Designing a Neighbourhood Health Service
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The Government have been clear on the need to shift care decisively out of hospitals and into communities, facilitated by the creation of a new NHS – what they call a Neighbourhood Health Service.
At the heart of this vision, is the potential for a system which is far more accessible, proactive and patient-centred than the current model of primary care. However, this will only be realised by being honest about and directly addressing long-standing barriers to change, including fragmented datasets, a deficit of local leadership capacity, and an outdated workforce model and GP estate.
Drawing on interviews with senior experts from the health and care sector, 'Designing a Neighbourhood Health Service' identifies examples of best practice from across the UK that should inform the Government’s approach – and lessons that should be taken from each – based on granting greater autonomy and resources to local providers.
Government will not be able to dictate what Neighbourhood Health looks like in every patch. Instead, by creating the right conditions and setting out key design principles for services to be reconfigured in radically different ways, it can promote a system that works on behalf of citizens and tackles the root causes of ill health in communities.
Re:State's research on this topic was kindly supported by Boots.
Design principles for a Neighbourhood Health Service:
- Leadership to drive neighbourhood-level change - including where leadership capacity has been freed up to think long-term about the services offered in a place and to support change management.
- Understanding of the determinants of health – including through integrating data on the wider determinants of health, and between health providers, local government, research partners and the VCFSE sector.
- Creative deployment of workforce and neighbourhood assets – including how staff in PCNs can be deployed to work in neighbourhood teams or be based in other hyper-local settings, and how (physical and virtual) neighbourhood assets can be used to help deliver health services.
Endorsements:
Dr Michael Dixon CVO OBE, GP and Chair of the College of Medicine: "Thriving neighbourhood health services, empowering local people and communities, are crucial for the survival of the NHS and society itself. Re:State's groundbreaking paper tells us how to do this and its lessons, particularly in devolving power and funding to the local level and supporting local leaders, can no longer be ignored."
Professor Kate Ardern, former Director of Public Health, Wigan Council: "I warmly endorse this thoughtful and very timely report from Re:State think tank setting out the principles and lessons for the development of Neighbourhood Health which for me is the critical component of the Government’s health mission and achieving the shifts to community and prevention. Put simply, geography, and social and economic context really matter to addressing persistent, structural health inequalities. Successful examples in the report, from across the UK, show that local knowledge and mobilisation of community assets are key, and will require devolution of power, resources and control."
Professor Sir Sam Everington OBE, GP, Bromley by Bow Centre and former Chair of the NHS Tower Hamlets CCG: "The Government's agenda of shifting care out of hospitals, and its focus on digitisation and prevention, emphasises the need for a model of neighbourhood health and a holistic approach to care. Re:State's report teases out examples of good neighbourhood health and models for the future, combined with an outline of the enablers of change.
Company Chemists’ Association (CCA) Chief Executive Malcolm Harrison: “This timely report recognises the huge potential to harness community pharmacy to deliver effective ‘neighbourhood health’. With more pharmacies in more deprived communities, a workforce typically drawn from nearby neighbourhoods and highly trusted by patients, the community pharmacy network is ideally placed to improve health outcomes. The Government has set an ambition to move care closer to the community and moving from treating sickness to preventing ill health. This report sets out some actionable steps to realise these shifts which we hope the Department and NHS take forward."