The NHS 10 Year Plan:How to prepare for the new neighbourhood contracts

I recently hosted an expert panel bringing together legal, financial, and clinical perspectives on what Dan Bunstone calls the "burning platform" facing primary care. Rather than simply admiring the problems or focusing on what's missing from the plan, we explored practical actions PCNs can take now.

"Do nothing at the moment probably isn't an option."

This is the stark warning from Ruth Griffiths, healthcare partner at Hill Dickinson, that captures the reality facing every PCN following the NHS 10 Year Plan. With implementation details expected in September/October 2025 and "Christmas falling right between" decision time and the April 2026 go-live date, the clock is already ticking.

This blog provides essential planning guidance for PCN development, plus access to our free Neighbourhood MOT assessment to evaluate your collaboration readiness and a link to the webinar if you missed this.

Let’s jump in!

Watch the webinar here

The NHS 10 Year Plan: Two-Contract Future

The NHS 10 Year Plan introduces two distinct contract types that will fundamentally reshape primary care delivery:

Single Neighbourhood Provider (SNP) Contracts

• Population: Approximately 50,000 patients

• Timeline: Expected from April 2026

• Key change: Current PCN DES likely rolled into these contracts

• Who qualifies: Existing PCNs and small federations

Multi-Neighbourhood Provider (MNP) Contracts

• Population: Around 250,000 patients

• Function: Umbrella coordinating multiple neighbourhoods

• Value: "Hundreds of millions" due to left-shift services

• Structure: Requires collaboration between providers

Ruth emphasised a critical point: "It's not a case of do I go for the SMP tier or do I go for the MNP tier? The two exist alongside each other."

What If You Don't Fit the Mold?

This was a popular question. What happens to PCNs under 50,000 patients or those in rural areas?

Ruth offered reassurance based on historical precedent: "If you look at what's come before with the way PCNs have run, yes, there has to be that flexibility because there can't be a one size fits all."

The Timeline Crunch

The panel laid out dates that should be circled on every PCN calendar:

• August 8, 2025: Pioneer ICB applications due

• September/October 2025: Implementation details expected

• December 2025 - January 2026: Begin scenario planning

• April 2026: New contracts go live

  
  

"The timescales are tight on this. Christmas falls right between September and go live in April." - Ruth Griffiths

Follow the Money

The financial implications are significant. Nick highlighted key concerns:

• PCN DES funding may disappear as a separate stream

• ARRS funding will "follow the services" to new contract levels

• ICBs can use alternative providers if PCNs aren't ready

By December, Nick advises practices and PCNs to start running some financial scenarios.

Real-World Success: The Pain Management Model

Vicki Maskell from Pure Unity Health demonstrated how scale can work in practice:

At PCN Level:

• Health coaches provide biopsychosocial support

• Pain cafes utilise patients' lived experience

• Early intervention prevents chronic conditions

At Scale:

• Consistent pathways across neighbourhoods

• Shared resources and expertise

• Integration with secondary care

"These patients are the revolving door patients that present highly within GP practices. They take up an awful lot of GP time, commonly attending at least once a month." - Vicki Maskell

The results? Reduced GP demand, better patient outcomes, and a model that scales.

The Maturity Test

What does it mean to be "ready" for these contracts? Dan Bunstone from Warrington Innovation Network was blunt:

"This might be controversial, but if, as a PCN, you devolve money to individual surgeries and effectively just run as the bank of a PCN... I don't think that describes maturity.

Signs of readiness include:

• Proven delivery of projects

• Incorporation and governance structures

• Services delivered at the PCN level, not just devolved

• CQC registration (for those pursuing it)

Warrington Innovation Network exemplifies this preparation: "We incorporated around three or four months ago, and we're at the stage now of going through CQC registration."

📋 FREE TOOL: The Neighbourhood MOT

The Neighbourhood MOT gives you:

✓ 12 strategic questions to assess your readiness

✓ Reflection spaces to capture insights and build consensus

✓ Clear identification of where you need support

Get instant access to the PDF assessment and our latest insights on PCN collaboration delivered straight to your inbox.

Download your Neighbourhood MOT

The Collaboration Imperative

Perhaps the biggest challenge isn't structural—it's relational. What if PCNs in your area can't work together?

Ruth observed: "They might not like each other, but they would dislike even more the idea of their MNP being trust-controlled and led... If there was ever an incentive to get people who hate each other around a table, that seems to be doing the trick at the moment nationally."

"It's a burning platform for me. It's no longer one of those things where you might need to do as a nice thing to do. I think it's probably a have to do." - Dan Bunstone

Next Steps

Medium-term Preparation (October 2024 - March 2025)

1. Run scenarios: Model complete loss of PCN income

2. Consider structure: "PCN Limited or super partnership at that level" - Ruth

3. Build evidence: Document successful delivery

4. Strengthen systems: Move from devolved to integrated services

Critical Relationships to Develop

• Neighbouring PCNs (even difficult ones)

• Local authority partners

• Voluntary sector organisations

• Hospital trusts

• Community providers

The Bottom Line

The NHS 10 Year Plan represents both the greatest opportunity and the biggest challenge facing primary care in a generation. The choice is stark:

Option 1: Engage actively, secure your seat at both SNP and MNP tables, shape your future

Option 2: Wait and see, risk having a change imposed by other providers

As Ruth Griffiths concluded: "There is the risk that comes from doing nothing."

Or as the panel put it even more memorably: "It's better to be around the table helping to design the future than to be on the menu."

The question isn't whether these changes will happen—they will. The question is whether your PCN will be ready to seize the opportunity or become someone else's lunch.

We hope this helps.

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 blogs sharing insights about primary care networks.

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