Neighbourhood contracts to be developed in the next financial year, says NHS England

New neighbourhood contract models will be developed in the next financial year, NHS England has said, as GP leaders raised concerns around the lack of extra funding associated with the model.

NHSE said that 2026/27 will be ‘a developmental year’ for the new contractual models announced as part of the 10-year health plan – despite the contracts initially being expected at the end of last year.

It comes after the Government confirmed earlier this week as part of a new framework that NHS trusts will have commissioning responsibilities for primary care, through new integrated neighbourhood organisation (IHOs) contracts.

In response to the framework, the BMA and RCGP said that GPs need to be at the centre of the discussion around the new contracts, while pointing out that the framework was published without any new funding attached to it.

NHS England said that it expects ICBs to be able to set out how they will have begun implementing some ‘outcome-based’ contracts ‘within three years’, with a view to integrated neighbourhood organisation (IHOs) contracts ‘becoming the norm’.

NHS England will designate the ‘first wave’ of providers eligible to hold IHO contracts ‘in Spring 2026’, it added.

The Government will consult on how multi-neighbourhood providers and single neighbourhood providers (see box) will work together with GMS and the PCN DES, including how primary care networks ‘might evolve into single neighbourhood providers’.

It also clarified that GMS and APMS contracts ‘will continue to be determined nationally and commissioned locally’.

According to the document, ICBs will contract a single IHO for an area, and the IHO will then contract a number of multi-neighbourhood providers, each of which will work with multiple single neighbourhood providers.

NHS England said: ‘Notwithstanding progress which has already been demonstrated by some local teams, 2026/27 will be a developmental year for the new contractual models.

‘The Department of Health and Social Care and NHS England will work closely with the first new single neighbourhood and multi-neighbourhood providers to develop the neighbourhood care model, and with ICB colleagues to develop new payment models to support neighbourhood services, including for the high-priority cohorts. We will outline the co-designed payment approaches for all ICBs to consider shortly.

‘In addition, we will continue to work with Integrated Health Organisation (IHO) and advanced foundation trust front runners, and their commissioners, to ensure that contracts and financial flows support the shift of resources into neighbourhoods.’

In a webinar this week, the BMA’s GP committee pointed out that no new funding was attached to the framework, and it stressed that GPs need to be involved in the reform.

GPC chair Dr Katie Bramall said: ‘In the publication of system architecture, you can see the language. It feels like a game of chess is being played whether or not we’re at the table, and yet we know this is doomed.

‘There’s no money, there’s no resource, there’s no time. Most likely what will happen is the status quo. Nothing will change, and I’m sorry, but nothing changing is a disaster for general practice in England.’

The BMA already argued that GPs must take leadership roles within neighbourhoods now, rather than wait for new contracts to be published by the Government – and it also warned that encouraging trusts to take over GP practice premises suggests the Government wants secondary care to lead neighbourhoods, rather than GPs.

The RCGP said that the framework provided ‘some clarity’ but that many details ‘still need to be worked through’ to ensure that the model is sustainable ‘in practice’.

RCGP chair Professor Victoria Tzortziou Brown said: ‘GPs must be central to both national and local discussions on how neighbourhood services are developed, and the model must remain firmly patient-centred.

‘The framework also sets out a range of national targets and outcomes. It will be important that these are developed transparently and co-designed with clinicians and patients, so they are meaningful, measurable and reflect what really improves care and outcomes.

‘The framework highlights the scale of expectations placed on general practice, which is already delivering very high volumes of care relative to its share of NHS resources, so these plans must be matched with sustained investment in the GP workforce and premises.

‘Clear governance and contracting arrangements will also be needed so that accountability is understood across neighbourhood services, and so that implementation reduces rather than adds to complexity, duplication and inefficiency across the wider system.’