NHS consultation on MNP & SNP contracts – key points for PCNs & Federations

NHS England’s long-awaited consultation on the proposed multi-neighbourhood provider (MNP) and single neighbourhood provider (SNP) contracting models was published on 16 July 2026. The consultation seeks views on how the two new contract models could support integrated care boards (ICBs) to commission more joined-up, population-based services across defined local footprints. The deadline for responses to the consultation is 10 September 2026. This article summarises the key proposals outlined in the consultation document.

The consultation confirms some important key intentions regarding the proposed neighbourhood health service contracts initially outlined in the 10 Year Health Plan. In particular:

• It is confirmed that general practice (GP) practice contracts (general medical services (GMS), personal medical services (PMS) and alternative provider medical services (APMS)) will remain in place for core services.
• SNP and MNP contracts will be locally commissioned and it will be for integrated care boards (ICBs) (or integrated health organisations (IHOs) where those are in place) to decide how the majority of neighbourhood health services are designed and funded.
• The new contracts are intended to make it simpler for commissioners to put in place services which are:
• more joined up and accessible for their local populations and focused on improving health outcomes; and
• support strong and sustainable GP and community services.

Multi-neighbourhood provider (MNP) contracts

MNPs will generally be expected to cover populations of around 250,000, but this is not expected to be mandated and local commissioners will be able to award contracts covering smaller or larger geographies.

MNPs will be commissioned using the NHS standard contract with a tailored schedule. It is expected that there will be two main options for local commissioners:

• Option 1: the MNP is commissioned to coordinate neighbourhood services and to fill in gaps where services cover more than one neighbourhood or where neighbourhood-level providers do not exist or opt out of provision. Existing contracts for neighbourhood services that are in place would continue.
• Option 2: the MNP is commissioned as a lead provider to deliver all elements of neighbourhoods services, ideally in an outcomes-based contract. The MNP would then sub-contract with SNPs and other providers. Existing contracts for neighbourhood services would be terminated (if permissible under their terms) or cease to be recommissioned when they expire.

It is expected that in most areas, option 1 will be utilised first but that local commissioners will move to option 2 over time.

MNPs will be expected to have clear relationships with GP practices and SNPs to ensure that neighbourhood services can be delivered to the registered patient population. It is proposed that local commissioners would be able to stipulate that the SNPs must sub-contract with SNPs where they exist.

Single-neighbourhood provider (SNP) contracts

The consultation confirms that SNP contracts are intended to enable enhanced services to be delivered through integrated neighbourhood teams (INTs) within a single-neighbourhood. SNP contracts will be an “evolution” of the primary care network (PCN) directed enhanced service (DES).

It seems to be intended that either the PCN DES or the SNP contract would be used in the same geography, and that the two forms of contract would not co-exist in the same area. The SNP contract will be based on “Neighbourhood Directions”, which would underpin the MNP contract.

Practices and PCNs should be reassured that the consultation proposes that the SNP contract would be awarded to all eligible providers (which is expected to mean providers with access to a registered patient list) who express an interest, in a similar way to the existing PCN DES. Unlike the PCN DES, local commissioners would be able to determine the length of the SNP contract. This opens the door to longer contract terms, which should be welcomed by PCNs as it enables longer-term planning.

SNPs will be able to opt in and out of services throughout the duration of the contract, with MNPs filling gaps.

The consultation also confirms that there would be minimum funding for neighbourhood service contracts to maintain PCN DES funding (including the additional roles reimbursement scheme (ARRS) funding).

SNP contract holders will be expected to work closely with GP practices and MNPs would be mandated to sub-contract neighbourhood-level services to SNPs where they exist.

The commissioning options for local commissioners outlined in the consultation are:

• Option 1: neighbourhood primary medical services are commissioned through the PCN DES with local variation agreements (LVAs) as required. LVAs would require national approval.
• Option 2: the SNP contract is used to commission enhanced neighbourhood-level services direct from SNPs which could run over multiple years. The SNP contract would be locally designed but there would be some basic mandatory elements (such as requiring practices to work together) and to maintain investment in neighbourhood-level enhanced services.
• Option 3: the MNP would be commissioned to coordinate neighbourhood services and would be mandated to subcontract to SNPs or PCNs if there is no SNP. The MNP would be expected to fill in any gaps in provision.

Under option 3, MNPs could also be commissioned to deliver specific additional local services, working with SNPs, such as:

• Urgent primary medical care services;
• Outpatient services for people with long-term conditions;
• Medicines optimisation;
• General practice resilience; and
• Leadership and transformation for the neighbourhood infrastructure.

Other key points

• The new contracts are expressed to be optional.
• The MNP and SNP contract geographical footprints will not be nationally mandated – the 250,000 and 50,000 footprints are a guide only.
• The MNP contract holders must be legal entities. These could be single entities or a lead provider on behalf of a consortium.
• There could potentially be more than one MNP in a single geography.
• It is envisaged that the MNP schedule to the NHS standard contract will include an ability to “sub-sub-contract” services and enable access to NHS pensions.
• There is no requirement for MNPs or SNPs to adopt a mandated corporate form – for example, there is no suggestion that MNPs or SNPs will have to be set up as community interest companies.

In summary, the consultation documents should not include too many surprises and should provide some reassurance for practices and PCNs that they will be able to continue to access current PCN DES funding, whether that is through a continuation of the PCN DES or a new SNP contract.

We are already working with our PCN and federation clients to plan for the introduction of the new contracts. The direction of travel outlined in the consultation is much as we expected and we would recommend that:

• PCNs should incorporate limited companies where they have not already done so to enable them to hold SNP contracts and / or sub-contracts from MNPs. This will enable PCNs to ringfence risk from their member practices and employ shared staff through a single legal entity.
• Where there is no federation (a single legal entity representing general practice across a geography at MNP level), practices should discuss forming such an entity to hold MNP contracts.
• Existing federations should:
• engage with their membership to agree which neighbourhood level option would work best in their geography and to ensure that the federation is able to satisfy the requirements for acting as an MNP in their area; and
• work with neighbouring federations where appropriate to agree appropriate collaborative arrangements for delivery of MNP contracts in their combined geographies (this is particularly the case for smaller federations which cover only part of a population which might logically be considered an MNP footprint).

Please contact Alison Oliver, Amanda McCabe or Justine Lee if we can assist you further.