NHS England’s proposed Single Neighbourhood Provider (SNP) and Multi-Neighbourhood Provider (MNP) contracts
Page Contents
What are SNPs and MNPs trying to achieve?
What is a Single Neighbourhood Provider (SNP)?
What is a Multi-Neighbourhood Provider (MNP)?
Does this replace Primary Care Networks?
Introduction.
NHS England has published a consultation on proposed Single Neighbourhood Provider (SNP) and Multi-Neighbourhood Provider (MNP) contracts as part of its wider ambition to develop neighbourhood health services. The consultation has generated considerable discussion within general practice, with understandable concerns about what these proposals might mean for GP practices, Primary Care Networks (PCNs) and the independent contractor model.
Having reviewed the consultation documents and accompanying questions and answers, our view is that the proposals are more evolutionary than many initial reports suggested. There are welcome reassurances throughout the consultation, but there are also significant questions that remain unanswered. This page summarises the proposals from a Wessex LMCs perspective, highlighting both what the consultation says and the issues we believe practices should continue to explore.
As is always the case with any NHS transformation, the real outcomes will depend on the appetite of all organisations to change and whether the funding genuinely moves to the community. “The proof will be in the pudding!”
What are SNPs and MNPs trying to achieve?
The proposals are intended to support the Government’s vision for neighbourhood health services by creating organisations capable of delivering more care closer to patients’ homes. Rather than commissioning individual services from multiple providers, NHS England envisages organisations that can bring together general practice, community services, mental health, social care and voluntary sector partners to deliver care for defined local populations.
The consultation makes it clear that this is intended to be a gradual evolution of existing neighbourhood working rather than an overnight reorganisation. Many of the principles will already be familiar to practices through Primary Care Networks and Integrated Neighbourhood Teams. The difference is that NHS England now proposes formal contractual arrangements to commission these broader neighbourhood services.
What is a Single Neighbourhood Provider (SNP)?
A Single Neighbourhood Provider would usually serve a population of around 50,000 people, although NHS England has deliberately avoided prescribing a national population size. In many areas, this could closely resemble the footprint of an existing Primary Care Network.
Importantly, the consultation does not propose that SNPs replace GP contracts. Instead, they would hold contracts for additional neighbourhood services that sit alongside existing GMS, PMS or APMS contracts. NHS England repeatedly states that core general practice would continue to be delivered through existing GP contracts.
In practice, many readers will recognise SNPs as a potential evolution of today’s more mature PCNs. The consultation acknowledges this possibility and seeks views on how PCNs might transition if commissioners and practices choose to adopt the new model.
What is a Multi-Neighbourhood Provider (MNP)?
Where an SNP focuses on one neighbourhood, a Multi-Neighbourhood Provider would operate across several neighbourhoods, typically covering populations of around 250,000 people or more. Rather than replacing neighbourhood teams, MNPs are intended to provide the infrastructure that supports them.
The consultation describes MNPs as organisations capable of delivering services that are difficult to provide at neighbourhood level alone. This could include workforce development, digital infrastructure, diagnostics, specialist community services, estates, clinical governance and shared support functions. NHS England suggests that many services currently commissioned separately could eventually be brought together through these larger organisations.
For practices, the key point is that MNPs are proposed as organisations working above neighbourhood level, not as replacements for individual GP practices.
Does this replace Primary Care Networks?
One of the biggest misconceptions following publication of the consultation was that PCNs were being abolished. Having read both the consultation and the accompanying questions and answers, we do not believe that is what NHS England is proposing.
Instead, NHS England consistently describes SNPs as an evolution of PCNs rather than their immediate replacement. Commissioners would retain flexibility over local implementation, and existing PCN arrangements could continue while any transition is considered. The consultation also suggests that existing investment in PCNs, including ARRS funding, would be protected during any future transition.
Whether PCNs eventually evolve into SNPs will almost certainly depend on local decisions rather than national direction.
Are GP contracts changing?
The answer is, quite clearly, no.
Throughout the consultation NHS England repeatedly states that GMS, PMS and APMS contracts are not being replaced by SNP or MNP contracts. Core general practice would continue to be commissioned through existing contractual arrangements. The new contracts are intended to commission additional neighbourhood services rather than absorb existing GP contractual responsibilities.
That said, the consultation also makes clear that neighbourhood services are expected to expand over time. Exactly where the boundary sits between core general practice and future neighbourhood services will therefore be something Wessex LMCs will monitor closely as the proposals develop.
Who could hold these contracts?
Another common assumption has been that these contracts will inevitably be awarded to acute trusts or large NHS organisations.
The consultation presents a much broader picture. NHS England envisages that MNPs and SNPs could be led by a variety of organisations, including collaborations involving primary care, community providers, NHS trusts, local authorities or voluntary sector partners. The consultation does not prescribe a preferred provider model, although any contract would require a single accountable legal entity.
This leaves an important opportunity for general practice. If practices wish to remain at the heart of neighbourhood services, they will need to consider what organisational models could enable primary care to lead, rather than simply participate in, future neighbourhood providers.
Funding and workload.
Perhaps the biggest unanswered question throughout the consultation is funding.
The ambition to shift care out of hospitals and into neighbourhood services is widely supported. However, the consultation provides relatively little detail about how funding will move alongside that work. NHS England indicates that practices should not lose existing funding if they move into these arrangements, but many of the financial mechanisms remain to be developed locally.
For Wessex LMCs, this is likely to become one of the most important aspects of the consultation. Successful neighbourhood working will depend not simply on new organisational structures, but on genuine transfer of both resources and clinical workload from secondary care into community settings.
The role of Wessex LMCs.
One welcome aspect of the consultation is the explicit recognition of Local Medical Committees. NHS England acknowledges that LMCs have an important role in supporting practices, representing general practice and helping commissioners engage meaningfully with the profession as these proposals develop.
That reflects the role Wessex LMCs already undertakes. We will continue to analyse these proposals in detail, work with our constituent practices, PCNs and commissioners, challenge areas where greater clarity is needed, and ensure that the voice of general practice remains central to the future development of neighbourhood services across Hampshire and the Isle of Wight.
Our overall view.
Our initial reaction to the consultation was one of considerable caution, and we suspect many practices shared that view. Having read the full consultation and accompanying questions and answers, there are undoubtedly more reassurances than the initial headlines suggested. However, reassurance on paper does not remove the need for careful scrutiny.
Many of the most important questions—including funding, governance, accountability and the practical relationship between neighbourhood providers and GP practices—have yet to be fully answered. We therefore see this consultation as the beginning of a conversation rather than the conclusion. Wessex LMCs will continue to engage constructively, support practices in understanding what is proposed, and advocate for models that strengthen rather than dilute the role of independent general practice.