How does the new GP contract contribute to the Neighbourhood Health Service?

IHPN’s Head of Policy (Primary, Community, and Diagnostic Care), Joshua Edwards, analyses the new GP contract and what it’s impact might be on the Neighbourhood Health Service

This week’s publication of the GP Contract for 2026/27 is a turning point – in process if not in practice. It marks the first time that the changes were not negotiated with the BMA’s General Practitioner Committee (GPC) – leading to some criticism and concern over the setting of unrealistic expectations – but instead involved a wider consultation with the Royal College of GPs, National Association of Primary Care (NAPC), Healthwatch England, National Voices and the NHS Confederation.

What has resulted is a contract that nonetheless addresses a range of issues affecting the sector, while also imposing some new expectations especially around patient access. At a time when other services are seeing restrictions on funding grow ever tighter, the uplift of 3.6% in cash terms is broadly welcome. Likewise, when GP underemployment has been a cause of political concern it’s no surprise to see some extra flexibility introduced into the Additional Roles Reimbursement Scheme to allow for the employment of experienced salaried GPs at a Primary Care Network level, and for funding to be made available to employ additional GPs/extra sessions at practice level, helping to meet patient demand and combat the much-maligned 8am rush. The Health Foundation’s polling this week on public perceptions of the NHS and general practice illustrates how vital getting this right will be, with just under half of people (48%) saying they had a health concern that they thought of contacting their GP practice about but delayed doing so, or did not contact it at all.

Alongside these long-standing issues, the contract also looks at meeting some emergent challenges to the health system. Increased funding for childhood vaccination and for tackling obesity, including wider prescribing of weight loss drugs, both help coordinate a response to societal challenges, in particular the recent rise in anti-vaccine scepticism and wider usage of GLP-1 medication.

These changes in workforce and funding for specific priority areas sit alongside new requirements for managing patient access. Patients identified as clinically urgent are expected to be dealt with on the same day, although some leeway remains on how these cases are determined. For non-urgent patients, practices will be required to provide an appropriate response by the end of the next working day, so they will know what their next steps look like.

Given the contract’s broader role in helping the Government answer its own manifesto commitments on opening up patient access and improving experience, it is a missed opportunity that this year’s changes don’t reflect the wider ambitions that the Ten Year Health Plan for England holds for at-scale working. GPs and PCNs have an important role to play leading the shift from hospital to community and creating a ‘Neighbourhood Health Service’. We know from speaking with members for our recent report into at-scale primary and community care that many of their services are already working to make these changes happen, in absence (for now) of clearer central guidance – whether that’s helping to reinforce continuity of care for patients that prioritise it, using data and analytics to better understand your population health needs or helping to shift treatment left, reducing pressure on the hospital sector.

Independent healthcare providers are already using their size and reach to deliver precisely the kind of accessible high-quality care to NHS patients that new Neighbourhood Health Services are seeking to achieve. 

If the Government genuinely wants to shift care out of hospitals and into the community, it must turbocharge NHS and independent sector partnership working – helping incentivise at-scale working and drive innovation in every community.