Multi-Neighbourhood Provider Contracting Clarification
At the end of January, NHS England published a document which provides an important update related to how Multi-Neighbourhood Providers (MNP) will be contracted from as early as April 2026. This does not provide clarity in relation to Single Neighbourhood Providers (SNPs) but it is a significant piece in the puzzle and indicates that progress is likely to accelerate as the end of the financial year approaches.
The 2026/27 NHS Standard Contract Technical Guidance includes the following statement at paragraph 7.6:
Multi-neighbourhood providers. We expect to develop a new schedule for use with the NHS Standard Contract in the commissioning of multi-neighbourhood services as described in the 10 Year Health Plan for England. This is likely to be published for consultation later during 2025/26 for use in 2026/27.
Whilst this may seem a minor comment but it has major implications.
No ‘new’ contract
The 10 Year Plan stated that ‘[the NHS] will introduce 2 new contracts…The first will create ‘single neighbourhood providers’…The second will create ‘multi-neighbourhood providers’…’. In our initial review of the plan in July we noted that the objectives could be achieved by using the existing contractual arrangements and it would appear that this approach has now been confirmed.
Service condition 4 provides existing contractual obligations related to co-operation within the NHS and SC 4.8 states the following:
Where the Provider provides community-based Services, it must use all reasonable endeavours to agree, with local Primary Care Networks, and implement ongoing arrangements through which delivery of those Services and the delivery of complementary services to the relevant Service Users by members of those Primary Care Networks will be effectively integrated.
This requirement can easily be amended to reflect the requirement to integrated with neighbourhoods and shows that the spirit underpinning the 10 Year Plan is already included in the contractual arrangements.
In addition to this there is already an established approach to managing the sub-contracting of services and the part 26 of the Technical Guidance addresses integrated working and alliance models. A further benefit is that the contract is already recognised by the NHS Business Services Authority as being eligible to provide employees with NHS pensions, which removes a problem which impacted primary care networks when they were first formed.
There is therefore an established and well tested framework. The new schedule is likely to use this as the foundation for the contracting of MNPs from April.
It may therefore be more appropriate to start referring to the ‘MNP schedule’ rather than the ‘MNP contract’ for future clarity.
Contract variations or additional service contracts
This approach creates an interesting option for commissioners and providers in relation to the MNP services. By making the MNP subject to a schedule within the existing contract, it opens the possibility that it could be added to an existing NHS Standard Contract by way of a variation.
This potentially creates an easier route to implement the arrangements. All NHS Trusts and most large GP federations hold NHS Standard Contracts, although with a significantly different scope and financial value.
The implementation of the MNP schedule would be subject to the Provider Selection Regime (PSR) and in particular any variation would need to satisfy the test for being a permitted modification.
If there is any delay in the implementation of the MNP schedule any NHS Standard Contracts entered for 2026/27 may in theory be designed with the intention of adding this schedule in the future which increases the likelihood of the variation being permissible.
Alternatively, the commissioners may issue NHS Standard Contracts including the MNP elements and these will need to comply with the PSR.
Managing procurement
The PSR remains a relatively new process and there is continual learning as it is implemented across the country.
It is recommended that whilst the system waits for the MNP schedule to be published, plans are produced and tested to ensure that they do not fall foul of the PSR, which could cause further delay and uncertainty when the schedules go live.
Specialist procurement advice may be required on this point and further clarification will be provided once the schedule has been published for consultation, but it is a factor to be considered by those involved in planning the MNP implementation in each area.
Timeframe
To achieve the projected timeframe and to undertake a consultation, the new schedule will need to be published within the first two to three weeks of February 2026. This would allow for a brief consultation window and opportunity for the final version to be published in time for contracts to commence in April 2026.
Managing the risk
Based on past years, it is possible that this timeframe is not achieved.
ICBs should consider alternative plans where they have been planning to terminate or restructure services into MNP arrangements from 1 April.
Whilst this may not be necessary it does represent prudent business continuity planning and reduces the risks associated with unintentional or uncontrolled service closures. It is important to consider what the impact would be on the patients relying on the services and on the staff employed to provide the services.
Providers should also test their business continuity planning and work collaboratively with the commissioners to identify alternative plans for effected services.
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