To gain insights and perspectives from across the industry, HTN asked a variety of professionals: What’s the greatest digital/industry/healthcare challenge with progressing towards neighbourhood health and how can digital be an enabler to realising success in neighbourhood health?
Dave Mills, Think Healthcare, notes the NHS’s “long history of building brilliant services in silos”, adding: “Neighbourhood health asks us to dismantle those silos, but the reality is that most organisations are not in a position to merge their systems, teams, or governance overnight.” Success, he says, will depend on the ability of multiple organisations to communicate and coordinate as if they were a single entity, “without forcing every partner to abandon the tools and platforms they already rely on”. A neighbourhood digital front door needs to do two things, he continues: aggregate access across multiple sites and platforms, and remain inclusive. “Sixty-eight per cent of patients still use the telephone as their first point of contact with the NHS. Any neighbourhood access model that doesn’t account for that is already leaving people behind.”
Comments from Marcus Baw, Baw Medical, point to the issue with neighbourhood health being that “it was conceived as a buzzword-first policy decision”, with uncertainty around what it might actually entail, or how services will be provided. “There is a significant risk that it will worsen overall care, but as a flagship reorganisation nobody will be allowed to point that out if it happens,” Marcus adds. “This is absolutely the worst kind of healthcare reform, a nation-sized experiment without a ‘control’ group.”
Agreement around lack of shared understanding of neighbourhood health is offered from Chris Robson, Living With, who states: “The NHS leadership have deliberately left this undefined so that in theory, local approaches can evolve organically. This is a strategic mistake when the NHS has so little resource, when ICB’s have been reduced by 50 percent, no one has a clear view of the direction, and the clarity gap will breed political decision making over system choices and budgets.” While digital can play an important role in helping to bring the pieces together, this relies on stakeholders having a shared view of direction and what good looks like, Chris continues.
For Grace Gimson, Holly Health, the biggest hurdle for neighbourhood health is the disconnect existing between reactive clinical care and daily life, with healthcare largely “ignoring” lifestyle factors like nutrition, sleep, and mental wellbeing driving the most prevalent chronic conditions, and treating digital tools as “short-term extras rather than core infrastructure”. To shift from treating sickness to maintaining population wellbeing, we need “digital glue”, Grace continues, “technology that scales human care rather than replacing it”. She adds: “By blending behavioural science with accessible technology, we can bridge this gap and extend the reach of local care teams directly into patients’ homes.”
“Neighbourhood health will only work if we deliver care with people, not to them,” Tom Micklewright, Orcha Health considers. “Digital can be a powerful route to achieving that, but only when the tools we direct patients towards are safe, evidence-based and genuinely fit for purpose. Consistency in how digital tools are assessed and deployed isn’t a nice-to-have. It’s the foundation that makes digital health work at population scale and the key to closing the health inequalities that neighbourhood health exists to address.” Prevention has been a declared priority for decades, Tom goes on, “yet the gap between stated intent and funded action remains one of the system’s most persistent failures”. Closing it, he estimates, will mean genuine co-production “alongside anchor institutions using their leverage as employers and procurers to improve the conditions in which people live”.
According to David Gunion, Sunderland GP Alliance, the joining up of systems and data will continue to be the health system’s biggest challenge. “In the absence of additional funding, we will also need to focus on maximising the value of existing systems to better support neighbourhood working,” he highlights. “Governance, while necessary, is likely to present a barrier. Sharing learning and experience across the NHS continues to be difficult. We need to find more effective ways to do this to avoid duplication.” That would include, David suggests, sharing reusable template information for things like governance processes completed for a supplier in one area across other organisations to reduce duplication in time, cost, and effort.
Edward Bellamy, Radar Healthcare shares insights from working with NHS organisations across the country, saying his team hear the same message: “Neighbourhood models make sense in principle, but there is inconsistent pull from providers while accountabilities and incentives remain misaligned.” With nationally adopted standards, systems could interoperate seamlessly, he notes, which would allow regions to deploy “best-fit” solutions without creating friction for those on the frontline. “In a complex, multi-vendor landscape, success depends on stakeholders working together, because true interoperability across settings (rather than single-system approaches) is what unlocks better quality and safer care,” Edward concludes.
