In July 2025, NHS England published Fit for the Future – the 10 year health plan for England. Building on past recommendation and plans to date, it describes three key shifts to transforming our health and care system to deliver better services and outcomes for our communities: hospital to community, treatment to prevention, and analogue to digital. Essential to achieving this is through the establishment of Integrated Neighbourhood Teams.
In response to these plans and to the 2022 Fuller Stocktake report, NHS West Yorkshire Integrated Care Board (the ICB) has been working across our Integrated Care System to develop our West Yorkshire Health and Care Partnership Blueprint for Integrated Neighbourhoods: Creating Healthier Communities - our plan for how we are going to transform healthcare delivery across West Yorkshire.
The blueprint describes how we are going to set up teams of health workers who will provide care closer to people's homes. The teams will aim to meet people’s physical, mental and social health needs, and reduce the inequalities in access and outcomes that affect some of our communities. These teams will be known as Integrated Neighbourhood Teams (INTs).
In line with the intentions set out in Fit for the Future, our work will focus on three key shifts: hospital to community, treatment to prevention, and analogue to digital.
In West Yorkshire, Integrated Neighbourhood Teams will:
- tackle health inequalities by using population health data to proactively identify residents within target populations and connect them into the services that they need to reduce the risk of escalating poor health and to stay well for longer. To address inequalities effectively, INTs needs to be wider than health e.g. addressing social determinants like housing and be community-based
- eliminate the need for referrals and hand-offs through a combination of integrated working, including regular communication and reviews and the use of digital and knowledge management tools, that support population data analysis and enable person-based care information to be shared across services
- work closely with residents and within communities to develop a clear understanding of what local needs are and the services that are best placed to meet these needs. They will identify and collectively respond to any gaps that may emerge as these needs change over time
- support and enable cross-system leaders holding collective responsibility for ensuring that the infrastructure, systems and processes needed to deliver integrated neighbourhood working are in place and remain fit for purpose
- provide holistic, person-centred care, closer to home that draws upon a wide range of offers from across health, care, VCSE, housing, and other local services. Our Integrated Neighbourhood Teams will take a strengths-based approach, so that residents are empowered to make decisions about their health and wellbeing, access the services that are meaningful to them and receive faster and more effective support at times of crisis or increased need
- ensure that all West Yorkshire residents receive the same standards of care, wherever they live and whatever their individual needs.
Our Integrated Neighbourhood Teams are being developed across our five places (Bradford District & Craven, Calderdale, Kirklees, Leeds, and Wakefield) with tailored plans for short, medium, and long-term actions. Delivery will focus on priority groups, such as people with frailty, dementia, and those needing end-of-life care.
People working to create these new teams will be supported by:
- workforce transformation and organisational development projects
- improvements in how we use digital tools, data, and technology
- better use of our buildings and facilities to bring services together under one roof
- resource allocation and financial planning.
We will measure the success of our programme by:
- reducing preventable unplanned care
- increasing early intervention
- improving patient and staff experience
- addressing health inequalities.
Our work in 2025/2026
A programme of work is underway that will act as a catalyst for Integrated Neighbourhood Teams to progress at pace, supported by funding of approximately £4-4.5million.
The projects in this programme are broadly:
- a technology-enabled service transformation fund: investing in innovative technologies to deliver care differently, with a focus on preventing falls to support people to stay well and independent at home
- a digital infrastructure fund: investing in the shared care records capabilities that all partners will need to deliver integrated neighbourhood healthcare, to ensure that patients experience care seamlessly and do not have to tell their stories multiple times.
- a data utilisation and improvement fund: improve how data is gathered, utilised and processed to inform the design and delivery of proactive care
- a transitional capacity and capability fund: investing in the key ingredients that will help people, professionals, services and organisations to work together differently, focusing on building the relationships, trust, understand and the change that will be delivered with and for patients.
- funding for putting people’s voices at the centre of integrated neighbourhood health
- funding to support the development of modern general practice.