Neighbourhoods and communities

Neighbourhoods and communities

At a neighbourhood level, our GP practices have come together as Primary Care Networks (PCNs) to cover populations of 30-50,000 patients.

These networks will become the foundations on which we will continue to develop and establish opportunities to meet our local population's health and wellbeing needs.

Our neighbourhood plans will look at how we provide a more comprehensive range of services, using the skills of a greater range of professionals and working closely with other services in the community through multidisciplinary teams.

Our ambition is to work in partnership with our colleagues across the health and care system to evolve and develop integrated neighbourhood teams with shared ownership for improving health and wellbeing. We want to understand the root causes of health inequalities and adopt a population-based approach, aligning our health services to address them.

Our four Primary Care Networks, led by General Practice, are core to our future neighbourhood approach. Implementing the recommendations in the Fuller Stocktake, we will work to understand and provide services for people across Guildford and Waverley at the most appropriate, effective and sustainable local level.

Our ambitions

Work alongside local people and communities

  • Individuals are supported to stay and age well via prevention interventions
  • Supported self-management
  • Active social prescribing and signposting
  • Communities supported to develop vibrant third sector volunteer opportunities supporting health and care

Create a clear development plan to support the sustainability of Primary Care

  • Ensure focus on unwarranted variation in access, experience and outcomes
  • Ensure understanding of current spending distribution across primary care, compared with the system
  • allocation and health inequalities
  • Support Primary Care where it wants to work with other providers at scale
  • Tackle gaps in provision including where appropriate, commissioning new providers in particular for the least well served communities

Enable all PCNs to evolve into integrated neighbourhood teams

  • Supporting better continuity and preventative healthcare as well as access
  • A blended generalist and specialist workforce drawn from all sectors
  • Focus on community engagement and outreach, across the life course
  • Proactively identify and target individuals who can benefit from interventions

Develop a single, system-wide approach to managing integrated Urgent Care

  • Guarantee same-day emergency care for patients and a more sustainable model for practices
  • Care will be provided using digital and total triage approaches in local care settings wherever possible and in an acute setting when not