Identifying at-scale primary care providers in England: a cross-sectional study of routine NHS data

The NHS Ten Year Health Plan introduces Multi-Neighbourhood Providers (MNPs) as organisations delivering integrated, preventive and community-based care to populations exceeding 250 000. No registry exists of at-scale primary care organisations in England, which limits our understanding of existing provision and organisational architecture.

To identify and characterise existing at-scale general practice organisations in England that could serve as prospective MNPs, describing their geographical distribution and key characteristics.

A cross-sectional study of Care Quality Commission (CQC) registered primary medical service providers (June 2025) and NHS Integrated Care Board expenditure data reporting transactions over £25 000 (April 2024 - May 2025). At-scale providers were defined through consensus with policymakers and provider leaders as organisations delivering primary medical services to populations exceeding 100 000 patients. Keyword searches (Federation, Alliance, Partnership), multi-location provision, and specific organisational structures (incorporated organisations, limited liability partnerships, Community Interest Companies) informed inclusion criteria. Two reviewers screened organisations via website review; a third reviewer resolved discrepancies.

From 56 030 registered providers and expenditure data, 661 organisations were shortlisted for screening. Screening is ongoing and results will be presented in full at the conference as choropleth maps, including details of provider- and practice-level characteristics.

This first systematic mapping of at-scale primary care providers reveals substantial existing infrastructure operating at multi-neighbourhood scale, with significant variation in structure and maturity. Findings provide essential baseline intelligence for implementing MNP policy and commissioning decisions. The methodology offers a replicable approach for ongoing surveillance of primary care organisational development in England.