Harborough Integrated Neighbourhood Team (HINT)
The landscape in which we work:
Healthcare in the Harborough area is managed within the Leicester, Leicestershire and Rutland (LLR) Integrated Care System (ICS) which replaced the three Clinical Commissioning Groups (CCGs). Within that system lie two acute hospital Trusts and three "places" – Leicester City, Leicestershire County and Rutland County. The role of the ICS is to commission and fund services through primary care (general practice), through the acute Trusts and through various other means including contracting service providers. The two acute Trusts are University Hospitals of Leicester NHS Trust (UHL) and Leicestershire Partnership NHS Trust (LPT). In addition, individuals who live in the Harborough area can and do access health services within neighbouring areas such as Kettering General Hospital (KGH) and the Urgent Care Centre (UCC) in Corby. Previously, East Leicestershire and Rutland CCG was the organisation responsible for healthcare within Harborough but this is now the responsibility of the ICS.
A History of Harborough INT:
In 2016 the local CCGs set up a programme of developing locality integrated teams. Five of the CCG's Localities at that time set up Locality Integrated Leadership Teams (LILTs). Harborough's team was set up by the then CCG Locality Manager in October 2017. The initial meeting agreed to concentrate on the health and wellbeing of individuals and adopted the vision of:
To enhance each individual's health and wellbeing experience through collaborative working.
During subsequent months the LILT grew in membership and attended a series of events intended to develop the vision, aims and objectives further. The Objectives of the LILT were defined at that time as:
- 1. Improving the health and wellbeing of individuals at home;
- 2. Promoting independence, self-management and the prevention of illness;
- 3. Working smarter as a care community within the wider team;
- 4. Identify gaps and overlaps within the current offering(s).
A fifth objective of "Ensuring we tackle loneliness and isolation within everything we do" was subsequently added to reinforce the LILT's interest in tackling the issues of loneliness and isolation in all groups.
During 2019 the LILT introduced a Focus Group made up of interested local individuals with experience of accessing services within Harborough, predominantly health services. The group met roughly every other month and was always on the lookout for interested individuals willing to join and contribute. Unfortunately, the COVID pandemic meant that this group went into abeyance and never recovered. Subsequently, the INT has developed relationships with the larger Patient Participation Groups (PPGs) within our catchment area.
In December 2022 it was suggested at System level that a harmonisation of terms be enacted. To this end the LILT has adopted the System terminology of "Integrated Neighbourhood Team". Simultaneously, the INT has expanded to incorporate the geographical footprint that matches the Harborough DC area and seeks to cover Lutterworth and Broughton Astley and areas surrounding those towns.
The INT today:
From small beginnings the INT has developed into a multi-organisational forum that meets monthly. Its current makeup includes:
- Primary Care representatives from local Primary Care Networks (PCN) and Patient Participation Groups;
- Primary Care professional representation from GPs, practice representatives, Social Prescribing Link Workers and Health Coaches.
- Secondary Care representation from LPT that includes the Community Nursing, Community Therapy and Community Mental Health teams.
- ICS representation from the Integration and Transformation Managers that link with the Primary Care Networks.
- Leicestershire County Council (LCC) Adult Social Care representatives.
- LCC Public Health, specifically relating to Sustainable Foods, is represented.
- The LCC Local Area Coordinator Team is represented and was involved in the facilitation of the Focus Group.
- Harborough District Council (HDC) representation including the Health and Wellbeing Manager, the Armed Forces Liaison Officer and other officers as required.
- The Voluntary and Charity Sector is represented through Voluntary Action South Leicestershire (VASL), Royal Voluntary Service, Home-Start South Leicestershire and the Harborough Children's and Young People's Charity (HCYC). Age UK has a permanent invitation to attend and the Market Harborough & Bowdens Charity previously attended.
- ELR GP Federation were instrumental in setting up the INT and have a standing invitation to attend.
- HealthWatch Leicester Shire send representation to the meetings although their membership has recently changed personnel so attendance is being refreshed. We ensure that they still receive papers.
In previous years the INT has developed a defined work plan. This has grown over the last two and a half years and now incorporates the priorities of those members who have been involved in setting the INT's work plan for the coming year. The headlines from the work plan are:
- Green Social Prescribing – following an unsuccessful bid for central government funds the INT decided to develop localised GSP. Working with HDC and other local organisations the PCN health and wellbeing teams are developing responses to the need for outdoor activities that help with physical and mental health and wellbeing. This has expanded to include Blue Social Prescribing.
- Better engagement with children and young people – recognising that today's children and young people are the service users of today and tomorrow the INT is seeking to increase awareness of services, initiatives and the issues that drive them locally. The changing roles within general practice is one theme the INT is keen to inform individuals about. Robust links with HCYC and their Speak Out magazine and website have been developed.
- Tailoring services to the Armed Forces Community – the community is relatively small in Harborough (3.9%) but is a significant proportion of the population of neighbouring Rutland. The INT has taken the view that by ensuring services meet the needs of the Armed Forces Community the wider population will benefit from the improvements made.
- Developing cross-organisational working – we have already worked closely with the Leicestershire Fire & Rescue Service to coordinate our local approaches to home assessments and increasing the scope for cross referral for those that are identified as needing assistance.
- Mental health initiatives – given that some GPs are reporting that as much as 70% of their appointments relate to mental health issues the INT made this a priority area of work and held a number of themed meetings with mental health focused presentations. PCNs have received additional funding for this and member organisations are working to improve the services on offer within Harborough including the Wellness Garden in Market Harborough and the PCN mobile sessions working with the Rural Community Council Coffee Bus.
- Encouraging joint working – the INT tries to link together organisations where joint initiatives, joint bids for funding or collaborative working is seen as benefitting everybody. Notable areas where this has happened was the joint bid for Green Social Prescribing Funding and use of the INT as a consultation body for member organisation's strategic plans and strategies, most recently the HDC Health and Wellbeing Strategy.
- Pushing the case for an Admiral Nurse in Harborough and being successful in securing funding and employing an excellent candidate.
Following the launch of the ICS a number of place-based Health and Social Care Plans, based on local authority footprints, are in development. The Harborough plan is now under development and the INT seeks to learn from the work on the Blaby plan which has impacted on their INT.
Following the demise of the Focus Group the INT gave a lot of thought to how we could continue to engage with individuals, gaining feedback and testing ideas and strategies. The INT has decided to establish stronger links with two PPGs from larger practices, SLMG and Market Harborough Medical Centre, to fulfil the role of engagement with patients and to provide feedback both to PPGs on our work but also from PPGs to the INT to inform direction and priorities. We hope to forge links with a third PPG in the Lutterworth area too.