Reflections on neighbourhood health comments of Yvette Cooper, Health and Social Care Secretary, at the Labour Party Conference, reported by GPOnline.
Yvette Cooper issued a call to action to the profession this week: seize the opportunity, champion neighbourhood health and help shape what comes next. If NHS reform is to succeed, primary care must be what the Health Secretary envisaged: at the heart of neighbourhood health, and at the heart of the communities it serves.
Speaking about the Government's neighbourhood health ambitions, she posited that these would work best if "seized on by GPs". She spoke of primary care leadership driving innovative ideas and envisaged a future in which neighbourhood health centres combine primary care with community services and wider local support - with primary care at their heart.
For those of us working closely with GP practices, Primary Care Networks and wider primary care organisations, Ms Cooper’s comments feel significant. They not only build upon the direction of travel already set by the NHS 10 Year Health Plan but add a distinct feeling of challenge to the long-standing message that neighbourhood health will be delivered by primary care.
Collaborative working will be central
Questions around neighbourhood health centres, community infrastructure and the future primary care estate matter: many GP premises are already operating at or beyond capacity and it is difficult to imagine a successful neighbourhood health model without sufficient space to accommodate multidisciplinary working. However, as Ms Cooper observed, the places progressing most quickly appear to be those where partnerships already exist between health services, social care, local authorities and wider community organisations.
Critical infrastructure is therefore organisational as well as physical. From integrated neighbourhood teams and provider collaboratives through to place-based partnerships and devolved regional models, healthcare organisations are increasingly operating within networks rather than silos. Neighbourhood health depends upon relationships, governance arrangements, shared objectives, data-sharing mechanisms and the ability of different organisations to work together around the needs of a population rather than within traditional organisational boundaries. That is where many of the real challenges will emerge.
Who is accountable when multiple organisations contribute to a single patient pathway?
How should risk be allocated across different organisations?
What governance frameworks are needed when NHS bodies, primary care providers, local authorities, third-sector organisations and private providers work together?
How can innovation be encouraged without increasing patient safety, regulatory or reputational risk?
Primary care leadership must drive innovative ideas
General practice retains advantages that few other parts of the health system can replicate. It is embedded within communities. It understands local populations. It manages long-term relationships with patients and families. It already coordinates care across organisational boundaries every day.
Yet leadership of neighbourhood health will require new capabilities alongside traditional clinical leadership. It will require practices and PCNs to think strategically about collaborative ventures, organisational models, workforce planning, digital transformation, governance and estates.
It may also require practices to become more comfortable with mergers, federations, strategic alliances and other forms of collaboration designed to achieve resilience and scale while preserving local relationships.
Safe transformation must remain the priority
The pressure to transform services comes at a time when the wider health system remains under significant strain. Demand continues to exceed capacity, workforce pressures remain substantial and primary care is likely to absorb additional workload while operating within challenging financial constraints. At the same time, organisations are being asked to embrace digital health, new technologies and innovative service models.
Essential transformation must also be safe. Patient safety and clarity of accountability are not competing interests and need to remain central considerations. Organisations that embed learning as part of their effective transformation are likely to be the organisations that deliver safer care.
How can Weightmans help?
We have discussed how primary care providers will not deliver the ambitions of the NHS 10 Year Plan in isolation. Our experience across the NHS, independent healthcare, social care, pharmacy, medical indemnity and regulatory sectors enables us to provide the joined-up insight and practical support needed to navigate increasingly integrated models of care.
Our primary care team is already supporting organisations with:
GP mergers, acquisitions and organisational restructuring
Collaborative working arrangements and partnership agreements
Primary care network governance
Estates and property matters
Commercial contracts and service agreements
Regulatory and governance frameworks
Data sharing and information governance
Employment and workforce issues
Risk management and patient safety considerations
Dispute resolution and organisational change programmes.
For more information, please contact our expert GP and doctors lawyers.
