First ‘neighbourhood contract’ links GP income to A&E attendances

Some £1.7m of primary care revenue will be tied to A&E attendances from next year, under a first-of-its-kind “neighbourhood” contract deal.

Kent and Medway Integrated Care Board has agreed the first local variations to the national primary care network contract with Kent Local Medical Committee.

It is understood to be the only local change to PCN contracts signed off so far by NHS England, under freedoms just introduced by the national body. 

The ICB said the deal will “support general practice to lead new single neighbourhood arrangements”. The national “single neighbourhood provider” contract promised in the 10-Year Health Plan  is yet to be launched.

K&M ICB said the changes to the PCN contract – known as the PCN direct enhanced service – would begin in July and be worth £10.1m in 2026-27.

The full-year funding will be £13.5m – with £9.9m coming from underspends in its primary care budget, and £3.6m from existing “local enhanced services” already commissioned by the ICB from GP practices.

The K&M contract will require PCNs to focus on about 92,000 people across the ICB area who have the most complex care needs, including care home residents, people on palliative care registers, and housebound patients with severe frailty.

GP practices will have to provide proactive interventions such as advance care planning discussions, comprehensive geriatric assessments and structured medication reviews.

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Source: HSJ, 10 June 2026