Delivery of a Neighbourhood Health Model
A recent Digital Healthcare Council roundtable on Neighbourhood Teams brought together NHS GPs, digital health leaders, colleagues from Sing Health and Accenture to discuss how neighbourhood teams can reshape healthcare delivery. The conversation was refreshingly candid about both the opportunities and challenges facing this transformation.
Key Highlights
Neighbourhood Teams as Change Agents The UK Government's 10-Year Health Plan is moving care away from "hospital by default" to community-based, digitally enabled and personalised approaches. Primary Care Networks (PCNs) serve as the operational blueprint for these teams, with a focus on sustainability and building on local strengths - especially in deprived communities. However, as one experienced GP noted, success will come from amplifying existing assets rather than waiting for new funding streams.
Digital Healthcare Council members like Livi UK are already demonstrating how digital-first approaches can extend primary care capacity, while HBSUK offers hybrid service models can address local health needs effectively. Lilli's technology can support people to live independently for longer - a core neighbourhood health objective that reduces pressure on acute services.
HealthNet Homecare (UK) Ltd shows how specialist clinical homecare can deliver complex treatments safely in patients' homes, supporting over 200,000 patients and enabling earlier hospital discharges Holly Health's app helps ease pressure on GP appointments and supports long-term health improvements.
Strategic Focus Areas Tackling childhood obesity, hypertension and long-term condition management are top priorities, mainly because they're achievable with existing resources. Success will be measured using Patient-Reported Outcome Measures (PROMs), with multidisciplinary teams (MDTs) providing essential clinical oversight Cemplicity work in this area shows how systematic outcome measurement can be practically implemented to track real patient impact.
The key insight: start with conditions where you have good data, clear interventions and measurable outcomes. DHC member Preventx demonstrates how accessible online services can address health inequalities by reducing barriers like travel and stigma for underserved groups, exactly the kind of community-focused approach neighbourhood health requires.
Driving Value Through Integration The greatest impact comes from integrating digital and data across sectors, rather than building entirely new systems. A unified data view is critical for tracking and monitoring outcomes, enabling earlier discharges, reducing emergency admissions and preventing readmissions. This validates the approach taken by Digital Healthcare Council members that focus on enhancing existing workflows rather than replacing them. This is about identifying the right integration points and building sustainable implementation pathways.
Innovative Payment Models Outcomes-based and capitated payment models are needed to incentivise better care and resource allocation, but the transition will be gradual and pragmatic. International perspectives, such as Sweden's performance frameworks and Singapore's community empowerment approaches, offer valuable lessons about systematic implementation rather than revolutionary change.
Measuring Success & Scaling Early measurement, ongoing evaluation and longitudinal tracking are essential but they must be practically implementable. Examples like digital tools reducing GP appointments while supporting long-term health improvements show the potential, but challenges remain in procurement frameworks and scalability. Digital Healthcare Council members are already generating this evidence base, creating the foundation for broader adoption. The critical question is how to systematically capture and share these insights to accelerate implementation across different contexts.
Takeaway Neighbourhood Teams have a place in the centre of healthcare transformation, but success depends on being able to scale what is already working. The companies making progress are those building on existing strengths, addressing real clinical needs and developing sustainable implementation approaches. International experiences remind us that community empowerment and social determinants are key drivers of health outcomes and that systematic, long-term approaches deliver better results than short-term projects.
What This Means for Innovative Companies that Partner with the NHS Our roundtable revealed that while there may not be new funding streams at the moment, there's clear validation for solutions that help the NHS do more with existing resources. Companies already working within NHS partnerships are well-positioned to increase their impact.
The critical success factors are becoming clear:
Integration capabilities that enhance rather than replace existing systems
Evidence generation that demonstrates measurable outcomes
Implementation approaches that work within current constraints
Understanding how to navigate the transition to outcomes-based models