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 scale of this challenge nationally has received a great deal of focus in recent years, with widespread agreement that the shift towards more preventative health and care services is essential in helping people live longer, healthier lives and in ensuring the performance and sustainability of the health and care system. The publication of the Fuller Stocktake Report in 2022 provided an early vision for the reorientation of health and care towards more proactive, personalised services by building ‘Integrated Neighbourhood Teams’ (INTs). It also highlighted the need for local systems to drive the change themselves, requiring primary, secondary, social care and voluntary services to work together to design and deliver an impactful new model of care for their population. The challenges presented by integrated ways of working are well known, alongside the difficulty with proving the impact of preventative services within a timeframe that supports significant and recurrent investment. However, the approach taken by Birmingham has led to hugely positive results in a relatively short space of time, generating significant national interest and providing a proven model for other systems to adapt and adopt for their own contexts.
What did we do? Birmingham’s journey towards impactful INTs began with detailed analysis of service use across the system. By combining patient- level data from all partners in 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.
This genuinely gives us the chance to make a fundamental difference to people for the long term.” CEO, Birmingham Community Healthcare NHS Foundation Trust
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