A summary of the new Neighbourhood Health Framework published by DHSC and NHS England

On 17 March 2026, the Department of Health and Social Care ("DHSC") and NHS England published the Neighbourhood Health Framework, setting out the government's vision for transforming how primary, community and social care services are planned, commissioned and delivered across England. 

This update is relevant for all independent providers who deliver, or wish to deliver, community, primary or integrated health services for the NHS.

Background

The neighbourhood health initiative is central to the government's 10 Year Health Plan for England, which committed to shifting care from hospital settings towards communities — what the government describes as the "left shift." The ambition is to organise NHS services around defined local populations, bringing together GPs, community health services, social care, and voluntary sector organisations to deliver more joined-up, preventative care closer to patients' homes.

The Framework, published alongside NHS England’s guidance on population health delivery models, sets out the governance structures, metrics, and new contractual models through which neighbourhood health will be delivered. Integrated Care Boards (“ICBs”) are being asked to begin implementing minimum requirements from the 2026/27 financial year, with more fundamental reform expected between April 2027 and March 2029.

New Contractual Models

The Framework introduces three new population-based contract types, each carrying distinct implications for independent providers:

• Single Neighbourhood Providers (SNPs): SNPs will deliver integrated neighbourhood team ("INT") services within a defined neighbourhood population of around 50,000. Importantly, the Framework contemplates that SNPs could be held by primary care providers, including general practice, building on existing General Medical Services ("GMS"), Personal Medical Services ("PMS") or Alternative Provider Medical Services ("APMS") contracts. NHS England has confirmed it will consult on how SNP arrangements will interact with Primary Care Networks, raising the possibility that existing independent primary care providers could transition into or alongside SNP contract holders.
• Multi-Neighbourhood Providers (MNPs): MNPs will co-ordinate delivery across multiple neighbourhoods, typically for populations of 250,000 or more. The Framework is less prescriptive about who may hold MNP contracts, creating a potential route for larger independent and third sector providers to play a significant role in commissioning and delivering neighbourhood health at scale.
• Integrated Health Organisations (IHOs): IHO contracts will “only ever be held by NHS organisations”. They give providers a whole population health budget for a defined geography. However, NHS England has indicated it will develop routes to enable "mature neighbourhood providers" to lead an IHO through alliances or joint ventures with statutory NHS bodies, which may open the door to some form of IS provider involvement.  This raises important structural and governance questions about how such arrangements should be constituted, and what protections will be needed in any sub-contracting or alliance agreements.
• SNP and MNP contracts: NHS England has confirmed it will provide further technical guidance for consultation on the implementation of novel SNP and MNP contracts, and will test out the different ways MNPs can be established and how the wider partnership of primary, community and social providers and an MNP relates to each other. Separately, NHS England will consult on how MNPs, SNPs, GMS and the PCN Directed Enhanced Service will work together, including how Primary Care Networks might evolve into SNPs. No specific date has been confirmed for this consultation, but 2026/27 will be a developmental year for all three new contracts, with DHSC and NHS England working closely with the first new SNPs and MNPs to develop the neighbourhood care model.
• IHO contracts: NHS England will designate the first wave of providers eligible to hold IHO contracts in Spring 2026, and will issue further detailed guidance in a Model IHO blueprint document in the coming months. The government's plan is for a small number of IHOs to become operational in 2027. A draft Advanced Foundation Trust Programme guide for applicants — setting out how newly authorised advanced foundation trusts can apply to become designated as capable of holding an IHO contract — was published for consultation in November 2025, with the final version expected in Spring 2026.
• Payment models: NHS England is working with some ICBs to develop new payment models to support neighbourhood services, including for high-priority cohorts, with the aim of reducing avoidable non-elective admissions, and will outline co-designed payment approaches for all ICBs to consider shortly. 

Forthcoming Consultations and Anticipated Timelines

The Framework is explicit that detailed contract terms for all three new models are still being developed, and independent providers should be aware of the following pipeline of consultations and publications:

Given this busy consultation calendar, stakeholders, including IS providers will need to act promptly to engage with each of these processes. 

Procurement Law Considerations

The Framework is clear that ICBs will be responsible for commissioning neighbourhood health services and setting contract terms. Under the Health Care Services (Provider Selection Regime) Regulations 2023 ("PSR"), NHS commissioners have discretion over how they procure health services, including whether to run competitive processes or make direct awards in certain circumstances. As these contracts are for, or mainly for, health care services, it is likely that the PSR will apply. In the absence of existing contracts, it is likely that the Competitive Process or the Most Suitable Provider Process will be used by ICBs to award new contracts. However, for areas that already have services similar to SNP and MNP contracts in place, modifications to existing contracts without these processes may be possible, which introduces the potential for certain direct awards to be made, depending on the extent of the changes to those contracts. This will need closer inspection on a case-by-case basis. 

Next Steps:

For now, the next steps for stakeholders, including IS providers, will be to look out for and then respond to the consultation on new contracts models and associated guidance. 

If you would like to discuss any of the matters discussed in this article, please contact Patrick Parkin, or another member of our Healthcare Team.