Two new contracts will be introduced from 2026 to encourage GPs to work across larger areas and lead ‘neighbourhood health services’ aimed at shifting care away from hospitals and into the community, the Government’s long-awaited 10-year health plan has said.
Launched today by Prime Minister Keir Starmer, the plan has said the two contracts will allow for the delivery of ‘enhanced’ services across differently sized population groups in England.
The first will support health services for a single neighbourhood – groups of around 50,000 people with similar needs – and likely to be based on the existing ‘PCN footprint’.
A second contract will be for larger providers working across several neighbourhoods with a population of 250,000 or more, and which will have much wider responsibilities including being able to take over the running of poorly performing GP practices or those struggling financially (see also box below).
At the heart of this new model will be the creation of neighbourhood health centres based in local communities, open 12 hours a day and six days a week.
They will bring bigger health teams together under one roof, and include nurses, doctors, social care workers, pharmacists, health visitors, palliative care staff, and paramedics. The centres will also offer services like debt advice, employment support and stop smoking or weight management, which affect health, the Government has said.
In addition, ICBs will be given powers to contract a wider range of providers – including NHS trusts – for neighbourhood health services.
The plan 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.’
Significantly, the Government has promised that health spending patterns will change so ‘the share of expenditure on hospital care will fall’ and proportionally greater investment be pumped into out of-hospital care. This shift in funding will take place over the next three to four years as neighbourhood health services build up.
A business case on using public private partnerships for developing the new neighbourhood health centres will also be drawn up, with a final decision to be taken at the autumn budget.
As expected, the plan sets out wider reforms based on not just the principle of moving care from hospital to community but also shifting from analogue to digital and from sickness to prevention.
Key points for primary care include:
- Where needed, patients will get a same-day digital or telephone consultation.
- Rolling out tech tools over the next two years to support GPs. Ambient voice technology (‘AI scribes’), digital triage and the single patient record will end the need for clinical notetaking, letter drafting, and manual data entry, the plan said.
- A framework for procuring ambient AI tech will be produced in 2026/27 that can be accessed by all NHS organisations and will provide support for GPs in adopting it safely.
- A promise to make the NHS app ‘a full front door to the entire NHS’ by 2028. For example, a new AI-enabled tool called My NHS GP will help patients get instant advice for non-urgent care 24/7 and help finding the most appropriate service first time, such as to a community pharmacy. They will also be able to manage medicines and book vaccines.
- Encouragement of more innovation in health models so, for example, GPs could run hospitals or acute trusts run community services.
- A promise to reform the CQC so it’s more data-led and can respond to concerns quicker. In future, following an inspection, CQC will provide verbal feedback at the end of an inspection, and written feedback within two days outlining any significant concerns.
- GP contracts will be terminated where there is ‘persistent poor-quality care’.
- Extra funding to be targeted to areas with ‘disproportionate economic and health challenges.
In addition, there will be the trialling of new ‘patient power payments’, which means patients are contacted after care and given a say on whether the full payment for the costs of their care should
be released to the provider. Whether this applies to general practice is not specified however.
Prime Minister Keir Starmer said the plan will ‘fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps, harnesses game-changing tech and prevents illness in the first place’.
Health secretary Wes Streeting said: ‘This Government’s Plan for Change is creating an NHS truly fit for the future, keeping patients healthy and out of hospital, with care closer to home and in the home.’
The BMA warned that the success of the plan hinges on addressing workforce challenges, ensuring there is support from staff, and on resourcing.
BMA council chair Dr Tom Dolphin said: ‘The shift from hospitals to communities cannot happen overnight and without a detailed plan on resourcing it properly. Done too quickly and without thorough thought it risks heaping pressure on both hospitals and primary care by taking resource away from one while piling work on to the other.’
He also added: ‘The kind of care described in this announcement is already happening in many places – often led by GPs and involving a wide range of staff. If practices were given the resources they need they could build on their local relationships and ensure even better continuity of care. Meanwhile different venues for people to access care and improvements to the NHS App seem positive, but miss an open goal to fix and expand NHS buildings and GP practices – and overhaul the outdated and incompatible IT that the NHS relies on – so services can meet patients’ needs.’
The Association of Independent Specialist Medical Accountants (AISMA) said moving services into the community was to be welcomed but also said it wasn’t clear how this will be funded.
Andy Pow, adviser to AISMA said: ‘Investment will be required to develop new and existing premises and to employ staff in the community. It remains unclear how this funding challenge will be met.’
Mr Pow also said there was no detail on how the new neighbourhood health service will interact with general practice.
‘Who will run the new contracts envisaged by the government? Who will be the employer and what will the legal structure be? These are important considerations which must be thought through carefully to avoid the pension access and taxation issues which arose when primary care networks were formed,’ he said.
What powers will multi-neighbourhood providers have?
GPs will be able to sign up to a new contract to lead ‘multi-neighbourhood providers’ that deliver care to several different neighbourhoods covering a population of 250,000 or more. However, these multi-neighbourhood providers will also be responsible for:
- unlocking the advantages and efficiencies possible from greater scale,
working across all GP practices and as well the smaller neighbourhood providers in their footprint. - delivering a shared back-office function, overseeing digital transformation and
estate strategy. They will also provide data analytics and a quality improvement function. - creating new commercial partnerships, including clinical trials, to encourage innovation.
- actively support and coach individual practices that struggle with either performance or finances – including by stepping in and taking over when needed.
Source: UK Government
