Consultation on new neighbourhood contracting models: Key points on SNPs and MNPs

NHS England has published its long-awaited consultation on two new contracting models designed to support the delivery of neighbourhood health services.

The proposals set out how Single Neighbourhood Providers (SNPs) and Multi-Neighbourhood Providers (MNPs) could help integrated care boards (ICBs) commission more joined up, population-based services across defined geographical areas.

This is the first detailed proposal setting out the contractual framework that would underpin the Neighbourhood Health Service outlined in the 10-Year Health Plan. Rather than introducing a new national contract, NHS England is proposing two optional local contracting models aimed at supporting the shift of services from hospitals into community settings and refocusing commissioning on population-based outcomes rather than individual services.

We set out key questions and answers to help clarify the proposals.

Will core GP services be in scope?

No. An important reassurance for general practice is that core GP services will continue to be commissioned via the GMS, PMS and APMS contracts.

What are SNPs and MNPs?

NHS England is proposing a two-tier provider model for neighbourhood services:

• SNPs operating at neighbourhood level, often around 50,000 population.
• MNPs operating across multiple neighbourhoods, typically around 250,000 plus population but no national size is proposed.

What does the consultation say about SNPs?

• Legal form: Only “eligible providers” will be entitled to hold SNP contracts. While the full criteria are not stipulated, there is an expectation that they must have a registered patient list. This would mean they are open to GP providers or consortium.
  Role: The SNP will be responsible for the delivery of enhanced neighbourhood-level primary medical services through integrated neighbourhood teams.
• Type of contract: The SNP is effectively the proposed evolution of the current Primary Care Network (PCN) DES model which aims to move towards clearer neighbourhood level contracting. The proposal is that the services requirements will be commissioned either as a variation to the PCN DES (any such variation would need the approval of NHS England) or via a new SNP contract (the form and detail of which are unclear). The consultation is clear that PCN DES and SNP arrangements should not co-exist in the same geography. Where SNP arrangements are adopted, we will see existing PCN DES arrangements being replaced.
• Options available: Three commissioning models are provided for in the consultation. 
  • Option 1 – localised PCN DES: ICBs continue using PCNs but with greater local flexibility through NHS England-approved variations.
  • Option 2 – direct SNP commissioning: ICBs commission SNPs directly using the new SNP contract. Practices voluntarily move from PCN DES to SNP arrangements.
  • Option 3 – MNP commissions SNPs: ICB commissions one MNP which then subcontracts neighbourhood-level services to SNPs. NHS England suggests this may become the most integrated model because it links neighbourhood delivery with multi-neighbourhood outcomes.
• Services covered: The consultation does not stipulate the services that will be covered but as a proposed evolution to the PCN DES model, and with commitments around funding levels under SNPs at least mirroring those under the PCN DES, it is assumed that they will replicate to a large part the requirements currently falling on PCNs.

What does the consultation say about MNPs?

• Legal form: It confirms that the MNP must be a legal entity (be that a GP federation, single large provider, NHS trust or otherwise) and whilst the detail is light it appears that there will be no restrictions on the type of legal entity that will be capable of holding the contract.
• Collaborations: Collaborations of providers are recognised as a possibility, but they will either need to nominate a lead provider to hold the contract on behalf of the consortium or establish an umbrella legal entity to sit above them.
• Role: It is proposed that the MNP would coordinate neighbourhood services, contract with SNPs, manage outcomes-based arrangements and potentially hold wider service budgets and pathway responsibilities.
• Type of contract: MNPs would be commissioned under the NHS Standard Contract with a new Neighbourhood Schedule and awarded through the Provider Selection Regime or other applicable procurement routes.
• Options available: Recognising that some existing contractual arrangements may already cover neighbourhood services, two proposals are put forward:
  • Option 1 – commissioning coordination model: The ICB retains existing provider contracts, while the MNP coordinates service delivery and integrated neighbourhood teams across those providers. Existing contracts remain in place.
  • Option 2 – Lead provider model: The MNP becomes responsible for delivering the whole neighbourhood service model and subcontracts to other organisations. Existing contracts would need to expire or be terminated.
• Services covered: While not an exhaustive list, the consultation envisages MNPs potentially coordinating or working with SNPs to commission urgent primary care (being a bundling of PCN extended access, GP out of hours, 111, minor injuries and urgent treatment services), outpatient services, medicine optimisations, general practice resilience, leadership and transformation.
• Interaction with GP practices/SNPs: Clearly, the MNPs will need to work closely with the SNPs in their given area. This is supported by a potentially far-reaching statement that commissioners would want confirmation that the local GP practices in the relevant SNPs support the Multi Neighbourhood Provider.

What are the opportunities?

The proposals could provide a number of opportunities, including:

• New population-based contracts.
• Greater local commissioning flexibility.
• Potential for outcomes-based incentives.
• Stronger role for primary care-led providers in the wider health and care ecosystem.

What are the challenges?

The challenges are likely to be wide-ranging, but the most significant include:

• Lack of detail on funding, governance and accountability.
• Procurement processes could favour larger providers.
• The relationships between MNPs, SNPs and GP practices are likely to be complex, and contractual arrangements alone will not be enough to realise the necessary collaborations.
• Existing contractual arrangements may limit efforts to deliver on the ambitions of the MNP and SNP models.

Have your say

NHS England is keen to hear from ICBs, general practice, PCNs, community and care providers, local authorities, patient representatives and other stakeholders. Patients and members of the public are also encouraged to share their views.

You can respond to the consultation here. The consultation is open until 10 September 2026.

Responses will help shape the final SNP and MNP contracting models.

A further consultation on the final proposals for both contracts is expected later this year. 

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