Also picking up on the theme of interoperability, Richard Keyse, 2iC-Care says “ensuring solutions are interoperable is the key to neighbourhood health”. Also required will be a “huge” culture change for frontline professionals, he states, needing changes to be made around target operating models, risk appetite, and “expectation management”. Digital is not just an enabler, but an “absolutely critical component”, Richard continues, and in a neighbourhood health scenario data collection becomes even more critical to ensuring patient safety. “Digital solutions that collect data in real time and provide rapid actionable insights are therefore key if someone is at risk of deterioration or another incident occurs,” he adds.
“There has certainly been a shift from analogue to digital in the community, and the launch of the NHS 10 Year Health Plan will continue to drive this change,” says GS1 UK’s Georgina Lawton. “However, as with secondary care, the challenge will be in connecting disparate digital systems to build an efficient, interoperable infrastructure that can genuinely support neighbourhood health.” Systems are often procured to “solve an immediate need”, she goes on, “without sufficient consideration of how data will be captured, structured, and shared seamlessly, or how new solutions will interoperate with existing architecture”. For this reason, data standards like GS1 should be regarded as essential from the outset, rather than added retrospectively after implementation, Georgina asserts.
Pat Goddard, Fun and Moving refers to a “significant proportion” of the population who still struggle to access conventional exercise, rehabilitation, or wellbeing services due to factors such as chronic illness, mobility limitations, and transport. There is a danger, Pat considers, that digital health “can unintentionally widen inequalities if it is designed mainly for already motivated, digitally confident or physically active users”. Digital can become a powerful enabler of neighbourhood health when it supports, rather than replaces, local relationships and services, she discusses, like with platforms designed to help people engage with activity in their own homes while also complementing community, leisure, social prescribing and healthcare pathways. Pat adds: “Neighbourhood health will be most successful when digital tools are not viewed as standalone interventions, but as connectors – helping people move more confidently between healthcare, community support and independent self-care in ways that feel achievable and sustainable.”
Feedback from the national neighbourhood simulation highlighted digital connectivity as the most powerful enabler of neighbourhood-based care, says Tom Oakley, Feedback Medical, pointing to the opportunity to prioritise investment in digital first to unlock more flexible, patient-centred models of care that wrap seamlessly around individuals and communities. “The key challenge is not capability, but mindset,” he explains. “Shifting from a traditional focus on buildings to recognising digital as the foundation of integrated care delivery. Encouragingly, frontline teams are already embracing this shift, calling for interoperable, flexible digital solutions that empower them to collaborate effectively. With the right investment priorities, neighbourhood health can scale quickly, safely, and sustainably.”
Orion Health’s Ian Binks talked about challenges with assigning accountability and maintaining that across a patient’s journey in a more distributed model, suggesting digital can play a role in helping make accountability more visible, helping to track what’s happening and who is involved across a pathway. “Shared care records have already proven really effective at connecting information across primary, secondary, mental health and social care, giving a more joined-up view of the individual,” Ian says. “We should now look to build on that to support more coordinated care in practice, not just seeing the information, but using it to manage what happens next and making it clear which team is picking that up.” Integration alone cannot solve the problem, he goes on, and without being able to see how care is moving across a pathway, or who is responsible at each point, “it becomes very difficult to make neighbourhood care work in practice”.
“Neighbourhood health will fail if we simply overlay new care models onto the same fragmented digital estate that already exhausts frontline teams with duplication, manual workarounds and disconnected systems,” say Aire Innovate’s Ian Dove and Cogniss’s Lloyd Humphreys. ” The opportunity is not another rigid platform rollout, but giving neighbourhoods the power to rapidly design and adapt local pathways around their population. Low-code and no-code technology gives the opportunity to convene health, social care and third sector teams, to build solutions that meet their local populations’ exact needs.” The organisations that succeed, they argue, “will be the ones that stop treating digital as a procurement exercise and start treating it as operational infrastructure for continuous local transformation”.
