Fit for the future: towards population health delivery models (NHSE, 17 March 2026)

Summary

The 10 Year Health Plan sets out an ambition to build a truly modern NHS that delivers better treatment for patients and better value for taxpayers. To realise this vision, we must deliver services in new ways that better meet patients’ needs, and provide care as close to home as possible, in a way that is most convenient for them and gives them what they need when they need it. As set out in the Neighbourhood Health Framework, this will mean improving routine healthcare services, moving to a more proactive care model for people with multiple long-term conditions and delivering better alternatives to hospital care.

Commissioning reform and development will support integrated care boards (ICBs) to become more expert strategic commissioners, moving to a population health approach that aligns incentives, reduces fragmentation and addresses the imbalance of resources. Commissioners will increasingly use population-based contract models to enable providers to work together to deliver joined-up care. Delivering this vision does not require disruptive organisational change.

Content

This publication sets out new population health delivery models to facilitate this change, supporting ICBs to commission providers around the needs of defined populations. ICBs – working with partners, including local authorities and health and wellbeing boards – will agree neighbourhood footprints that form clearly defined populations. Single neighbourhood, multi-neighbourhood and integrated health organisation contracts will be commissioned around these populations.

• Single neighbourhood providers (SNPs) will deliver services, through integrated neighbourhood teams, within a defined single neighbourhood, enabling primary care to take on new neighbourhood services that are not contracted through today’s general practice contracts – General Medical Services (GMS), Personal Medical Services (PMS) or Alternative Provider Medical Services (APMS) – which will continue to be determined nationally and commissioned locally.
• Multi-neighbourhood providers (MNPs) will co-ordinate the consistent delivery of services across multiple neighbourhoods. This may include delivering services directly at a larger scale than a neighbourhood or by ‘filling in’ services where an SNP is not willing or able to.
• Integrated health organisation (IHO) contracts will give providers a whole population health budget for a geographically defined population, underpinned by a contract. The model will empower highly capable providers to lead change through their understanding of local population need, knowledge of activity and costs, and ability to engage frontline clinicians in service redesign. IHOs will undo needless NHS fragmentation and create incentives to invest in community-based preventative care.