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Host Dr. Tommy Perkins is joined by Sarah Cook, a specialist medical solicitor from DR Solicitors, to unpack NHS England's recent consultation on the future of neighbourhood healthcare — a topic that could reshape how general practice is delivered.
Key topics covered:
The consultation at a glance — NHS England isn't asking whether neighbourhood healthcare is coming; it's asking who will deliver and control it. Two models are on the table: a Single Neighbourhood Provider (SNP) built on existing PCN footprints (~50,000 patients), and a Multi-Neighbourhood Provider (MNP) spanning multiple neighbourhoods (~250,000+ patients) that would coordinate a wide range of services across primary and community care.
Three SNP delivery routes — (1) Vary the existing PCN DES (already in regulations since May), (2) Have the PCN hold a single neighbourhood contract directly, or (3) Let an MNP sweep up services and subcontract them — the option GPs should most want to avoid.
Income & risk concerns — Dr. Perkins raises the fear that MNPs could strip away enhanced-service income (LESs, DESs) that practices rely on top of the frozen global sum. Sarah reassures that GMS/PMS contracts remain and PCN/ARRS funding is intended to be protected — but only if practices stay engaged and organised.
The legal entity question — Any SNP contract must be held by a legal entity. Since PCNs aren't legal entities, many are incorporating as limited companies to gain limited liability, cleaner governance, and the ability to hold contracts and employ staff (with NHS pension access confirmed).
Future of PCNs — PCNs are expected to evolve into neighbourhoods rather than disappear outright. A limited company structure gives practices future-proofing and flexibility for that transition.
What practices should do now — Assess your current organisational model, consider whether a limited company makes sense, read the consultation, and get both legal and accounting advice. DR Solicitors offers a free initial consultation and has a webinar on their website.
Bottom line: Neighbourhoods represent a potential growth opportunity for GP-led organisations — but only for practices that get structured and ready before contracts arrive. Those that disengage risk losing control and income to MNPs.
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