PCNs are formed when GP practices sign up to the Network Contract Directed Enhanced Service (DES), which was first introduced on 1 July 2019 and sets out core requirements and entitlements for a PCN. PCNs are also supported by the PCN Development Programme which is centrally funded and locally delivered. DES is part of the GP practice's GMS contract.

The network contract Direct Enhanced Service (DES) underpins the role of primary care networks in empowering general practice within the wider NHS and improving the range and effectiveness of primary care services.

The 2020/21 Network Contract DES introduced three new services to be delivered by PCNs from 1 October 2020:

• Enhanced Health in Care Homes
• Early Cancer Diagnosis
• Structured medication reviews and medicines optimisation

PCNs are also entitled to earn additional funding through an incentive scheme – the Investment and Impact Fund.

The following additional services were introduced by PCNs during 2021/22:

• Cardiovascular disease (CVD) diagnosis and prevention
• Tackling neighbourhood inequalities
• Personalised care
• Anticipatory care

The Network Contract Directed Enhanced Service (DES) will be updated annually until at least 2023/24.