The Integrator: Neighbourhoods brought to life (HSJ, 9 June 2025)

Summary

Few areas of health policy have been untouched by the NHS structural turbulence of recent months, not least “place” and “neighbourhood” working. On the plus side, these parts of the system are at least used to performing without a script. 

London, for example, is pushing ahead with its own ambitious plan to explore the practicalities of implementing neighbourhood health across the city.

Last week a “simulation” event trialling the plan for the capital was held. 100 participants acted out nine months of how the model might work in just a day and a half. 

In London, the 30-odd boroughs act as “places” within five integrated care boards. For each place, an “integrator” organisation is to be selected.

The borough-level integrators could be trusts, councils, primary care providers, or even a partnership of several. They will host the functions needed to bring separate neighbourhood services and providers together, under the London NH vision.

Would-be integrators were represented in London’s simulation, alongside acutes, community services, primary care, the London Ambulance Service, place leaders, voluntary services and residents representing a wide range of patient groups with complex needs. 

The simulation session was encouraging overall. But the growing pains of its first few hours also served as a reminder of what could go amiss in the real world.