Neighbourhood care teams are a specific example of integrated care.

These are usually local teams comprising health and social care professionals, sometimes supported by housing professionals or the voluntary sector, that work with people with long-term or multiple conditions or the frail elderly. The service user usually has access to a case worker or navigator for a single point of access, medical records are usually shared between the members of the team, and members of the team may be drawn from different organisations. Their aim is to support people to remain in their own homes and live as independently as possible, and to avoid unnecessary hospital admissions.

They may also be known as integrated local care teams, locality care teams, virtual wards, neighbourhood teams or similar. Neighbourhood care teams or similar models are a feature of many local Sustainability and Transformation Plans (STPs).

What examples are there of neighbourhood care teams in practice?

The document from NHS England on new care models (1) provides examples of a couple of schemes similar to neighbourhood care teams, namely Fylde Coast Local Health Economy and Stockport Together.

Other examples include:

• Lincolnshire Health and Care Integrated Neighbourhood Care Teams
  http://lincolnshirehealthandcare.org/en/lhac-initiatives/neighbourhood-teams/
• Leeds Community Healthcare NHS Trust Neighbourhood Care Teams
  http://www.leedscommunityhealthcare.nhs.uk/our-services-a-z/neighbourhood-teams/
• South Manchester Integrated Community Care Team
  http://smanchesternt.manchester.nhs.uk/

What’s the evidence for neighbourhood care teams?

A Nuffield Trust report (2) looking at different community interventions including integrated health and social care teams found no evidence of a reduction in hospital admissions, but this may be due to ‘case finding’ identifying previous unmet needs, and any reduction in admissions may only happen in the long-term.

However, there is evidence (3) that co-ordination of care through integrated teams improves patient experience and quality of life, and some evidence that chronic care management models are associated with lower costs.

Further reading

1. NHS England (2016). New care models: Vanguards – developing a blueprint for the future of NHS and care services https://www.england.nhs.uk/wp-content/uploads/2015/11/new_care_models.pdf
2. Nuffield Trust (2011). An evaluation of the impact of community-based interventions on hospital use https://www.nuffieldtrust.org.uk/files/2017-01/evaluation-community-based-interventions-hospital-use-report-web-final.pdf
3. King’s Fund (2015). Care co-ordination through integrated health and social care teamshttps://www.kingsfund.org.uk/projects/gp-commissioning/ten-priorities-for-commissioners/care-coordination

Social prescribing is a means for GPs and other primary care professionals to refer patients to non-medical interventions that can be used to improve their physical or mental well-being. The kinds of options available for prescribing could include walking groups, knit and natter groups, cookery classes, adult learning, volunteering, and self-help reading (the Books on Prescription scheme is an example of social prescribing).

Social prescribing is mentioned in the NHS England document ‘Next Steps on the Five Year Forward View’ and in the General Practice Forward View as a means of reducing avoidable demand, with an aim to work with the voluntary sector and primary care to ‘design a common approach to self-care and social prescribing’. A national clinical champion for social prescribing was appointed by NHS England in 2016.

Social prescribing is a feature of many local Sustainability and Transformation Plans (STPs), including the one for Shropshire and Telford & Wrekin.

What examples are there of social prescribing in practice?

There are plenty of examples, some of which are listed in the evaluation carried out by the University of York on pages 5-7. The Commissioning Handbook for Librarians provides suggestions for searching for material about social prescribing which will help identify more.

The Rotherham social prescribing service is a very large scheme, and was mentioned in the NHS Five Year Forward View as an emerging model for the future.

What's the evidence for social prescribing?

A systematic review carried out in 2016 and published in BMJ Open found that there was there was little good quality systematic evidence to inform the commissioning of social prescribing programmes, as did a previous review of 2015 published by the University of York’s Centre for Reviews and Dissemination.

There is some evidence that social prescribing schemes can make a difference to outcomes such as quality of life, levels of depression, and reduction in use of health services, and social prescribing schemes show high levels of satisfaction from users and health care professionals. However, much of the evidence is qualitative, is from self-reported outcomes, and is from small-scale schemes. Most studies focus on a particular intervention rather than social prescribing generally. Evidence on the cost-effectiveness of social prescribing is limited.