The NHS Neighbourhood Health Framework, published on 17 March 2026, is not a consultation or a pilot. It sets binding national targets, a formal delivery architecture, and a clear implementation timeline running to March 2029. For PCN Clinical Directors and Practice Managers, this is the most significant structural reform to primary care since PCNs were created in 2019.
This post explains what the framework requires, what the key deadlines are, and what your practice needs to have in place to meet them.
What Is the NHS Neighbourhood Health Framework?
The framework is the government’s implementation plan for neighbourhood health, a core element of the 10 Year Health Plan published in July 2025. It moves NHS service delivery from organisational boundaries your practice, the community trust, the mental health trust to defined geographic neighbourhoods, where multidisciplinary teams work together across shared patient populations.
The 2025 neighbourhood health guidelines gave systems direction and flexibility. The 2026 Framework replaces that flexibility with named national targets, a formal provider architecture, and structured commissioning requirements. If the 2025 guidelines were a roadmap, the 2026 Framework is the contract.
For practices, the shift matters because it changes what ICBs will track, what they will commission against, and what they will expect your data to show.
The Five National Goals
The framework sets five national minimum goals with metrics and timescales running to March 2029. These are the numbers your ICB will be held to, and by extension the numbers that will define what your practice is expected to contribute.
Goal 1: GP access
90% of clinically urgent patients seen on the same day by March 2027. Routine access and patient satisfaction will be baselined in 2026/27, with national targets set from 2027/28 onwards.
Goal 2: Planned care transformation
A 25% diversion of referrals via single points of access across 10 high-volume specialties by March 2027, supporting waiting list recovery. Named specialties include gastroenterology, ENT, cardiology, respiratory medicine, diabetes, gynaecology, and urology.
Goal 3: Urgent and emergency care
A contribution to 82% A&E four-hour performance by March 2027, moving to 85% over time. Reduction in non-elective admissions for high-priority cohorts, defined as people with severe frailty, care home residents, housebound patients, and those at end of life.
Goal 4: Community services
At least 78% of community health service activity occurring within 18 weeks by 2026/27, rising to 80% by 2028/29, with ICB plans in place to eliminate all 52-week community waits.
Goal 5: Patient and staff satisfaction
Nationally defined metrics to be confirmed during the 2026/27 baseline year.
The New Provider Architecture
The framework introduces a layered provider structure that will reshape how general practice is organised and commissioned. You do not need to manage all five tiers, but you need to understand where your practice sits.
Single Neighbourhood Providers (SNPs) deliver integrated services within one neighbourhood, covering a population of around 50,000. SNPs hold the contract for neighbourhood-level service delivery. PCNs may evolve into SNPs through a forthcoming consultation. Your existing GMS, PMS, or APMS contract is not directly affected.
Multi-Neighbourhood Providers (MNPs) coordinate services across multiple neighbourhoods, typically covering around 250,000 people. They will provide shared functions including IT, workforce, training, and quality improvement across your area.
Integrated Health Organisations (IHOs) sit above MNPs and hold whole-population health budgets. They are primarily relevant to commissioners but will determine the funding flows that reach your neighbourhood.
Integrated Neighbourhood Teams (INTs) are the teams that will affect your practice most directly. An INT is a multidisciplinary clinical team bringing together GPs, community nurses, pharmacists, mental health practitioners, social care workers, and allied health professionals to serve a defined neighbourhood. The framework does not nationally mandate INT size or composition. This is determined locally based on population need.
For PCN Clinical Directors, the key question right now is whether your PCN is positioned to evolve into an SNP. If your governance, data infrastructure, and MDT working are already functioning, you are ahead. If your PCN is still primarily a contractual arrangement rather than an operational team, the framework creates urgency.
What the Framework Requires of Your Practice
The framework sets minimum expectations directed at ICBs, which flow down to practices through commissioning and local implementation plans. Here is what will land on your desk.
Same-day urgent access. The obligation to provide same-day access for clinically urgent patients is already in effect from April 2026 under the GP contract. The framework adds a measurable threshold: 90% by March 2027. The 2026/27 year is your baseline. The 90% target is measured on recorded data, not clinical intent. Practices that are compliant but poorly coded will appear non-compliant. Fixing your urgency coding in your clinical system is a priority task now.
Digital systems and shared care records. Practices must support shared care record access for all INT members working with your patients. The NHS App becomes the default channel for patient messaging and push notifications. The framework commits to expanding AI-assisted triage pilots and embedding online consultation tools through the NHS App. These are system-level initiatives made available to practices, not mandated deadlines for individual adoption. If your practice is offered access to AI triage tools, the framework signals they should be evaluated seriously.
