The GP Contract 2026/27 and the Neighbourhood Health Delay: Piecing Together What We Know
- 6 hours ago
- 4 min read
Updated: 5 hours ago
On 12th February, the HSJ reported that neighbourhood provider contracts won’t arrive until 2027–28 at the earliest. On 24th February, the official GP contract letter for 2026/27 landed from Dr Amanda Doyle.
I think it’s important to look at these documents together and to keep in mind what’s still to come to help us take a measured approach.
In this blog, we cover:
What's actually changing in the 2026/27 GP contract
What the neighbourhood health delay means
Why do you need to read them together
And six questions every PCN should be asking right now
The blog at a glance
The GP Contract 2026/27: What’s Actually Changing?
The headline figure is £485 million of additional investment, bringing the total GP contract value to £13.86 billion. That’s a 3.6% cash increase or 1.4% real terms growth. But the number that matters most for PCNs is £292 million.
That’s the amount being repurposed from the PCN-level Capacity and Access Payment into a new practice-level GP reimbursement scheme. The CASP and CAIP are being removed from the Network Contract DES entirely.
The money is moving from the network level back to individual practices, specifically to fund GP recruitment and additional sessions for same-day urgent access.
Many PCNs distribute this money to practices anyway, but this will obviously impact those that do not.
On ARRS, the restriction limiting GP recruitment to recently qualified GPs has been removed. The maximum reimbursable amount is increasing to the top of the salaried GP pay range, plus on-costs. PCNs can also recruit broader roles where agreed with commissioners.
There are new expectations, too. PCNs must ensure care home residents are offered vaccinations. Cancer referral requirements are being strengthened.
Continuity of care through risk stratification is becoming a core expectation. And PCNs will be required to align their registered lists with neighbourhood boundaries where they don’t currently match.
At the practice level, clinically urgent patients must now be seen the same day, online consultation systems cannot cap requests, and practices showing unwarranted variation must engage with ICB support.
QOF changes include new obesity indicators, updated heart failure measures, and improvement thresholds for childhood vaccinations.
The Neighbourhood Health Delay: What It Means
Now place the contract letter alongside the HSJ report. The 10-Year Health Plan said neighbourhood provider contracts would begin rolling out this year. That’s not happening.
The SNP and MNP contracts won’t arrive until 2027–28 at the earliest, and a public consultation still needs to happen first. But I would be surprised if those in the National Neighbourhood Health Implementation Programme (NNHIP) aren’t already exploring what those contracts could look like.
In the HSJ article, Sir Jim Mackey described 2026–27 as a “stabilisation” year — local development of neighbourhood working, not formal contract structures. A “model neighbourhood” document is expected imminently, so hopefully we will know more soon.
My take is to treat your neighbourhood development as business as usual.
Why Context Matters
Here’s why reading these two documents together matters more than reading either one alone.
The GP contract is pulling £292 million out of PCN-level payments and back to practices. At the same time, it’s adding expectations at the PCN level, care homes, cancer, continuity, and neighbourhood alignment. And the contract structures that were supposed to support the next phase of neighbourhood health? Delayed by at least a year.
The direction hasn’t changed. Neighbourhood health is still the stated ambition. But there is a gap between vision and infrastructure.
That’s not a criticism. It’s a description of where we are.
Resist the Noise and the Gossip
There will be lots of clickbait headlines, and it’s really tempting right now to react, to conflate, to catastrophise.
I’d encourage you not to. We still need to see what emerges from the 2nd March webinar. We still need to see the actual GP contract, the PCN DES and neighbourhood guidance to come.
Final Thoughts
It’s like a game of chess. NHS England has made some moves. Let’s pause, take stock
What do our practices think of the perceived changes?
What’s the impact of the Capacity and Access funding being removed?
Does our PCN geography match what our ICB considers a neighbourhood?
What’s the impact of ensuring that eligible residents in aligned care homes are identified and offered seasonal and routine vaccinations in line with national recommendations?
What’s the impact of the new demand metrics for practices?
Can we articulate what the PCN does that practices cannot do alone?
If the honest answer is that the network has primarily been a funnel for funding, money in from the DES, money out to practices, then this letter has simply formalised what was already true.
If the network has been the thing that holds practices together, coordinates delivery, manages relationships with the ICB, and provides the leadership that no single practice can resource alone, then that value doesn’t disappear because the funding mechanism changes. It intensifies. The question is whether you can name it clearly enough that others see it too.
About Us
THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. With over 20 years in the industry, we've supported more than 200 PCNs through interim management, training, and consultancy.
Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blog posts sharing insights on primary care networks.
Check out our facilitation services here: https://www.thcprimarycare.co.uk/primary-care-network-facilitation
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