What are Integrated Neighbourhood Teams?
Integrated Neighbourhood Teams are groups of healthcare professionals from different specialties and different organisations across health and care services, that are working together to provide coordinated care and to improve health outcomes for the local population.
Integrated Neighbourhood Teams can provide coordinated, holistic support, rooted in communities, informed by local needs and focused on what matters most to the person, not just their medical diagnosis.
Central Basildon Integrated Neighbourhood Team
The approach of Integrated Neighbourhood Teams in mid and south Essex can vary depending on the needs of a particular area and the partners involved.
In Basildon and Brentwood Alliance, our Central Basildon Integrated Neighbourhood Team used primary care data to identify 600 young adult patients with mental health conditions who were each attending their GP over 25 times a year, or visiting A&E over 10 in a year.
Nnamdi Ndukwe, Care Coordinator at Central Basildon Primary Care Network, contacted each patient to discuss their health and wellbeing and provide holistic support to help address the factors which were negatively impacting their health.
By understanding the patient’s needs, Nnamdi could suggest different types of support that are available and arrange for the patient to receive help from relevant services.
Nnamdi explains: “The Integrated Neighbourhood Team mapped over 60 local groups, organisations and services that could support patients with their mental health and frailty needs. Our aim was to identify the non-medical factors impacting their health and wellbeing. During our conversations, we found that many patients find it difficult to recognise or accept that they need help, or to feel comfortable asking for it. Some told us they had lost confidence and did not believe they would receive support even if they asked. Having the Integrated Neighbourhood Team working alongside GP practices enables primary care to take the time to offer a more holistic approach. We were able to listen, understand their situation, and recommend suitable support tailored to their individual needs. We believe our success so far is rooted in the strong relationships built with local groups, organisations and services that we had identified.”
Benefits of this approach
Supporting this group of 600 patients with their mental health improved their overall wellbeing and helped them achieve personal goals, it also resulted in:
- A 50% reduction in the number of primary care appointments
- A 30% reduction in A&E visits.
What happens next?
Work is underway in Essex to make the national vision for Integrated Neighbourhood Teams – as set out in the NHS 10 Year Plan for England – a reality
Our initial focus over the next year will be to support our aging population by focusing on frailty. We used data and insights to assess the priorities across our geography and identified frailty as the area our Integrated Neighbourhood Teams can make the biggest difference to our residents.
Frailty responds well to a holistic approach to patient care, because the physical, mental, and social factors that impact someone with frailty are often interlinked. By using the collective expertise of our Integrated Neighbourhood Teams will allow for better monitoring and management of frailty, with timely interventions that can significantly improve outcomes and enhance quality of life for vulnerable patients.
Did you know?
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