Neighbourhood Health — Partners Playbook

What is Neighbourhood Health?

In one sentence: It's the NHS joining up GP practices, community services, mental health, social care and voluntary organisations to provide coordinated care closer to home.

Instead of patients bouncing between different services, the idea is that local teams work together — sharing information, coordinating care, and focusing on keeping people well rather than just treating them when they're ill.

The three big shifts ("the left shift")

Fragmentation → Cohesion: Ending the era of patients being passed from pillar to post across disconnected services
Crisis → Prevention: Proactively managing high-priority cohorts before conditions escalate into acute emergencies
Silos → Ecosystems: True partnership combining NHS clinical delivery with local authority social care and public health

What this isn't

It's not abolishing GP practices. It's not forcing you into a health centre. It's not replacing what works — it's about better coordination between services that already exist.

The 6 Core Components

NHS England has set out six building blocks that every area needs to have in place. Here's what they mean in practice:

1

Population Health Management

Using data to identify patients at risk before they become seriously unwell. Your ICB will provide risk stratification tools.

2

Modern General Practice

Streamlined access via NHS App, online consultations, Pharmacy First. Making it easier for patients to reach the right person first time.

3

Standardised Community Services

Consistent community nursing, therapy services, and mental health support across the neighbourhood — not a postcode lottery.

4

Neighbourhood MDTs

Multi-disciplinary teams wrapping around complex patients. GPs, nurses, social workers, pharmacists, and others meeting regularly to coordinate care.

5

Integrated Intermediate Care

"Home first" approach — rehabilitation and reablement at home rather than in hospital. Supporting safe discharge.

6

Urgent Neighbourhood Response

2-hour urgent community response and virtual wards. Treating people at home who would otherwise go to A&E.

The Neighbourhood Health Framework

On 17 March 2026, the government published the Neighbourhood Health Framework — the most significant policy document for primary care since the 10 Year Health Plan (published 3 July 2025). This sets out how neighbourhood health will actually work.

Three new contract types (from April 2027)

2026/27 is a developmental year only— none of these contracts go live until at least April 2027. But it's important to understand them now:

SNP (Single Neighbourhood Provider): ~50,000 population. Delivers INTs and new primary care services. Held by primary care networks/alliances. Shared risk for preventative care.
MNP (Multi-Neighbourhood Provider): ~250,000+ population. Designs and co-ordinates consistent services at scale. Held by scaled alliances. Shared risk across neighbourhoods.
IHO (Integrated Health Organisation): Whole system, geographically defined. Handles resource allocation, pathway planning, shifting acute spend to community. Held by designated advanced NHS foundation trusts. Ultimate holder of whole-population health budget.

Your GMS/PMS/APMS contract remains untouched — you operate within the SNP/MNP ecosystem, not under it.

Neighbourhood Health Centres

The government has committed to building physical neighbourhood health centres — single, consolidated community hubs bringing GP services, community care, VCSE services, local authority support, and Best Start Family Hubs under one roof:

27 centres open by 2027 (Wave 1 — repurposing existing NHS/LIFT estates in areas of high deprivation)
120 centres open by 2030
250 centres open by 2035

Wave 1 is aligned with the One Public Estate agenda. Many neighbourhoods will continue working as virtual teams across existing premises — NHCs are not mandatory.

The 10-Year Success Dashboard (2026-2029 targets)

Health outcomes: 10% reduction in non-elective admissions/bed days for frailty; 10% improvement in evidence-based clinical outcomes (CVD, diabetes, COPD, dementia)
GP access: 90% clinically urgent patients seen same day by March 2027
Planned care: 10% reduction in secondary care follow-up appointments by March 2027; 10% reduction in acute outpatient appointments for under-16s
Urgent/emergency care:82% four-hour A&E trajectory by March 2027; reduce Category 3 and 4 ambulance conveyances for frail/end-of-life cohorts
Patient and staff satisfaction: 95% of people with complex needs have an agreed care plan by 2027

The three clinical delivery agendas

The Blueprint sets out three parallel work programmes for neighbourhoods:

Agenda 1 — Routine Care: GP access recovery, Pharmacy First (prescribing by September 2026), AI-assisted triage, and frictionless primary-secondary interfaces via the Red Tape Challenge
Agenda 2 — Proactive Complex Care:Delivered via Integrated Neighbourhood Teams (INTs) focusing on frailty, end-of-life, multiple long-term conditions, and women's health hubs
Agenda 3 — Alternatives to Hospital: Expanded urgent community response, virtual wards, step-up/step-down intermediate care, and 24/7 mental health centres

Where GP practices sit in the new structure

The Blueprint sets out a five-level contracting hierarchy. Your practice is at Level 5 — and your GMS/PMS/APMS contract remains untouched:

Level 1 — ICB: The strategic commissioner
Level 2 — IHO: Holds whole-population capitated budget (held by advanced NHS Trusts)
Level 3 — MNP: Co-ordinates service delivery across multiple neighbourhoods
Level 4 — SNP: Delivers integrated teams within a defined single neighbourhood footprint
Level 5 — GP Practices: National GMS/PMS/APMS contracts remain untouched, but operate within the SNP/MNP ecosystem

What does this mean for you right now?

