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ICBs facing clash between PCNs and neighbourhood health

Dozens of primary care networks in some areas may need to be reorganised to take on neighbourhood contracts, because they do not cover a coherent geographic area.

Of 1,210 multipractice primary care networks nationally, between 166 and 392 (14% to 32%) have member GP practices that are intermingled with others, and/or do not serve a single joined-up area, HSJ analysis has found. They make up 900-2,000 of the 6,100 total practices nationally.

Five integrated care board areas – mainly in London and inner West Midlands – are particularly affected, with more than half of PCNs not serving a single joined-up patch (see below).

The pattern reflects how PCNs were formed in 2019. GPs were allowed to determine networks, with little challenge from NHS England. Many were decided based on factors such as pre-existing practice relationships or common working methods.

In contrast, ICBs and councils have set boundaries for neighbourhood teams largely based on municipal or other natural boundaries.

For now, ICBs are mainly working around the mismatch with PCNs. In urban areas, they have set “neighbourhood” or “locality” footprints with large populations, which they say will function with multiple intermingled PCNs within them.

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Source: HSJ, 28 May 2026

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