PCN DES confirms footprints will need to change to align with neighbourhoods

PCNs will be contractually required to split up and re-form if their footprints are not aligned with ‘neighbourhood health’ plans, NHS England has confirmed.

The move, first announced in the contract letter to the BMA in February, will only be enforced in ‘limited cases’, according to NHSE Network Contract DES guidance for 2026/27.

The Government had previously said this ‘is not intended to signal widespread reconfiguration of PCNs’ and an explanatory note from NHS England on the DES, published yesterday, reiterated that stance.

It said: ‘PCNs are required to work with their ICB to better align PCN lists with neighbourhood boundaries, this is only intended for limited cases where current geography does not reflect local communities and is not intended to disrupt well‑functioning PCNs with geographically contiguous boundaries.’

From 1 April, the PCN contract will be updated to state neighbourhood collaboration as one of the core functions.

The guidance stipulates among four key functions of PCNs to ‘collaborate with non-GP providers to provide better care, as part of an integrated neighbourhood team’.

DAUK co-lead Dr Steve Taylor told Pulse: ‘The fact that current PCNs, which have only existed since 2019 and have only been properly functioning in the past few years, are potentially being split to fit with neighbourhood footprints shows how poorly thought through parts of neighbourhood health is. 

‘Breaking existing PCNs to fit with a new geographical neighbourhood seems to be the wrong approach.

‘It is also possible that on a smaller scale GP practices could find themselves in two or more neighbourhoods, to fit with geographical “natural communities”.

‘This top-down approach to community care risks losing much of what has already been developed in communities for the sake of a “vision” not shared by all who will have to provide it.’

The PCN DES also states that practices will be contractually required to risk-stratify patients for continuity of care, as reported by Pulse this morning.

Meanwhile, among other non-clinical updates, the DES will now contractually require practices to participate in the General Practice Staff Survey.

And NHS England’s explanatory note said GPs hired via the Capacity and Access Payment can move to the practice-level reimbursement scheme when the £292m pot gets repurposed from 1 April.

It said: ‘We have repurposed the Capacity and Access Payment, worth £292 million, to introduce a new practice‑level GP reimbursement scheme. This will enable practices to recruit new GPs or increase the number of sessions from GPs already working in the practice.

‘These changes are designed to strengthen clinically urgent same‑day access in general practice. GPs already employed through this funding will be eligible to transfer to the GP reimbursement scheme.’

As previously reported, the changes will also see the existing PCN-level additional roles reimbursement scheme (ARRS) opened up to experienced GPs, and not just those that are recently qualified.

NHS England’s guidance said that ‘in order to support the recruitment of GPs via the ARRS’ it will increase the maximum reimbursement amount that PCNs can claim from £82,418 in 2025/26 to £118,759 in 2026/27 and to £120,921 for GPs in London (representing the top of the salaried GP pay range).

‘This reflects that the scheme is now open to a wider range of GPs,’ it said.

GP practices that are signed up to the Network Contract DES will have their participation automatically renewed from 1 April, unless they opt out by 30 April.