2026/27 is Stage 1 (Immediate Action): agree plans to reduce non-elective admissions, meet urgent GP access requirements, define initial neighbourhood footprints, and establish priority INTs. Stage 2 (Strategic Reform, 2027-2029) is when new contracts go live and final geographies are confirmed.

What's Actually Changing?

GP Contract 2026/27 (from 1 April 2026)

£485 million uplift (3.6% cash, 1.4% real terms)
Same-day access requirement: Clinically urgent patients must be seen the same day
Online consultation caps removed: Systems must not cap request volumes during core hours — parity with phone and walk-in
Advice and Guidance:Now embedded in core funding (was an enhanced service). Use A&G before planned care referrals where clinically appropriate
CAP retired: £292m moved from the PCN Capacity and Access Payment to practice-level GP Reimbursement Scheme
QOF additions:+18 points including obesity indicators, updated diabetes (all 8 NICE care processes), heart failure “4 pillars”, enhanced childhood vaccination indicators

ARRS changes for 2026/27

GP eligibility expanded: Any GP can now be recruited through ARRS (the 2-year qualification restriction has been removed)
GP reimbursement increased: Maximum salary reimbursement rises to £118,759 (£120,921 in London)
Flexible roles: PCNs can recruit non-direct patient care roles from ARRS budget if agreed with commissioner
Advanced practice: Mandatory accreditation requirement for advanced practice nurses dropped

For your practice

Digital access: NHS App, online consultations (no more capping), structured triage at first contact
Data sharing: Working towards a single shared record across health and social care
Care coordination: 95% of complex patients should have a care plan by 2027
MDT participation: Regular multi-disciplinary meetings for your neighbourhood
Priority cohorts: Focus on frail elderly, housebound, care home residents, end-of-life
PCN alignment: Work with your ICB to align PCN boundaries with neighbourhood footprints where needed

At system level

ICB mergers (Phase 1 — live): England now has 36 ICBs (down from 42). Thames Valley ICB is live, serving Bucks, Oxon and Berks. Phase 2 mergers planned for April 2027
Neighbourhood Health Providers:New contract types (SNP, MNP, IHO) defined in the Framework but won't go live until April 2027 at earliest
Place-based working:More decisions made at local “place” level rather than region
AI-assisted triage pilots: Rolling out to GP practices under the Neighbourhood Health Service

Priority patient cohorts (continuing into 2026/27)

Adults with moderate-to-severe frailty
Care home residents
Housebound patients
People with palliative/end-of-life care needs
Frequent A&E attenders

Over 75s living with frailty represent 25% of non-elective admissions and 50% of bed days. The Framework targets: 95% of these patients with care plans by 2027, and a 10% reduction in non-elective admissions by March 2029.

Integration beyond healthcare

The Blueprint expects neighbourhoods to link with wider public services:

Best Start Family Hubs: Streamlining 0-5 health services and early child development
Young Futures Hubs: Targeted early mental health advice and youth support
WorkWell & Pathways to Work: Integrating health and employment support
Pride in Place: Engaging neighbourhood boards in overlooked communities to shape local health priorities
Changing Futures: Holistic support for multiple disadvantage (homelessness, rough sleeping, substance use)

How it's being funded

Key principle: neighbourhood health will be funded by rebalancing existing resources out of the acute sector, not relying on entirely new funding streams. Three approaches:

Amending block contracts (2026/27): Adjusting payment flows to help systems invest in the left shift
Incentivising deflexion:New payment approaches that explicitly reward neighbourhoods for reducing A&E attendances and non-elective hospital admissions
Population budgets: Risk- or outcome-based contracting (like IHOs) to capture the financial value of preventative care

What Stays the Same?

The fundamentals aren't changing

GP practices remain independent contractors. Your GMS/PMS contract continues. Patients stay registered with your practice. You remain the clinical backbone of the neighbourhood.

PCNs aren't going away

The guidance builds on PCNs rather than replacing them. Your PCN is the foundation — Integrated Neighbourhood Teams add extra layers around it (community services, social care, voluntary sector).

PCN boundaries might not perfectly match neighbourhood footprints, so some cross-boundary working may be needed, but the structure stays.

You're not being forced into a health centre

The government has committed to 250 Neighbourhood Health Centres by 2035 (27 by 2027, 120 by 2030). But these are optional physical hubs — not mandatory. The model is about coordination, not co-location. Many neighbourhoods will continue working as virtual teams across existing premises.

