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My Lords, success will be measured against five minimum national goals in the neighbourhood health framework, which was published in March 2026. That will include improved access to general practice and better urgent and emergency care performance. Integrated care boards and local authorities will establish locally owned neighbourhood plans with metrics that reflect population needs. An independent national evaluation, which will be commissioned through the NIHR, started this April to support national policy and delivery of neighbourhood health and evaluate its adoption and uptake.
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My Lords, I thank the Minister for that Answer. She set out the government policy, which states that local health and well-being boards will work with communities, health and care organisations and wider partners to establish outcome measures that cover the whole life course of the individual and reflect both health and social care needs. Can the Minister say how, bearing in mind the wider devolution agenda, the Government will measure neighbourhood health outcomes to allow for effective comparison between regions?
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The noble Baroness set out exactly what the plan is, and I am grateful to her for doing so, but I emphasise that the whole point of the independent national evaluation is that it will evaluate the whole breadth of neighbourhood health. It started in April and will run for three years. I further emphasise that it is about continual engagement and developing different ways that neighbourhood health can be successful. It will also model what the long-term outcomes and improvements can be, depending on how you do it. All that will mean working with the local ICBs to see about their progress, but they are well aware of the expectations upon them, and they will set their own ways forward.
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My Lords, if neighbourhood health services are to succeed, more care will be delivered through general practice and community settings, yet NHS funding allocated to general practice has fallen over the last decade. Will the Government consider introducing a primary care investment standard to ensure primary care can grow in line with this ambition?
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We do not intend to bring forward the investment standard that the noble Baroness seeks. I am aware that a discussion is going on—probably as we speak—through the Health Bill, which is about to be introduced to your Lordships’ House. That is about increasing accountability and responsiveness to local needs and improving outcomes. I say to the noble Baroness that our fear is that bringing in yet another approach, through an investment standard, risks undermining that.
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My Lords, since 1948, successive Governments have shifted care into the community without a simultaneous shift of people, estates or money. We have just heard that general practice now receives its lowest share of the NHS budget for a decade. Will the Minister agree to address this so that GPs can deliver continuity of care, which we know improves access, reduces demand, improves outcomes and fundamentally delivers better value for money?
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I say to the noble Baroness that that is what I feel the whole neighbourhood approach to the NHS is. As she is aware, it is about joining up around the person and bringing together teams, including GPs. It is important to acknowledge outcomes: we have delivered nearly 14 million additional appointments through GPs in the year to June 2026, and patient satisfaction is going up with GP access. We need to look at what the situation is as well as the concerns.
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My Lords, one of the most important contributions of a neighbourhood health service is in the preventive work that it does—things like exercise, smoking cessation, addiction counselling, and so on. Does my noble friend agree that it is important to measure those aspects, which reduce further the demand for hospital and primary care services?
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I certainly do agree with my noble friend, who sets out what is at the core of this key shift, which is one of three. There are many examples. The service in Kensington, Chelsea and North Paddington has already supported people to access the right care in the right way. It has seen a reduction of over a third in GP appointments, of over two-thirds in A&E attendances and of over half in sick notes issued, with residents reporting a 40% increase in well-being. That is what can happen when we join up around the person.
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My Lords, I welcome the Government’s continuation with the initiatives taken by the previous Government to develop much greater online activity and contact between patients and their GPs, but how do we deal with people who are particularly vulnerable, particularly the elderly—those who do not have direct access to online activity? How can they be looked after or helped to be in touch with the new facilities that are going to be available?
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As this will be locally led, the priority groups will be those who are more excluded, and that may well include those who are digitally excluded. But the noble Lord makes an important point. It is not just about local care in a physical sense—indeed, we have already committed to over 120 neighbourhood care centres—but it is also about digital access, because that is how many people now access it. However, in every single case, if someone cannot, there is an alternative for them.
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My Lords, I draw noble Lords’ attention to my registered interest as chairman of King’s Health Partners. The Minister will recognise that, increasingly, pathways of care for the management of chronic diseases will extend across institutional boundaries, both in primary and secondary care, and will be delivered by multidisciplinary teams of different healthcare professionals. Is she content that the present regime for regulation, both institutional and professional, will facilitate that cross-institutional delivery of care and care delivered by multidisciplinary teams?
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As we develop neighbourhood provision, bring care closer to home and join up as the noble Lord suggested, it is key that the regulatory framework supports that as well as all the other work. We are ensuring that the regulators are able to do that. Dr Penny Dash recently did a review and we are looking at what more needs to be done.
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My Lords, I thank my noble friend Lady Maclean for the Question, but I want to go back to points made by the noble Baronesses, Lady Pidgeon and Lady Gerada. Successive Governments have spoken about the shift from hospital to community, but one reason it has not always happened is that there has not been a commensurate or corresponding shift in the funding. I therefore ask the Minister once again: what consideration are the Government giving to rebalancing existing funding—I stress “existing”—to deliver that shift from hospital to community?
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First, we are investing where it is needed, particularly on new estates and on improvement support. We are also asking ICBs to refocus their existing resources. This is not just tinkering; it is a fundamental shift—one of the three main shifts—to deliver neighbourhood health, which people very much welcome. We are also creating financial incentives. We are creating—the national evaluation will assist us more with this—funding flows and payment mechanisms, which means that savings from improved quality of care will then go into investment in new services. I say to the noble Lord that that has not always been the case in the past.
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My Lords, we know, and it is very well researched, that people with learning disabilities face enormous barriers in access to primary health care and have lower life expectancy as a result. Can the Minister assure me that these neighbourhood health services will ensure that screening and support for people with learning disabilities will be embedded in this service?
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I certainly can. To support that, the prevalence review, which focuses particularly on mental health services for those in the group that the noble Baroness describes, will soon come forward with its report, which will help us greatly. Certainly, there are priority cohorts, which are listed by definition, but localities can add cohorts. I very much expect that the group to which she refers would absolutely be a priority.