NHS will ‘build on’ PCNs to create a neighbourhood health model

The NHS will need to ‘build on’ existing cross-team working, such as PCNs, to move to a neighbourhood health service, NHS England has said.

In the neighbourhood health guidelines 2025/26, published last week alongside the operational planning guidance, NHS England said there was an urgent need to ‘transform’ the health and care system and that it would need an integrated response to do so.

It said integrated working should be the norm and not the exception, and that some had already made progress in developing an integrated local approach.

It added that for this integrated vision to take place: ‘All parts of the health and care system – primary care, social care, community health, mental health, acute, and wider system partners – will need to work closely together to support people’s needs more systematically, building on existing cross-team working, such as primary care networks, provider collaboratives and collaboration with the voluntary, community, faith and social enterprise (VCFSE) sector.

‘In some parts of the country this is already happening, and much can be learned from these experiences.’

The document set out six ‘core components’ of an effective neighbourhood health model, which it says should continue to be embedded, standardised and scaled in 2025/26. These are:

1. Population health management,
2. Modern general practice,
3. Standardising community health services,
4. Neighbourhood disciplinary teams,
5. Integrated intermediate care with a ‘Home First’ approach,
6. Urgent neighbourhood services.

It added that systems should consider improving coordination, personalisation and continuity of care for people with complex needs, and that systems should tackle health inequalities when developing their neighbourhood health service.

The document said the full vision for neighbourhood health would be set out in the 10-year health plan, including proposals to make the ‘emerging vision’ a reality.

However, it added that the guidelines were currently ‘deliberately short and permissive about how neighbourhood health should be implemented’, so that it can be tailored to local need.

Dr Sajid Nazir, clinical director at Viaduct PCN, West Yorkshire, said there was a ‘curious absence of any significant mention of PCNs’.

He said: ‘It is interesting that that the neighbourhood health core components mirror and build on key functions of PCNs, for example, population health management, collaboration between providers, targeting resources and reducing health inequalities.

‘These documents alongside other like the Darzi report which also mentioned PCNs sparingly, present some uncertainty for PCNs. My own view is that PCNs may evolve into neighbourhood teams, rather than [INTs] replacing them [PCNs]. It would be shame to lose some of the valuable knowledge and foundations PCNs have built.’

Ruth Rankine, director of primary care at the NHS Confederation, added:  ‘We know across many parts of the country PCNs have already been a core catalyst for neighbourhood working, their scale means they can enable population health driven planning and bring together a diversity of professions to create more proactive and wraparound model of care.

‘What is most important for the success of neighbourhood working is that it is built around trusted bodies, and familiar expertise rooted in communities. For the NHS, this is typically general practice or community pharmacy.

‘A prescriptive model for how to build a neighbourhood health approach is unhelpful and we support empowering local systems and leaders to make decisions, focusing on function over form. But we encourage systems not to underestimate the important role of Primary Care infrastructure.’

National Association of Primary Care (NAPC) chair, Dr Caroline Taylor, said: ‘We welcome the further commitment and clarity on the development of integrated neighbourhood working and support the government’s commitment to reducing demand through a greater focus on the shift from sickness to prevention, hospital to community and analogue to digital.

‘In our experience this results in greater patient satisfaction and outcomes and supports the need to tackle health inequalities. It is essential that the NHS workforce is supported to make this radical shift in approach without delay.’

It comes after PCNs were asked to engage patients in conversations about the 10-year health plan by 14 February, as part of a national conversation about the future of the NHS.