Population health management. Risk stratification moves from good practice to a measurable expectation. Your practice will be expected to identify patients in priority cohorts, use validated tools to segment your population by risk level, and ensure 95% of patients with complex needs have agreed, documented care plans by 2027.
INT participation. The framework’s model depends on GP practices actively participating in their local INT. Expect joint governance, shared patient data within information governance requirements, joint meetings on priority cohorts, and co-location of INT staff where appropriate. This is a clinical team, not a paper process.
Referral reform. The framework requires participation in single points of access for at least 10 specialties in 2026/27. Digital referral pathways that route patients to the right service first time, with standardised pathways and reduced back-and-forth between primary and secondary care. The e-Referral Service will be used for all Advice and Guidance requests from July 2026.
The Priority Cohorts
INTs will not try to manage the entire population from day one. The framework defines four national priority groups, which represent the highest-risk patients in any neighbourhood.
- People over 75 with moderate to severe frailty
- Care home residents
- Housebound patients and those at end of life
- People with multiple long-term conditions
These cohorts represent roughly 3 to 5% of most registered populations but account for a disproportionate share of hospital admissions, A&E attendances, and community health activity. The framework’s logic is that effective proactive management of these cohorts is the fastest route to reducing acute demand.
For practices, this means your risk stratification tools need to be identifying these patients reliably, and your INT needs a clear operational process for their care.
The Dates That Matter
Where Triage Infrastructure Fits In
The framework explicitly names AI-assisted triage and online consultation as tools for delivering the access goal and supporting the digital shift. This is not incidental. The 90% same-day access target cannot be met through capacity alone. It requires a system that identifies urgency accurately at first contact, every time, across every channel.
Practices that operate a total triage model, capturing every contact regardless of whether it arrives by phone or online, coding urgency at the point of request, and routing automatically to the right clinician or care pathway, are already doing what the framework requires. The data they generate from that system is exactly what ICBs will need to see.
Klinik’s platform captures 100% of incoming contacts across both online and telephone channels, applies AI-driven urgency assessment to every submission, and generates real-time analytics on demand patterns and outcomes. Practices using Klinik are not starting from scratch on the 90% target. They are starting with a data record that demonstrates what they are already delivering.
The framework does not specify which triage tools to use. It specifies outcomes. The question for every Practice Manager right now is whether your current setup can produce the data that proves you are meeting them.
Frequently Asked Questions
What is the NHS Neighbourhood Health Framework?
It is a policy document published by DHSC and NHS England on 17 March 2026. It sets out how the NHS will organise services around geographic neighbourhoods, with five national goals, a new provider architecture, and a delivery timeline running to March 2029. It is the implementation plan for the neighbourhood health element of the 10 Year Health Plan.
Is the Neighbourhood Health Framework mandatory?
The five national goals are mandatory minimum requirements for ICBs, who will implement them through commissioning and local plans. Individual practice requirements flow from your ICB’s local implementation. Your existing GMS/PMS/APMS contract is not replaced, but the framework’s expectations will shape what is commissioned and monitored.
What does the 90% same-day access target mean for my practice?
By March 2027, 90% of patients presenting with clinically urgent needs must be seen on the same day. The definition of clinically urgent is set by clinicians, not administrators. The baseline year is 2026/27. The target is measured on recorded data from your clinical system, so urgency coding accuracy matters as much as clinical compliance.
What is an Integrated Neighbourhood Team?
An INT is a multidisciplinary clinical team working across a defined neighbourhood population. It brings together staff from GP practices, community health, mental health, pharmacy, and social care. INTs focus initially on high-priority patient cohorts: frail older people, care home residents, housebound patients, and those with multiple long-term conditions.
What happens to PCNs under the Neighbourhood Health Framework?
PCNs are expected to evolve over time. The framework introduces Single Neighbourhood Providers (SNPs) as the contract-holding entity for neighbourhood-level services, covering populations of around 50,000. There will be a consultation on whether and how PCNs transition to SNPs. The PCN DES arrangement is under review as part of this process.
How does AI triage support the framework’s requirements?
The framework names AI-assisted triage as a tool for improving GP access and supporting the digital shift from analogue to digital care. A structured triage system that codes urgency at first contact, routes automatically to the right clinician, and generates auditable data on demand and outcomes directly supports compliance with the 90% same-day access target and ICB reporting requirements.
When do I need to start preparing?
Now. The same-day access obligation is already in effect from April 2026. The 90% target baseline is being set during 2026/27. Practices that are not yet systematically capturing urgency data are already behind the curve.
Sources: Neighbourhood Health Framework, DHSC and NHS England, March 2026. NHS Confederation analysis, March 2026. Health Innovation Yorkshire and Humber, Klinik PCN case study. Klinik Healthcare Solutions, About Us. NHS England, ARRS guidance.