A new operating model for Integrated Neighbourhood Teams in Birmingham
Understanding the challenge Like much of the country, Birmingham’s health and care services were under significant pressure from rising demand. As a result, residents were not always achieving their best outcomes whilst the financial position of the health and care system was becoming increasingly unsustainable. The publication of the Fuller Stocktake Report in 2022 provided an early vision for the reorientation of health and care in Birmingham towards more proactive, personalised services by building ‘Integrated Neighbourhood Teams’ (INTs). Designing the operating model Birmingham’s journey began with detailed analysis of service use across the system. By combining patient-level data from all partners in the Birmingham and Solihull Integrated Care System, it found that 57% of services were being used by the top 5% of service users. Having identified this high frequency user cohort, further analysis, including multi-disciplinary case reviews, enabled system partners to further understand the impact of delivering preventative interventions to these individuals.
This evidence was then used to co-design a new operating model for Birmingham’s INTs, including the membership of the team, the services they would provide, and new ways of working. Four interventions were found to match 75% of the needs of the target cohort, including community mental health, social prescribing, structured medication reviews, and social care assessments. This understanding of the specific needs and volume of the target cohort was central to the design of the new team. Over 200 members of staff across the system were involved in the design process from social care, primary care, the acute, community and mental health providers, the voluntary sector and the Integrated Care Board. Not only did this ensure that the design of the new teams and services benefited from the full breadth and depth of clinical and operational experience within the system, but also helped to build the belief, commitment and new integrated ways of working that would ensure the effectiveness and sustainability of the new model.
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