Two new GP contracts to support care across larger areas, says NHS 10-year plan

The Government will introduce two new contracts aimed at enabling GPs to work across larger geographies, according to its long-awaited 10-year plan for the NHS.

Set to roll out early next year, the new contracts will offer ‘an alternative’ to the traditional GP partnership model, the document released this morning confirmed, and will also be offered to hospital trusts.

The first of the new contracts will support the creation of ‘single neighbourhood providers’, delivering enhanced services to people with similar needs across a defined local area, typically covering a population of around 50,000 – similar in scale to current Primary Care Networks.

The second will establish ‘multi-neighbourhood providers’, which will serve around 250,000 people and focus on delivering services that require coordination across multiple neighbourhoods, such as end-of-life care.

ICBs will also be given powers to contract a wider range of providers – including NHS trusts – for neighbourhood health services.

Multi-neighbourhood providers will ‘actively support and coach’ individual practices who struggle with either performance or finances. including by ‘stepping in and taking over when needed’, the plan added.

The document said: ‘Where the traditional GP partnership model is working well it should continue, but we will also create an alternative for GPs.

‘We will encourage GPs to work over larger geographies by leading new neighbourhood providers. These providers will convene teams of skilled professionals, to provide truly personalised care for groups of people with similar needs.’

The plan also promises to ‘shift the pattern of health spending’ with ‘greater investment’ into out-of-hospital care, adding that over the next decade the share of expenditure on hospital care will fall.

‘We will also deliver this shift in investment over the next three to four years as local areas build and expand their neighbourhood health services,’ it added.

It also renews the Government’s promise to ‘train thousands more’ GPs ‘in the coming years’ and increasing the proportion of staff trained for community and primary care roles, as well as new NHS app functions including ‘instant advice’ for non-urgent care, and wider use of artificial intelligence in general practice.

The plan also cements the Government’s intention to consider private investment in primary care infrastructure, including Public Private Partnerships (PPP).

It will bring forward a proposal for a new programme to establish a neighbourhood health centre ‘in every community across the country’.

It added: ‘We will start now, in some of the most deprived communities, by using public capital to update and refurbish existing, under-used buildings. However, we also need new facilities, developed through a rolling approach, to realise our ambition.

‘We will progress rapidly, working across government, on a business case around neighbourhood
health centres that sets out the potential and an assessment of value for money so that a final decision on the approach can be taken by the time of Budget 2025 in the autumn.’

Prime Minister Sir Keir Starmer said: ‘More care will be available on your doorstep and from the comfort of your own home. It will be easier to see a GP and neighbourhood health centres will be available in every community.

‘This is a time for radical change – major surgery, not sticking plasters. The measures in this plan are radical and urgent. It won’t be easy, but the prize will be worth it. This is a plan that will take the NHS from the worst crisis in its history, and renew it so it serves generations to come.’

Health secretary Wes Streeting said: ‘NHS staff, and our social care workforce, are up for the challenge. I am sometimes told that they are resistant to change. In my experience, they are crying out for it.

‘They have suffered the moral injury of turning up to work, slogging their guts out, only to leave at the end of the day feeling exhausted and demoralised by the conditions that patients are being treated in because of circumstances beyond their control.

‘They are the ones driving innovation on the frontline and their fingerprints are all over some of the best ideas in this plan.’

It comes after Mr Streeting argued that as part of a radical reform of the NHS, acute trusts should be able to provide primary care services and that ‘successful GPs’ should be ‘able to run local hospitals’.

The BMA has recently raised concerns about plans to transfer some ICB functions to neighbourhood teams, saying that these pose an ‘existential threat’ to GPs as independent contractors.

The two new GP contracts

1) ‘single neighbourhood providers’

They will deliver enhanced services for groups with similar needs over a single neighbourhood (c.50,000 people). In many areas, the existing primary care network (PCN) footprint is ‘well set up as a springboard for this type of working’.

2) ‘multi-neighbourhood providers’

Serving 250,000 people, these larger providers will deliver care that requires working across several different neighbourhoods (e.g. end of life care).

They will work across all GP practices and smaller neighbourhood providers in their area.

They will support ‘sustainability and professional autonomy’ by delivering a shared back-office function, overseeing digital and estate strategy, and by ‘providing data analytics and a quality improvement function’.

They will be large enough to create new commercial partnerships, including clinical trials.

They will actively support and coach individual practices who struggle with either performance or finances – including by stepping in and taking over when needed.

Source: NHS 10-year plan