A plain-English guide for GP practices in England
Updated April 2026In 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.
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.
NHS England has set out six building blocks that every area needs to have in place. Here's what they mean in practice:
Using data to identify patients at risk before they become seriously unwell. Your ICB will provide risk stratification tools.
Streamlined access via NHS App, online consultations, Pharmacy First. Making it easier for patients to reach the right person first time.
Consistent community nursing, therapy services, and mental health support across the neighbourhood — not a postcode lottery.
Multi-disciplinary teams wrapping around complex patients. GPs, nurses, social workers, pharmacists, and others meeting regularly to coordinate care.
"Home first" approach — rehabilitation and reablement at home rather than in hospital. Supporting safe discharge.
2-hour urgent community response and virtual wards. Treating people at home who would otherwise go to A&E.
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.
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:
Your GMS/PMS/APMS contract remains untouched — you operate within the SNP/MNP ecosystem, not under it.
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:
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 Blueprint sets out three parallel work programmes for neighbourhoods:
The new contract types create a layered structure. Your practice is at Level 5 — and your GMS/PMS/APMS contract remains untouched:
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.
Over 75s living with frailty, those at end of life, and care home residents account for 3-5% of the population yet represent over 25% of non-elective admissions and 50% of bed days. The Framework targets: 95% of people with complex needs with care plans by 2027, and a 10% reduction in non-elective admissions by March 2029.
The Blueprint expects neighbourhoods to link with wider public services:
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:
GP practices remain independent contractors. Your GMS/PMS contract continues. Patients stay registered with your practice. You remain the clinical backbone of the neighbourhood.
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.
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.
NHS jargon decoded:
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).
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.
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.
New contract type coordinating across multiple neighbourhoods (~250,000+ population). For federations and primary care collaboratives. Expected from April 2027.
New contract type holding a whole-population health budget for a defined area. The most integrated form of neighbourhood provider. Expected from April 2027.
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.
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.
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.
The wider partnership of NHS, councils, and voluntary sector in your area. The ICB is the NHS bit; the ICS is everyone together.
A team meeting where different professionals discuss complex patients together — typically GP, district nurse, social worker, pharmacist, and others as needed.
Funding for PCNs to employ extra staff — clinical pharmacists, social prescribing link workers, physiotherapists, mental health practitioners, etc.
The "third sector" — charities, community groups, faith organisations. Neighbourhood working expects closer integration with these local organisations.
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.
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.
Using data to identify at-risk patients proactively, rather than waiting until they're ill. Your ICB should provide risk stratification tools.
The local area within an ICB — often a council boundary. "Place-based" working means decisions made closer to communities, not at regional level.
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.
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.
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.