North West London (NWL) ICB has drawn up first-of-its-kind plans to introduce ‘integrated neighbourhood teams’ inspired by the Fuller Stocktake.
All NWL providers are now ‘asked to put their plans in place’ to ‘enact the vision’ for integrated neighbourhood teams, according to a document presented to the board last week.
NWL ICS chair Dr Penny Dash issued the paper setting out ‘the next stages in the development of integrated neighbourhood teams’ for the area.
There will be 25 integrated neighbourhood teams, each made up of one or more PCNs and of about 100 staff members, looking after a population of 50,000 to 100,000 residents.
Providers ‘will work towards hub arrangements’ in which core services will be housed ‘behind a single reception’, creating a ‘single neighbourhood hub’ that provides ‘a range of health and care services’.
However, the document warned that ‘challenges remain’ in the implementation of INTs, including the boundaries of the ICB’s PCNs ‘not fully aligning to INT boundaries’.
The NWL plan said the hubs will all contain core services including:
- General practice
- Care navigation
- Adult social care
- Community mental health, nursing, therapies and pharmacy
- Children’s services (including antenatal and post-natal care)
- Social prescribing
- Dentistry and optometry
- Domiciliary care and health visiting
- Voluntary Community and Social Enterprise
- Public health intelligence
It comes after the new Government pledged to ‘reform’ primary care, trialling ‘neighbourhood health centres’ which would have GPs and other community health staff ‘under one roof’.
And an independent investigation into the NHS, led by Lord Ara Darzi, found that neighbourhood working and multidisciplinary teams will be the way forward for the system.
According to document, services will take a ‘no wrong front door’ approach for ‘all services’ which will be accessed ‘digitally, by telephony or in person’.
The document referenced Professor Claire Fuller’s landmark review from 2022, and said that integrated neighbourhood teams ‘are the vehicles for implementing’ the changes set out by Professor Fuller.
An ICB spokesperson said: ‘INTs are about connecting wider system support up and focusing on meeting the needs of a neighbourhood population.
‘We expect that general practice will have closer connections with community providers, VCS providers, social care and community health services as a result of these developments.
‘These organisations will work more closely together in prevention of ill health and management of complexity in a community setting.
‘In implementing INTs, we will be levering the resources within our system to deliver the model of care. There are no changes proposed to arrangements for GP budgets.’
Each INT will also have an ‘integrator function’, a role performed by a person or a small team, responsible for facilitating practical operations within the team, such as business intelligence, workforce and organisational development.
The ICB said it expects these ‘integrators’ to come from a primary care organisation, community health service provider or local authority and to be in place by March 2025.
Londonwide LMCs said that currently there is ‘no set model’ for the integrator role and a funding stream ‘has not yet been identified’, but it ‘has obtained reassurance’ that general practice budgets will be ring fenced and ‘alternative funding’ will be identified to support this work.
The plans were discussed during an ICB meeting last week, in which members of the public raised concerns about the future of PCNs within the plan.
One question submitted to the board said: ‘Why in this paper I cannot see the term PCN mentioned even once?
‘It would certainly make sense to me to build on these existing effectively neighbourhood teams to create this “integrated model”.
‘Although some of these would have to get together to reduce the number to 25 as you seem to want.
‘Why seemingly re-start from new which could be as good a recipe for absolute chaos leaving residents with an unsatisfactory health and care system for years?’
Professor Claire Fuller’s landmark review in 2022 recommended the creation of integrated neighbourhood teams, as well as ‘single urgent care teams’ which would ‘offer their patients the care appropriate to them when they pop into their practice, contact the team or book an online appointment’.
A version of this story was first published on our sister title Pulse.
