Image Credit: Somang Lee
The Work
Co-designing, prototyping and delivering Integrated Neighbourhood Teams to bring health and social systems closer together for 500,000 residents. Convening over 100 stakeholders and organisations to close a 10-year life expectancy health inequality gap.
A key pillar of NHS England’s vision for the future is to respond to the social determinants of health by bringing health and social ecosystems closer together via INTs. We ran a programme of qualitative and quantitative research with residents and providers, plus several innovation workshops to define what INTs mean to the system and to build the conditions for successful and sustainable delivery. We (are currently) developing and prototyping components of INTs across the boroughs of Westminster and Kensington & Chelsea, involving local authorities, NHS bodies and the voluntary and community sector.
About INTs
Integrated Neighbourhood Teams are an ambitious initiative introduced by NHS England to enable better outcomes for population health through collaboration between organisations across the health, Local Authority, private, voluntary and community sectors.
INTs are not new. As with other initiatives and movements in the past, they recognise that the health of any population does not exist in a vacuum of healthcare, but an ecosystem of preventative health, proactive health and reactive care. Beyond this, they must incorporate the organisations, local assets and individual behaviours that shape the everyday lives of residents unique to their communities beyond health. This encompasses housing, public spaces, pollution and the local environment, local government and services, social care, employment and schools to name several.
NHS England has encouraged every local authority to explore how this might work for their own unique context and mix of assets and challenges. Following this phase of organic and distributed exploration and innovation, NHS England will mandate INTs and provide further structure. This will also likely give a boost of funding and re-allocating of resources to realise the ambitions of every neighbourhood ecosystem of organisations and residents currently feeling out what matters most to them, and how they feel it might be delivered.
The Bi-Borough Partnership
It has been a privilege to facilitate this process with the Bi-Borough partnership of Westminster and Kensington & Chelsea. Top of their priorities is reducing the life expectancy gap and health inequalities between the most and least affluent in their boroughs. Despite surface perceptions of these areas, they are patchwork quilts of extremely high and low deprivation, as is the case across London and many other metropolitan areas.
“We are bringing together local services across health, social care and community groups to support better health and wellbeing in our neighbourhoods. Our vision is to halve the life expectancy gap of residents by 2035, aligned with the Health and Wellbeing Strategy.”
– Bi-Borough Place-Based Partnership
Our guide to INTs was recently published on the NHS website informs both internally and externally. Internally, it provides the principles, goals and ambitions to help align efforts and bring the social and health spheres closer together. Externally, it provides thought leadership that may be useful to other Local Authorities finding their own path to realising INTs.
This work reflects the past year and a half that I have been working within the machinery of the NHS and its foundations, the North West London Integrated Care System, the two Borough Councils and all the partners that interact with it. Through a series of three large workshops, each bringing together around 100 stakeholders from across the public, private and third sectors, we developed the vision and specifications for key functions on how INTs can realise ambitious outcomes for residents and enable collaborative impact and collaboration between organisations.
What’s in the Document
The guide was designed to succinctly outline the vision, mission and principles that will guide this work towards more ambitious outcomes and results for residents, and quickly grounds this in the changes that we want residents to see in their everyday lives, and highlights the initiatives already taking place and demonstrating new more collective ways of working that are already showing results. Again, INTs are not new, but reflect an emphasis by the NHS and national and local government that this is the direction of travel.
At the outset we set ourselves a challenge to keep the document to a dozen pages. With the three large stakeholder workshops, qualitative research with residents and many co-creation sessions with the editorial team, the easier option would have been to create a tome. This simple directive was designed to force us all to be succinct, to leave the detail to other connected initiatives and documents and to keep laser-focused on the absolute essentials.
What’s next
I have always been an advocate of the process being a means to the ends (defining and realsing the outcomes and change we want to see) as well as a productive ends in itself (the cultural and organisational grass-roots work to build momentum and sustainability). It has brought together many organisations and individuals to be fully included in developing and shaping how INTs will work for them. As we navigate the less glamorous phase of aligning the models, cases for change, systemic machinery, metrics, workstreams, enablers, funding, resources and people of the ecosystem, this document is being continually revisited as our north star.
As the guide forced us to be succinct about communicating the various facets of now INTs will work, we are now in a stage where we unpack those things again, moving from key features and specifications into the real detailed work of how multiple organisations will share the efforts and rewards of working in new (and not so new) ways.