NHSE reveals more details on neighbourhood contracts as consultation launched

NHS England has launched an eight-week consultation on the proposed new neighbourhood contract models, including further detail on what the contracts are expected to look like.

The consultation, launched today and closing on 10 September, is aimed at general practice, PCNs, ICBs, community and other providers, local authorities, patient representatives and other stakeholders.

Additional documents published as part of the consultation said that the single neighbourhood provider (SNP) contract is ‘an evolution’ of the PCN DES which local systems ‘can take forward at their own pace’.

Practices would have the option to remain in the PCN DES or ‘take up one of the other options if their commissioner proposes it’.  

There will be ‘minimum funding requirements’ for SNPs, to ensure practices do not see a drop in funding with the move to SNP, the documents added.

The consultation proposes using the NHS standard contract with an additional ‘neighbourhood’ schedule for commissioning a multi-neighbourhood provider (MNP). 

NHS England plans for MNPs to use their scale to ‘design and co-ordinate neighbourhood health services in their footprint’, which may include delivering NHS services directly at a larger scale than a single neighbourhood, or ‘filling in’ services within a single neighbourhood where it is locally agreed to be more appropriate for an MNP to deliver.

It said that trusts ‘may be more familiar’ with the NHS standard contract that NHSE sees ‘many organisations having the potential’ to take on MNP contracts.

NHS England is ‘considering a safeguard’ where commissioners would need to ensure there is ‘GP support for any MNP’.

The documents also said that there could potentially be more than one MNP contract within a single geography, for example one MNP contract may be focused on 24/7 urgent general practice and another focused on coordinating integrated neighbourhood teams to deliver a service.  

And where integrated health organisations (IHOs) contracts are established, the contract holder will ‘take on responsibility for resource allocation and service planning’ for the whole care pathway.

The commissioner said that it wants the process to be ‘transparent and accessible’, even though the subject matter itself is ‘complex’.

NHS England said: ‘We are keen to make it easier to commission neighbourhood health services, and this consultation sets out two proposed contract types to help do that.

‘Getting this right requires engaging with some technical topics – contracting models and NHS Standard Contract mechanics – and we know not everything will be familiar to everyone with a stake in the outcome.

‘That’s why our approach to this consultation is deliberately two-track. We are engaging directly with stakeholder groups who bring existing contracting and commissioning expertise, so we can test the detail of these proposals with people who can fully explore the detail.

‘Alongside this, we will run webinars for wider groups open to anyone who wants to understand the proposals better, regardless of their starting point.’

The consultation documents said that ‘in the short term’ NHSE wants to give commissioners the choice over keeping the current PCN DES or moving to one of the proposed options.

It added: ‘We see LMCs playing a key part in coordinating this transition with commissioners and practices.

‘We see the SNP contract as an evolution and a strengthening of the PCNs which have been running since 2019.

‘To that end, we will be protecting the PCN funding (including the Additional Roles Reimbursement Scheme) as systems move towards SNP contracts.’

NHSE said it would protect GP practice funding which could potentially be reduced if locally commissioned services are bundled into an SNP contract or modified PCN DES.

It said: ‘We would protect the income by putting minimum funding requirements in place for any variations to the PCN DES and in the SNP Contract.

‘We also think that for general practice to opt out of the PCN DES and switch to an SNP Contract, they will want to see not only simpler service specifications but additional services and funding.’

The contracts were announced as part of the 10-year plan and were initially expected at the end of last year.

Last week, the new BMA GP committee chair told Pulse that it is ‘completely necessary’ that partnerships are protected within the neighbourhood health model.

And a senior former adviser on neighbourhood health warned that the shift to neighbourhood health ‘will likely fail’ unless the new Prime Minister changes its current direction.

A new Pulse investigation has looked into what neighbourhoods and a new Prime Minister will mean for the future of GP local enhanced services.