Inside neighbourhood health: don’t leave health planning too late

Experienced healthcare planner and Sewell Advisory Deputy CEO Jonathan Turner continues our series of articles exploring neighbourhood health, looking at why it’s essential to engage early with healthcare planners on primary and community care buildings.

Delivering neighbourhood health is a key part of the vision set out in the 10 Year Health Plan, and involves bringing together a wide range of health, social care and voluntary sector services. An intrinsic part of the vision is the delivery of physical neighbourhood health centres, seen as the place to go for most health needs in every locality.

Neighbourhood health centres are intended to form part of a complete neighbourhood approach, building on existing community strengths, services and partnerships. With the intention to support prevention, integration and place-based working by connecting health services with wider networks of support, community activity and health promotion, rather than operating standalone, they contribute to a wider ecology of care that supports people throughout their lives.

However, we have historically seen health buildings which are underutilised or purely act as co-location points, rather than enabling truly integrated care. I believe it’s essential that everyone planning a new healthcare facility – and especially primary and community care buildings – needs to engage with health care planners on the schemes from the outset. Towards the end there are four key stages where health planners can provide real support to systems and partners.

Stage 1: Service Brief

Healthcare planners can support systems to develop a clear service brief based upon the national guidance around neighbourhood health archetypes and models.

Core+ centres include additional space for services such as family support and children’s services, mental health provision and minor injuries or walk‑in services, and core++ centres also include diagnostic space, supporting local need and, where appropriate, acute services.

The choice and mix of services should be based upon acknowledged population health needs and identify the preferred model to improve outcomes and reduce inequalities. Finally, the brief should state the benefits anticipated, including socio-economic, health outcomes and local regeneration, all of which can be supported by the Strata platform.

Stage 2: Activity and Capacity Modelling

The development of a robust service brief allows activity modelling to be undertaken to calculate the required patient‑facing clinical spaces for the new neighbourhood health centre, based on population, opening times, and average appointment length.

The model is driven by the annual number of appointments for each of the key services, including GP, community and secondary shift activity along with wider neighbourhood services and diagnostics; the capacity is then based upon 6 days per week, 12 hours per day and with an 80% utilisation factor.

There is then a need to assess the percentage of activity to be delivered in-person, virtually or in a patient’s home, then finally what type of spaces are required for the face-to-face care. This then provides the requirements in terms of clinical capacity. There will also need to be consideration for where back office, team bases and administration spaces are within any facility.

Stage 3: Schedule of Accommodation

Standard schedules of accommodation (SoAs) have been developed centrally, which are driven by the activity and capacity model and based upon a range of standard assumptions around clinical spaces being aligned to HBN 00-03 or HBN 11-01, plus allowances for waiting/reception spaces, virtual consultation, administration space, staff welfare and departmental uplifts for circulation, engineering etc.

Linked to the 10 Year Health Plan and the drive from analogue to digital, there is a specific requirement to provide dedicated virtual consultation pods, along with digitally-enabled meeting space for virtual multidisciplinary team (MDT) meetings.

One of the key skills of a health planner is being able to interpret the guidance but then translate it to make it relevant to local needs and ambition.

Stage 4: Key Principles

Finally, as part of the briefing stage, health planners can work with systems and partners to develop high level Output Specifications, which provide guidance for design teams as well as laying down clear principles for how any neighbourhood health centre will need to function to fulfil national guidance.

From experience some of the key principles which ensure neighbourhood health buildings are successful include:

Facilities at the heart of the communities they service, considering location, footfall, social value and the power to support regeneration.

Forming anchor institutions and their civic nature means their “public” areas, both internally and externally, will be active, flexible spaces that promote wellness and community activity, rather than purely functional content.

Being a ‘one stop shop’ for patient care, and recognised as the place to go for most health needs.

Being a place which enables truly integrated care, not just co-location, delivered through shared delivery, office and staff facilities, digital connectivity and multidisciplinary team collaboration across physical and virtual settings.

Providing additional opportunities with a wide range of partners from local government and the voluntary sector to work together in a more integrated way.

Providing spaces which are flexible and adaptable as service models change, and where utilisation can be effectively monitored and managed,

An ability to provide training and education opportunities both for teams and for the local community.

If you bring health planners in at an early stage of your project, you’re much more likely to achieve the goals of neighbourhood health centres – meeting population needs holistically, maximising value for money and building a truly modern NHS.

If you’re working on a new or remodelled neighbourhood health facility, our experienced health planners can support you through all stages of your project. Get in touch for advice at info@sewell-advisory.co.uk