Timeline

January 2025

Neighbourhood Health Guidelines 2025/26 published

3 July 2025

"Fit for the Future" 10 Year Health Plan published

October 2025

Medium Term Planning Framework published (covers 2026/27 to 2028/29)

17 March 2026

Neighbourhood Health Framework published — defines SNP, MNP and IHO contract types, five national minimum goals

April 2026 (Now)

ICB Phase 1 mergers live (42 to 36 ICBs). GP Contract 2026/27 in effect. ARRS GP eligibility expanded. Pharmacy First prescribing expected by September 2026. 2026/27 is the developmental year (Stage 1) — agree plans to reduce non-elective admissions, define neighbourhood footprints, establish priority INTs.

April 2027

ICB Phase 2 mergers (to ~26 ICBs). New neighbourhood provider contracts (SNP, MNP, IHO) expected to go live. First 27 Neighbourhood Health Centres open.

2027-2029

Stage 2 Strategic Reform: locally owned Neighbourhood Health Plans via HWBs, incorporated into ICB 5-Year Strategic Commissioning Plans. Final geographies confirmed, IHO governance structures formalised. 82% four-hour A&E trajectory. 10% reduction in non-elective frailty admissions by March 2029.

2030-2035

120 Neighbourhood Health Centres by 2030, 250 by 2035. Full integration with wider public services. NHS App as full front door to the NHS by 2028.

Glossary

NHS jargon decoded:

INT

Integrated Neighbourhood Team

The core engine of neighbourhood health. GPs, nurses, therapists, care workers and others delivering assessment, care planning, and co-ordination for the most vulnerable. Not mandated by form, but by function — how they look will vary locally. Key focus areas: frailty and end-of-life, multiple long-term conditions (CVD, diabetes, COPD, dementia), and children and young people (universal community access by 2028/29).

NHF

Neighbourhood Health Framework

Published 17 March 2026, this sets out the plan for neighbourhood health including new contract types, national goals, and the path to Neighbourhood Health Centres.

SNP

Single Neighbourhood Provider

New contract type serving ~50,000 population in one neighbourhood. Can be held by GP practices building on existing GMS/PMS contracts. Expected from April 2027.

MNP

Multi-Neighbourhood Provider

New contract type coordinating across multiple neighbourhoods (~250,000+ population). For federations and primary care collaboratives. Expected from April 2027.

IHO

Integrated Health Organisation

New contract type holding a whole-population health budget for a defined area. The most integrated form of neighbourhood provider. Expected from April 2027.

NHC

Neighbourhood Health Centre

Optional physical hubs bringing GP, community, and social care under one roof. 27 planned by 2027, 120 by 2030, 250 by 2035. Not mandatory — many neighbourhoods will work as virtual teams.

PCN

Primary Care Network

Groups of GP practices working together, typically covering 30,000-50,000 patients. PCNs remain the foundation of neighbourhood working — they're not being replaced.

ICB

Integrated Care Board

The NHS organisation responsible for planning and funding health services in your area. Phase 1 mergers reduced ICBs from 42 to 36 in April 2026. Phase 2 (April 2027) will bring it to ~26.

ICS

Integrated Care System

The wider partnership of NHS, councils, and voluntary sector in your area. The ICB is the NHS bit; the ICS is everyone together.

MDT

Multi-Disciplinary Team

A team meeting where different professionals discuss complex patients together — typically GP, district nurse, social worker, pharmacist, and others as needed.

ARRS

Additional Roles Reimbursement Scheme

Funding for PCNs to employ extra staff — clinical pharmacists, social prescribing link workers, physiotherapists, mental health practitioners, etc.

VCFSE

Voluntary, Community, Faith and Social Enterprise

The "third sector" — charities, community groups, faith organisations. Neighbourhood working expects closer integration with these local organisations.

UCR

Urgent Community Response

2-hour response service for urgent (but not 999) needs. Aims to treat people at home who would otherwise go to A&E or be admitted.

Virtual Ward

Hospital-level care delivered at home with remote monitoring. Patients who would otherwise be in a hospital bed are cared for in their own home.

Population Health Management

PHM

Using data to identify at-risk patients proactively, rather than waiting until they're ill. Your ICB should provide risk stratification tools.

Place

The local area within an ICB — often a council boundary. "Place-based" working means decisions made closer to communities, not at regional level.

HWB

Health and Wellbeing Board

Joint committee of NHS, local authority and other partners. Under the Blueprint, HWBs will develop locally owned Neighbourhood Health Plans and set whole-life-course outcome measures.

JSNA

Joint Strategic Needs Assessment

The data-driven assessment of local health needs produced by HWBs. The Blueprint uses JSNAs to set locally tailored outcome measures alongside the national goals.

Practice Readiness Checklist

A starting point to think about where you are. You don't need to tick everything — but it's helpful to know where the gaps are.

Don't panic

You don't need to have all of this in place today
Much of this will be led by your ICB and PCN, not by individual practices
The point is awareness — knowing what's coming so you can engage, not be surprised