The Mandatory Network Agreement

The Mandatory Network Agreement was published by NHS England and the British Medical Association and is available here.

Published in Practice Management 8 May 2019

The practices in your Network should have signed up to this by 15 May as part of the registration process for the Network Contract DES. However, you have until 3 June to complete the Schedules (except Schedule 1 which specifies the geographical area). While the agreement is mandatory, the detail needs to be agreed by your Primary Care Network (PCN), some of which are covered in my April article.

The Mandatory Network Agreement is a legally binding document, although a ‘practice’ is not a legal entity. Therefore, it is important you ensure that each partner of each practice is a named party and signs the agreement.

The Principles in clauses 8–14 would be very difficult to enforce legally as to show that someone was not working together, or cooperating, would, in most cases, be hard to prove. It is not an NHS Contract, so disputes are not automatically referred to the Secretary of State to resolve. It is suggested that they are referred to the local medical committee (LMC), but this may result in conflicts of interest, and you have the option of deciding your own dispute resolution provisions.

The Financial Obligations are left for you to fill in in Schedule 4 and, under the DES Directions, you need to nominate one of the practices to receive the payments and then state the terms under which they are holding the money, and agree when it is paid out. There are no provisions dealing with the sharing of staff, and this will be the subject of a later article in this journal as to what to put in Schedule 5.

There are provisions for the sharing of information, including patient records. You will need to ensure you have the requisite consents from patients and the information remains within the PCN. There is a requirement to enter into a separate datasharing agreement between the practices before sharing records.

Conflicts of interest arrangements have not been specified in detail. There is a blanket agreement to share intellectual property at no fee, which could mean practices giving away valuable rights if it has developed IT solutions. Provisions regarding new practices joining the PCN and those leaving it are vague, so it will be important to agree those terms, although the clinical commissioning groups will have to agree terms for a core network practice to join and the terms on which one leaves. Like the GMS/PMS contracts, national variations may change the terms of the contract.

The Mandatory Network Agreement provides a framework, but much of the detail needs to be worked through and terms agreed before the July deadline.


  1. The Primary Medical Services (Directed Enhanced Services) Directions 2019 paragraph 5 (3) b