London’s five ICBs, along with NHS England London Region and the wider London Health and Care Partnership, have joined together to issue a ‘target operating model’ for neighbourhood health in the London region, based on engagement across the capital which highlighted a desire for more accessible and consistent care and using new technologies “where appropriate”.
Work on developing key enablers has uncovered specific needs around workforce, interfaces, population health management, inequalities, access, technology, and the flow of resources, noted the ICBs. Meeting related challenges and improving health and wellbeing will require an organisation in each place partnership to host required functions and infrastructure, taking on an “integrator role” to enable London to operate as a neighbourhood health service and draw down on relevant system, regional and national resources. To support this, it continues, “a core set of requirements will be developed, building on the model for London and emerging national guidance”.
The model presents a view of neighbourhood care in London delivered by a “Team of Teams”, outlining aligned functions, tailored functions, consistent functions, hyper-local functions, and the resident at the centre of all neighbourhood working. This will mean defining clear membership, roles and responsibilities, it continues, with the aim being that “professionals can operate within and across the right spatial levels, with geographic coherence, and with respect to capacity and demand in each place”. Key enablers here will include tools which support seamless communication and messaging for patients and across neighbourhood teams, as well as interoperable IT systems which can enable data-sharing to support real-time decision making and coordinated care.
Working within each ICS, place partnerships will be responsible for agreeing the footprints of neighbourhoods based on local evidence and data around capacity, demand, assets and needs. The integrator role as outlined by the ICBs will be central to bridging existing fragmentation, adapting to local needs, promoting consistency, and offering access to real-time population health data, to allow targeted interventions. Leading on cross-borough collaboration and scaling of best practice, the provision of essential infrastructure, and additional support options will be essential features of this role.
Next steps as set out within the model, look at such as enabling integration, ensuring participation, implementing a population health management approach, and developing key relationships and interfaces. Adopting a consistent approach to patient flow, supported by interoperability between systems in use in the London region, is one of the factors central to success. For information sharing, it looks to develop the OneLondon Shared Care Record model across London, ensuring new platforms and systems adopted across the system are interoperable, rolling out region-wide data sharing frameworks, future-proofing information systems to include a consideration for wearables and remote monitoring, understanding how to effectively apply emerging technologies such as AI triage, and developing principles to enable Londoners to own their own data.
On fostering a shared approach to digital evaluation and innovation, the model also highlights next steps around working with partners to evaluate existing and new digital technologies and tools, offering clear guidance on how these can be used toward neighbourhood health, and applying learning from virtual wards programmes to service delivery. For pilot projects, it notes plans to agree a route through which successful tests can undergo phased implementation and achieve scalability. At place level, the focus is on developing digital literacy, enabling neighbourhood teams to have the confidence and skills required to both read and write to shared digital records.
Digital transformation in the London region
The first instalment of HTN’s Primary Care Region Series looked to the London region, exploring the latest on digital and data in primary care from each of the seven NHS regions in turn. As well as covering digital strategy from integrated care boards, we heard from professionals in the region, and explored market trends.
A framework for implementing and monitoring AI in the London health and care system has been published, covering five key areas: partnership, infrastructure and data, use cases, AI delivery approach, and communication and workforce development. It spans governance, roles, responsibilities, delivery lifecycles, proof of concepts, pilots, data pipelines, business as usual, scaling, through to monitoring.
In a meeting of the North West London ICS board earlier this year, a summary of Integrated Neighbourhood Teams in NWL cited the importance of tying in “supporting concepts” such as health literacy and digital literacy to the broader neighbourhood working model, “enabling people to better manage their own health and care needs where possible”.
