Neighbourhood Provider (MNP) | Around 250,000 or more (working assumption, not mandated) | Co-ordinates consistent delivery of neighbourhood health services across several neighbourhoods, and may sub-contract primary medical elements to SNPs | A single legal entity or lead provider for a consortium, for example a primary care organisation, Community Interest Company, limited partnership or NHS trust |
| Integrated Health Organisation (IHO) | Larger defined population, aligned to one or more MNP footprints | Holds a whole-population capitated budget and takes responsibility for resource allocation and service planning across the whole care pathway | NHS organisations only, initially high-performing advanced foundation trusts designated by DHSC and NHS England |
None of these are compulsory in 2026/27. The framework describes NHS England taking “an enabling, non-prescriptive approach”, and the July 2026 consultation confirms there is no new national funding attached to the SNP or MNP contracts, they are locally defined and locally funded options that ICBs and practices can choose whether and when to take up. We look at the practical implications for PCNs specifically, including the three commissioning options NHS England has put out for consultation, in Do PCNs Have a Future Under the Neighbourhood Health Framework? and in our broader guide, Primary Care Networks Explained: A Legal Guide for GP Practices.
What ICBs Are Required to Do This Year
For 2026/27, the framework sets a specific list of minimum actions for ICBs and health and wellbeing boards, working jointly. These matter to practices because they will shape what your ICB asks of you locally over the coming months. ICBs must:
- Agree an initial plan to reduce non-elective admissions and bed days through expanded urgent, rehabilitation and reablement capacity at neighbourhood level
- Agree a plan to tackle unwarranted variation in access to general practice, ensuring core hours and the newly introduced urgent access requirements in the GMS contract are met
- Agree neighbourhood footprints aligned to natural communities for the future development of integrated neighbourhood teams
- Agree plans to establish INTs focused on high-priority cohorts (people with frailty, those approaching end of life, people with multiple long-term conditions, children and young people, and people living with cancer), including whether devolved care budgets are appropriate locally
- Begin planning a neighbourhood approach to elective pathways and confirm how the Better Care Fund will be used in line with national guidance
- Confirm data-sharing arrangements for robust patient identification and evaluation
If your practice has not yet had a conversation with your ICB about neighbourhood footprints or INT priorities, it is worth raising this proactively. The framework is explicit that health and wellbeing boards, not individual practices, will set the geography, but general practice clinical leadership is described as essential to the model working at all.
Neighbourhood Health Centres: What the Estate Plan Means Locally
The government has committed to building and upgrading 250 Neighbourhood Health Centres (NHCs) by 2035, with 120 delivered by 2030. These will bring GP services together with community, local authority and voluntary sector services under one roof. The framework confirms that 20% of new-build NHCs will be funded from public capital, with the rest funded through public-private partnerships, and that the first wave (2026/27) will largely focus on repurposing existing NHS Property Services and NHS Local Improvement Finance Trust (LIFT) estate in areas of highest deprivation, rather than new construction.
For practices, this raises genuine premises and contractual questions: what happens to an existing GP lease or licence if services are asked to relocate into an NHC; how co-location arrangements with community and voluntary sector partners are structured; and how existing LIFT or NHS Property Services arrangements interact with any new estate strategy. These are exactly the kind of commercial property and NHS regulatory questions where early legal input avoids expensive problems later. Our NHS regulatory compliance team and our healthcare team for GPs can help you work through what any local estates conversation means for your existing arrangements before you agree to anything.
What This Means for GP Partnerships
Two things are worth separating clearly. First, the framework itself does not change your GMS, PMS or APMS contract, your partnership structure, or your existing PCN participation. Second, it does set in motion a process, running through consultations, local ICB planning and (from 2027/28) local neighbourhood health plans, that is likely to change how enhanced and neighbourhood-level services are commissioned around your practice over the next three years.
For GP partnerships, the practical governance question is what legal form you use if your practice wants to take on a role in a Single Neighbourhood Provider or a wider consortium arrangement. The consultation makes clear an SNP contract holder must be a legal entity, and this could be an existing lead practice acting for others, a new limited liability partnership, or a Community Interest Company. Whichever route your PCN or practice group considers, this has direct implications for your partnership agreement, profit-sharing arrangements and liability exposure between partners. If your partnership agreement was drafted before PCNs existed, or has not been reviewed since, now is a sensible time to have it looked at. Our guide, GP Partnership Agreements: What Every Partner Should Know, sets out what a modern agreement should cover.
What This Means for Your Practice
The Neighbourhood Health Framework does not require you to do anything differently in your consulting room tomorrow. But it does mark the start of a three-year process that will shape how your practice’s services are commissioned, funded and delivered alongside community, mental health and social care partners, and it puts a live consultation on the table (closing 10 September 2026) that could reshape how PCN funding and governance work from 2027 onwards. Practices that engage early, through their ICB, their PCN and, where relevant, the NHS England consultation, are better placed to influence the detail than those who wait for it to be decided for them.
If this affects your practice and you would like to talk through what it means for your partnership agreement, PCN arrangements or premises, get in touch with our healthcare team or call us on +44 207 566 1188. You can also email us at info@gurvelegal.com.
