When NHS England first published its proposals for Single Neighbourhood Providers (SNPs) and Multi-Neighbourhood Providers (MNPs), many in General Practice reacted with understandable scepticism. Is this the end of Primary Care Networks? Is this another step towards dissolving the independent contractor model? Will neighbourhood services simply become another vehicle for transferring work away from hospitals without the resources to match? Given the pace of NHS reform over recent years, those questions are entirely reasonable.
However, having worked through the consultation alongside the accompanying questions and answers, the picture is rather more nuanced than many of the initial headlines suggested. NHS England goes out of its way to state that GMS, PMS and APMS contracts are not being replaced, that PCNs are expected to evolve rather than disappear overnight, and that neighbourhood providers are intended to hold additional services rather than absorb core general practice. Importantly, the consultation explicitly recognises the important role that Local Medical Committees (LMCs) should play in supporting practices and commissioners through any future transition from OPCN to SNP, something that has not always been reflected in previous national programmes.
That doesn’t mean every concern has been answered. Many of the difficult questions remain: where will the funding genuinely come from, how will governance work, who will ultimately hold these contracts, and will resources really shift from hospitals into neighbourhood care? These are precisely the issues that Wessex LMCs will be examining on behalf of practices. We believe our position and role is neither to dismiss these proposals nor to endorse them uncritically, but to separate reassurance from rhetoric, challenge assumptions where necessary, and ensure that any future model strengthens the position of general practice for our communities.
The move towards neighbourhood working appears unlikely to disappear. The opportunity now is to ensure that General Practice helps shape what comes next, rather than having it designed for us or imposed on us. Wessex LMCs will continue to analyse the consultation in detail, represent the views of practices across Wessex, and provide practical updates as the proposals develop.
NHSE is now asking for feedback on its proposals from you.
Please consider your own views on this consultation and provide feedback by following the link in the box below. We would also urge your organisation to consider how these proposals will impact you and provide a collective response:
| Consultation: MNP/SNP neighbourhood provider models |
Here are NHSE’s Questions and answers: aimed to help further clarify the proposals