Spotlight 

Learning from York’s approach to Neighbourhood Health - Claire Fuller

I recently went to York where I met healthcare professionals from across the Humber and North Yorkshire ICB. What I witnessed gave me genuine optimism about our collective ability to deliver the transformational changes outlined in the NHS 10 Year Health Plan. 

The visit showcased exactly the kind of innovation and collaborative working essential for implementing neighbourhood care models across England. I was particularly struck by the maturity and sophistication of the local approaches, which showed the fundamental shift towards community based care is happening now with measurable results. 

The South Hambleton and Ryedale (SHaR) PCN’s demonstration was equally inspiring. Operating across 600 rural square miles, serving 38,000 patients across seven practices, it’s achieved 6,371 patient contacts in just five months saving over 1,500 GP hours. It’s 98.9% patient satisfaction rate, despite geographical challenges and complex demographics, shows what can be achieved when services are designed around patient needs, rather than organisational convenience. 

The neighbourhood approach represents a fundamental shift towards models of care that put relationships with communities and improved outcomes at its heart.  The ultimate aim is achieving the "left shift" of funding from hospitals to community settings, something we've attempted for decades but haven't successfully achieved at scale. 

Financial sustainability, contractual frameworks and how we balance continuity with accessibility are complex issues, which is why we're working intensively through summer ‘sprints’ to provide much greater clarity by the end of this month on contracting, definitions and operational guidance. We must balance providing certainty with maintaining the flexibility local systems need, to adapt to their unique circumstances. 

Without bringing together primary and secondary care other improvements simply cannot be achieved. The progress I saw in Humberside and North Yorkshire, with its mature interface relationships and established governance structures enabling "left shift" initiatives, shows this integration is possible and essential. 

What struck me most about my York visit was the focus and coordination of the local healthcare system, compared to previous years. The team has successfully unblocked services and improved patient outcomes through its collaborative approach, not only making services more effective for patients, but enjoyable for staff to work in. 

This transformation requires all to work together, learning from local innovations and maintaining the collaborative spirit I witnessed in York.  The future of the NHS lies in these neighbourhood models and such visits give me confidence that with the right support, flexibility and continued dialogue, we can deliver the fundamental changes our patients need and deserve.