Integrated Neighbourhoods
Neighbourhood Health and Integrated Neighbourhood Teams (INTs), with primary care providers being at the heart of these teams, are integral to NHS reform.
The focus on INTs is central to the Government’s plans to improve the NHS and feature heavily in the recently published 10 Year Health Plan for England, but at present there is also a lack of concrete guidance on how INTs should be configured.
The plans says this will bring professionals into patient-centred teams, reducing fragmentation of care and improving access to general practice and enabling hospitals to focus on providing specialist care.
The Government says the neighbourhood health service will embody their new preventative principle that care should happen as locally as it can: digitally by default, in a patient’s home if possible, in a neighbourhood health centre when needed, in a hospital if necessary.
A neighbourhood is a defined local area, typically covering a population of 30,000–50,000 people, where health, social care and community organisations work together to improve population health and deliver more care locally.
Neighbourhoods are designed to reflect natural communities and local geographies, ensuring services are organised around the populations they serve.
In some areas, neighbourhoods may align with existing Primary Care Networks (PCNs). In other places, neighbourhood boundaries may differ depending on local population needs and service configuration.
The NHS faces increasing demand due to:
- An ageing population
- More people living with multiple long-term conditions
- Rising pressure on hospital and urgent care services
The 10 Year Health Plan recognises that the current model of care is becoming unsustainable and highlights neighbourhood health as a way to:
- Reduce fragmentation between services
- Improve prevention and early support
- Deliver care closer to home
- Support people to live healthier, more independent lives
The aim is to provide care at the right time, in the right place, and in ways that fit around people’s lives.
Principles
• Moving care towards a more integrated model based around people, communities and relationships.
• An INT takes collective responsibility for improving the health and wellbeing of everyone in the local community.
• Person-centred care needs to be flexible, joined up, proactive and preventative.
• Partnerships to strengthen primary and community based care key to success.
• Leverage community insights.
• Avoid rigid geographic boundaries.
Operating model
• The INT’s approach must be data driven.
• Likely to involve a core NHS team comprised of general practice, PCN, community services and mental health teams.
• Require multidisciplinary teams to work across organisational boundaries.
• Require strong infrastructure and coordination at regional, ICS and local levels.
• Place-based models and potentially provider collaboratives likely to take a key role.
