ICBs have been told to focus on reducing demand through the development of the neighbourhood health service model, in the new operational and planning guidance from NHS England.
The guidance, which included a document setting out neighbourhood health guidelines for 2025/26, said ICBs should have an ‘immediate focus’ on preventing long and costly admissions to hospitals and improving access to urgent and emergency care.
It set out six ‘core components’ of an effective neighbourhood health model which it asked systems to standardise into existing practice (see box).
Core components of an effective neighbourhood health model
- Population health management,
- Modern general practice,
- Standardising community health services,
- Neighbourhood disciplinary teams,
- Integrated intermediate care with a ‘Home First’ approach,
- Urgent neighbourhood services.
Through the standardisation and scaling of these areas, the guidance said systems would be asked to focus on the aim of preventing people spending unnecessary time in hospital or care homes for 2025/26.
It suggested systems focus on supporting those with complex health and social care needs who require support from multiple services.
The guidance said: ‘This cohort has been estimated at around 7% of the population and associated with around 46% of hospital costs, according to NHS England analysis from adapted Bridges to Health data.
‘It is likely that systems will initially prioritise specific groups within this cohort where there is the greatest potential to improve levels of independence and reduce reliance on hospital care and long-term residential or nursing home care, both improving outcomes and freeing up resources so systems can go further on prevention and early intervention. This approach is likely to focus on around 2% to 4% of the population.’
Examples of these groups include adults with moderate or severe frailty, palliative care needs, complex physical disabilities, and those with high intensity use of emergency departments.
It added that as systems develop relationships between local partners, they will be expected to work over the next five to 10 years on strengthening primary and community-based care to enable more people to be supported closer to home or work, and connecting people accessing health and care to wider public services and third sector support, including social care, public health and other local government services.
Aims for all neighbourhoods over the next five to 10 years
- NHS and social care working together to prevent people spending unnecessary time in hospital or care homes.
- Strengthening primary and community based care to enable more people to be supported closer to home or work.
- Connecting people accessing health and care to wider public services and third sector support, including social care, public health and other local government services.
The document added that the full vision for neighbourhood health would be set out in the 10-year health plan.
However, it added that the guidelines were ‘deliberately short and permissive about how neighbourhood health should be implemented’, so that it can be tailored to local need.
The operational planning guidance also said NHS England would remove ‘most’ ringfences from funding, giving ICBs more freedom to allocate their resources.
Responding to the publication of the NHS operational planning guidance Matthew Taylor, chief executive of the NHS Confederation, said: ‘NHS leaders will welcome the reduction in national targets and clearer priorities that are set out in the planning guidance, so it is clear that the government and NHS England have been listening to our members.
‘But we should be under no illusion – this is going to be one of the most challenging financial settlements of recent years and these ambitions will be unbelievably stretching for the NHS.’
He added: ‘While we understand the guidance is focused on recovery, putting the NHS on sustainable footing will require more radical reform and delivery of the government’s three shifts. This should not be a zero-sum game.
‘Moving care out of hospitals into the community, improving digital technology and providing more preventative interventions will also help the NHS now, not just in the future. The NHS needs to drive up performance in the short-term but without long-term reforms the health service will not be able to meet rising demand in the future.’
