Neighbourhood health centres are being built without a locum clause

NHS England has now set out what a neighbourhood health centre has to be: general practice on site, open at least 12 hours a day, six days a week, serving a population of around 50,000. Regions had to submit their proposed building pipelines by 28 May 2026. What the published guidance does not say is how the clinicians working inside those buildings will be engaged, and if you are booked by the session, that silence is the part that decides your money.

What the guidance actually specifies

The 10 Year Health Plan set the direction. The operational detail arrived this year, in NHS England's neighbourhood health centre guidance for regions and integrated care boards, published on 16 April 2026 and last updated on 30 July 2026.

A neighbourhood health centre brings general practice together with community services, mental health, social care and civil society organisations in one place. On-site general practice is a core requirement rather than an option. The centre must open for at least 12 hours a day, six days a week, and serve a population of roughly 50,000. The long-term programme is 250 centres by 2035, 120 of them by 2030. NHS England expects around 20% of new-build schemes to use public capital and the remainder to use public-private partnership routes. The delivery route is decided centrally for each scheme; this is not a funding formula for every building. Refurbishments use public capital only.

Note what is specified and what is not. The guidance describes buildings, opening hours, catchment size and capital structure. It does not specify employment models, contractor arrangements, sessional terms or locum provisions.

The contracting model is still being drawn

The companion document, "Next steps on neighbourhood health and new delivery models", published on 18 March 2026, describes 2026/27 as "a developmental year for the new contractual models". In practice that means integrated care boards and local government agreeing neighbourhood footprints, integrated neighbourhood teams being established, and the first single neighbourhood providers and multi-neighbourhood providers working directly with DHSC and NHS England. Local neighbourhood health plans are finalised in 2027/28, and ICBs are expected to begin outcome-based contracts within three years.

The existing architecture is being bent towards the same shape. From 2026/27, PCNs must align with neighbourhoods where ICBs and local authorities have defined them, and must use risk-stratification tools to identify and prioritise cohorts for continuity of care.

Which professions end up in the building

General practice first, because it is named as a core requirement of the centre. The other services named in the guidance carry the rest of the workforce with them: community nursing, mental health practitioners, pharmacy, physiotherapy and the paramedic roles already working in primary care. The guidance names services, not job titles, so the exact make-up of any one team is a local decision taken by an ICB and a local authority, not a national list you can plan against.

That matters more than it sounds. If you already work across several settings, a centre that houses general practice, community nursing and mental health under one roof is a single site where several of your usual bookers now sit inside one organisation. The body that signs the contract may not be the body whose patients you see. For GP locums the counterparty has been drifting for a decade already: Nuffield Trust figures put GP partners at 68% of the GP workforce in 2015 and 46% in 2025. For physiotherapists and other AHPs, the community trust or the PCN was never the only option, and a neighbourhood provider adds another.

The contracting party is the question that decides your money

Three things change when the party booking you is new.

The first is pension. Whether a session is pensionable in the NHS Pension Scheme turns on the status of the body engaging you, not on the building you sit in or the patients you see. A single neighbourhood provider or a multi-neighbourhood provider is a new kind of counterparty, and the neighbourhood guidance says nothing about its treatment. Do not assume that work in an NHS building through a new provider entity carries the same pension route as a session at a GMS practice. Ask, in writing, before the first session, and see which employers count in the pension guide.

The second is invoicing. A new legal entity means a new payer: different payment terms, possibly a purchase order requirement, a different person approving the invoice and a different finance system generating the remittance. Where an ICB moves to outcome-based contracting, the provider's own income stops tracking activity delivered, which changes how it thinks about buying a session.

The third is status. A provider running a building 12 hours a day, six days a week has a rota to fill at times a practice never opened. Regular, rostered, evening and weekend sessions for a single organisation look different from ad-hoc cover, and the difference shows up in how the engagement is written. That is a question for your accountant and for the contract itself, not one the neighbourhood guidance answers.

What to check before you accept a neighbourhood session

Get the named legal entity on the contract and the invoice, and check it matches the body actually paying. Establish which contract the work sits under: a practice's own GMS contract, a PCN arrangement, or a provider contract held by something new. Confirm the pension treatment in writing rather than by assumption. Confirm which indemnity arrangement covers the work and check it with your defence organisation. Read the hours clause against the 12-hour, six-day opening pattern, and the cancellation and notice terms with it. Agree payment terms, the approver and any purchase order number before you start. If a new counterparty means a new set of invoices, the invoicing guide covers what each one needs to carry, and Sessional keeps them next to the shift log they came from.

What is still missing

Two gaps are worth watching. The 10 Year Workforce Plan, expected in spring 2026 and designed around the staff needed for models of care outside hospital, with fewer NHS staff by 2035 than the 2023 plan envisaged, had not been confirmed as published when this piece was researched in September 2026; if it has appeared since, its staffing assumptions are the next thing to read. And the model is not moving at one speed across the UK: Northern Ireland's GP committee paused engagement with its neighbourhood model over undelivered funding commitments, according to the BMA's update of 24 August 2026.

The first wave of centres has been reported in the trade press with a headline count and a capital figure attached. Neither appears in the NHS England documents used here, so neither is repeated. What is published is a building specification, a set of milestones and an open question about who employs or engages the people in it. Until a contract lands on your desk with a name on it, that question is answered one booking at a time.

Sources

• Neighbourhood health centre guidance for regions and integrated care boards (NHS England, 16 April 2026, updated 30 July 2026)
• Next steps on neighbourhood health and new delivery models (NHS England, 18 March 2026)
• Primary Care Networks: Network Contract Directed Enhanced Service from April 2026 (NHS England, 26 March 2026)
• Changes to the GP Contract in 2026/27 (NHS England, 24 February 2026, updated 4 March 2026)
• The NHS workforce in numbers (Nuffield Trust, December 2025 data)
• Northern Ireland GP contract update (BMA, updated 24 August 2026)
• 2026 is pivotal for the NHS workforce and digital policy (EMJ Reviews, 9 January 2026)