Nigel Edwards
NAPC Senior Advisor
The new government and Lord Darzi’s review both set the direction of travel towards a
neighbourhood National Health Service (NHS). They also stress the long-standing failed
ambition to shift resources and focus from secondary care to community and primary care
and to boost prevention. This is very much in line with the vision in the Fuller Stocktake and
progress towards this was already underway prior to the election.
There is a lot to do to develop this vision and, at the same time, address serious concerns
about general practice and its sustainability. The idea of what a successful Integrated
Neighbourhood Team (INT) will look like is still emerging. However, previous experience
developing integrated care and the Vanguard programme highlights some serious
weaknesses in the approach to change in this area. Many attempts to create different types
of integrated care have had disappointing results but there is an opportunity to do things
differently this time.
The National Association of Primary Care (NAPC) has a long history of being at the forefront
of thinking about the future of primary care and some key elements of current policy reflect
ideas that it has developed. This paper brings together NAPC’s experience of how to make
INTs work and how to manage the challenging process of change and is designed to provide
a guide to creating a neighbourhood health service.
