• Home
  • Who We Are
    • Our mission
  • Our Services
  • Blog
    • Blog Index
  • Podcast
    • Podcast Index
  • Resources
    • PCN Plus Conference: The Future of PCNs 2025
    • TV documentary
    • The Future of General Practice: Book
  • Contact Us

No products in the basket.

  • Home
  • Who We Are
    • Our mission
  • Our Services
  • Blog
    • Blog Index
  • Podcast
    • Podcast Index
  • Resources
    • PCN Plus Conference: The Future of PCNs 2025
    • TV documentary
    • The Future of General Practice: Book
  • Contact Us

30
oct
2

The Neighbourhoods are Coming

Posted by Ben GowlandBlogs, The General Practice Blog2 Comments

The new government is a fan of “neighbourhoods”.  They continually talk about how the NHS will become a “neighbourhood health service”.  A few weeks ago I considered the potential impact on practices and PCNs of neighbourhoods, based on the NHS Confederation’s report on the same.  But now some more concrete proposals have emerged.

North West London ICB have published a Board Paper entitled “Development of Integrated Neighbourhood Teams in North West London”, which outlines its plan to put these teams in place over the next few years.  This is the first of its type that we have seen, and so what can we learn about the potential impact of these teams on general practice and PCNs?

Before we get into that we should bear in mind that this is the same ICB that wanted to mandate the introduction of same-day access hubs for urgent primary care appointments separate from GP practices, and only backtracked in the face of significant pubic and professional resistance to the plan.  So this is not an ICB that has the needs of general practice anywhere near the forefront of its thinking.

As with many NHS Board papers, it is not easy to distil exactly what is intended.  The Integrated Neighbourhood Teams are apparently an alignment (whatever that means) of what are termed “core services” around geographical neighbourhoods.  These core services include general practice, along with mental health, community nursing, social care, health visiting and a whole range of other services, with the expectation that there will be over 100 professionals working in each team.

It appears that these teams won’t become organisations in their own right but will have a “dedicated integrator function” that will be a person or small team from one organisation (either a primary care organisation, community health provider or Local Authority) working with all such teams in each place area.  These are expected to be in place by March next year.

I don’t know the at-scale general practice set up in NW London, but it seems there are very few primary care organisations across the country with the capacity to take on this integration function.  This in turn means that ultimately control of neighbourhood teams will lie outside of primary care, which could have huge implications for the future independence of the service, especially if the collaboration of these teams turns into something more formal in future years.

The ambition of the plan is then to have population health management, interoperable IT and an estates plan allowing single neighbourhood hubs to be in place by 2026, joint workforce planning and co-location by 2027, and then shared budgets and integrated funding streams by 2029.

What the plan does not explain is how independent organisations (like GP practices) and their staff will function as a single team.  The responsibility for this seems to lie with the integrator function, and organisations are instructed to create plans to “enact the vision of INTs” and align operational teams to neighbourhoods, but these levers on their own seem insufficient to create what is envisioned.

The document recognises (but does not seem overly concerned by) the fact that PCN boundaries do not align to the INT boundaries.  While in previous national documents the onus has always been on community services to ensure they align with PCN boundaries, the new focus on neighbourhoods makes this much more unlikely. It is hard to envisage a future where PCN boundaries will not have to flex to accommodate recognised local authority/community services neighbourhoods.

The model also appears to lack any significant additional funding.  Dr Joe McManners explained very eloquently in a recent podcast that investing in neighbourhoods will not make the NHS cheaper, but will prevent it from getting worse in the future.  There is no invest to save business case that can fund these teams.  But getting these teams to work does require investment and an element of double running at least in the short term, yet in North West London there is no additional funding provided even for the pivotal integrator function.  The risk, of course, is that funding for this is taken from the core teams themselves, which in turn will simply serve to make these services worse.

The danger is that neighbourhood teams, as the flavour of the day, will be imposed (like in NW London) without the required investment, incentives and support to make them effective.  The government has hinted at additional funding for primary and community care, but we need to see it before embarking on this neighbourhood journey which otherwise seems destined to fail.


Subscribe Today

Subscribe today to receive our weekly newsletter giving details of each episode of the General Practice Podcast as it is published plus our weekly blog and useful links for anyone interested in general practice innovation.  You’ll also receive a free copy of “Ten Steps for Establishing a Powerful Voice for General Practice”. Simply enter your email address and tick the box.

Latest developments New ways of working
Ben Gowland

About Ben Gowland

Ben Gowland Ben is Director of Ockham Healthcare, and a former NHS CCG Chief Executive

2 Comments

  • Shaun Hockey says:
    Oct 31 2024 8:31 am Reply

    Great read as always.

  • Richard Ward says:
    Oct 31 2024 5:08 pm Reply

    Thanks for the heads up. The North West London document is interesting. I’m reminded of the Yogi Berra quote on the difference between theory and practice. “In theory there’s no difference between theory and practice, but in practice there is”. Nice bit of prose with in theory, but not much detail on the practical mechanisms for change. Its a start though…

Leave a Reply Cancel Reply

Your email address will not be published.

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>

Subscribe Today

Subscribe today to receive our weekly newsletter giving details of each episode of the General Practice Podcast as it is published plus our weekly blog and useful links for anyone interested in general practice innovation. You’ll also receive a free copy of “How to Establish GP Influence Within an ICS”.

Subscribe Today

Subscribe to Podcast

Apple PodcastsAndroidby EmailRSS
Amazon Podcasts the general practice podcast

CONTACT INFO

Telephone: 07956 348654
E-mail: ben@ockham.healthcare

Recent Posts

  • Why Engage with Neighbourhoods?
  • Podcast – Rachel Morris – Conquering Stress and Enhancing Communication
  • How Can PCNs Prepare for Neighbourhoods?

Follow Us

Cookie Policy

website acceptable use policy

terms of website use

privacy Policy

Latest Tweets

© Copyright 2016 - 2024 by Ockham Healthcare. All Rights Reserved.
Contact Us
This site uses cookies. By continuing to use this website, you agree to our cookie policyAccept Read More
Privacy & Cookies Policy

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled
Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.
Non-necessary
Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. It is mandatory to procure user consent prior to running these cookies on your website.
SAVE & ACCEPT