Ricky Moore, Totalmobile also highlights the importance of addressing fragmentation in order to allow neighbourhood health to succeed. “Across systems, organisations and the workforce, too many teams still operate without the visibility or coordination needed to deliver truly joined-up care,” he remarks, the result of this being a reactive model, rather than proactive, place-based support. Digital should be focused on the delivery of care in the community, offering organisations real-time operational visibility and helping to coordinate workforce, he acknowledges, as well as giving frontline teams the mobile tools needed to improve productivity and care quality. “Ultimately, neighbourhood health depends on turning strategy into action on the ground,” Ricky notes. “That’s where digital has the biggest role to play – connecting services, improving coordination, and helping deliver more responsive care closer to home.”
Integration with local authority, social care, and voluntary partners is essential to neighbourhood health’s delivery, according to Steve Wightman, Access Health (part of The Access Group), with commissioning frameworks, funding flows, and accountability structures all needing to reflect shared responsibility, rather than reinforcing existing organisational silos. At present, these silos mean information from GP records, social care, and community nursing “sit in separate systems with no reliable flow between then”, he considers. “That is not a technology limitation. The capability to connect these systems exists. It is a prioritisation problem.” Health professionals involved in the same person’s care often have no way to communicate with each other, Steve shares. “Neighbourhood working will bring that gap into sharper focus, and any digital strategy that ignores it will fall short. The Single Patient Record has the potential to help…But the priority should be less on building something new and more on scaling what already exists. Investing in safe, effective information integration across the existing tech estate will deliver more, and faster, than starting from scratch.”
Simon McNair, Restore Information Management shared: “Neighbourhood health will fail if we simply digitise. The biggest challenge isn’t a lack of technology it’s that health and care systems still in many cases operate in organisational silos. Digital should not be seen as an add-on or efficiency tool; it must become the infrastructure that enables genuinely joined-up care.” That includes interoperable data that can follow citizens, real-time intelligence to identify risks earlier, and AI-enabled workflows freeing-up time to care for frontline teams, along with services designed around communities rather than organisations, he noted. “The uncomfortable truth is that neighbourhood health requires a shift in power: from hospitals to communities, from reactive treatment to prevention, and from isolated datasets to shared accountability. Digital can accelerate that shift, but only if we stop treating it as an IT programme and start treating it as a fundamental redesign of care”
“Local health providers shouldn’t have to shoulder complex technical and regulatory burdens alone,” says Adam Spinks, 8fold. “To successfully deploy community technology and remote diagnostics, the new neighbourhood model must be built on a shared governance framework that balances speed with safety – an objective that mechanisms like the Innovator Passport are perfectly positioned to enable.”
For Nick Knight, Babblevoice, one of the biggest challenges in delivering neighbourhood health is in achieving effective coordination across multiple organisations that are “often working with disconnected legacy systems”. Primary, community, and social care providers need technology that is easy to implement and integrates smoothly with existing infrastructure, supporting joined-up care, rather than adding further complexity, he shares. “Digital health providers need a clear appreciation of the needs of both clinicians and patients alongside a strong understanding of the technology landscape across primary and community care. Solutions must work in real-world healthcare environments and support better communication, accessibility and operational efficiency.” This includes supporting high priority patient groups, many of whom experience significant digital exclusion, Nick continues, and integrating digital enablers such as AI, automation, and integrated communications that will be key to maximising neighbourhood health’s potential.
Similarly, Riviam Digital Care highlight the challenges of bringing together health, social care, and VCSE organisations with differing working practices and levels of digital maturity to deliver coordinated care, acknowledging “much of today’s digital infrastructure is still not designed to support neighbourhood health and multi-agency care delivery”. Over time, the digital landscape will look very different, Riviam continues, “and the pace of digital change will need to keep up with the demands of patients and the transformation”. Digital should underpin this by making multi-agency working simpler, more connected and more transparent, helping teams spend less time navigating systems and more time supporting people in their communities.
