The Healthier Communities and Older People Overview and Scrutiny Panel met to discuss the development and proposed implementation of Integrated Neighbourhood Teams (INTs) across Merton. The panel noted the progress made in developing the INT model, which aims to improve resident experience and outcomes by bringing together health and care professionals to work collaboratively within local communities.

Integrated Neighbourhood Teams (INTs)

The panel received a comprehensive update on the development of Integrated Neighbourhood Teams (INTs) in Merton, a key initiative designed to deliver more joined-up, proactive, and person-centred care. The report presented outlined the vision, principles, operating model, and implementation steps for INTs, which aim to align health, adult social care, and voluntary sector services around the needs of local residents.

The development of INTs is driven by national health and care reforms, including the NHS 10-Year Health Plan and the London Integrated Neighbourhood Teams Target Operating Model, which advocate for care to be delivered closer to home and for services to work together more effectively. Locally, this aligns with Merton's own Health and Wellbeing Strategy 2025-30. The case for change was supported by reviews of 116 adult and child cases, which indicated that improved integrated working could have led to better outcomes, potentially preventing or delaying crises and reducing the need for residential care.

The initial pilot for the INTs will focus on older residents living with frailty, dementia, and those approaching the end of life. This prioritisation is based on national guidance and local data, as this cohort accounts for a significant proportion of health and care spend and unplanned activity. The first pilot site has been selected as the Morden Primary Care Network (PCN), chosen for its high over-65 population, significant health and care spend, and readiness for change.

The INTs will be multidisciplinary teams comprising professionals such as GPs, nurses, social workers, and reablement staff, led by an INT Service Manager. The aim is for residents to experience a more seamless and person-centred approach, where they only need to tell their story once. Success will be measured by resident experience, including ease of access, reduced repetition of information, and feeling involved in decisions, as well as system outcomes such as reduced hospital admissions and improved independence.

During the discussion, councillors raised questions about the selection of Morden for the pilot, the transfer of lessons learned to other areas with different demographics, and the engagement of local councillors in the process. Officers explained that Morden was chosen based on a data-led approach considering various factors beyond just spend, and that the pilot is designed as a test and change initiative to learn and adapt. They also committed to improving engagement with councillors as the INT model expands to new areas. Concerns were also raised about potential issues at the edges of neighbourhoods where INTs operate, and how to manage referrals and ensure continuity of care for residents registered with GPs outside the pilot area.

The panel was informed that the INT service manager role is funded externally, while the remaining staff are existing personnel. Commissioning budgets will remain separate, but the pilot aims to identify opportunities for efficiency through reduced duplication and earlier intervention. The report also detailed the planned work programme for the Healthier Communities and Older People Overview and Scrutiny Panel, including future discussions on topics such as St Helier Hospital and the Annual Public Health Report.

The panel was asked to note the work being undertaken to develop the INTs, with a decision on the recommendations to be made at a future meeting.