What are PNGs and why are they important in neighbourhood care?
As neighbourhood care develops, you will begin to see more use of Johns Hopkins patient need groups (PNGs). These groups help us understand the complexity of a person’s health and wellbeing needs, so we can offer the right level of joined-up support.
What are Johns Hopkins patient need groups?
Johns Hopkins patient need groups (PNG) is an evidence-based population health tool. Every patient is placed into a group, using the information we have about their health, ranging from one to 11. The higher the number, the more complex the person’s physical, social or psychological needs are likely to be.
The groups help health and care teams to identify:
- who may need more proactive or preventive care
- who is at higher risk of hospital admission
- who might benefit from multi-disciplinary support
- where neighbourhood teams can make the most difference to wellbeing and independence.
These groups do not ‘label’ people and someone’s number can change over time. They simply guide us to consider the level of coordinated support groups of people are likely to need so we can plan our services to meet those needs and help us plan care.
1 - Non-user
2 - Low need child
3 - Low need adult
4 - Low complexity multi-morbidity
5 - Medium
complexity
multi-morbidity
6 - Pregnancy low complexity
7 - Pregnancy high complexity
8 - Dominant psychiatric condition
9 - Dominant major chronic condition
10 - Multi-morbidity high complexity
11 - Frailty
Supporting people in PNGs 10 and 11
These include people with complex, often multiple, long-term conditions. This group may have frequent contact with services, rely on unplanned care and be at risk of increasing frailty. Many are managing a combination of physical, psychological and social needs which can change quickly.
For this group we will have:
- a clear, up-to-date personalised care plan which reflects what matters to the person (for example, Respect form or comprehensive geriatric assessment (CGA) for patients living with frailty)
- regular multi-disciplinary reviews across neighbourhood teams bringing together physical health, mental health, social care and voluntary sector support.
- more proactive checks when someone’s circumstances or health changes
- better continuity, so the person knows who is involved in their care
- clear escalation routes which avoid unnecessary transfers to hospital, linked to someone’s RESPECT form.
- support for carers, recognising their role in keeping someone safe at home.
Community, therapy, nursing, primary care and voluntary sector colleagues will work together for this group, with an emphasis on advance treatment planning and avoiding hospital admission.
Focusing on the ‘rising risk’ group – PNGs five to nine
Patient need groups five to nine are groups with lower complexity, but who may be starting to develop more complex needs, or have specific needs related to their current health. They may have one or two long-term conditions, be pregnant, have mental health issues, or be impacted by social factors affecting health. Supporting this group is central to neighbourhood care. Small, proactive interventions or supported self care can help someone stay well or independent for longer and avoid a decline.
For example, we can support people in these groups by:
- identifying early changes in mobility, mood or ability to self-manage
- offering structured self-management support for long-term conditions (for example, falls prevention programmes)
- focusing care to improve outcomes for those with long term conditions such as diabetes or hypertension
- understanding how health inequalities occur in our population groups and how we can improve care for specific groups
- connecting people with voluntary sector services and community groups
- reviewing medicines and reducing risks linked to medicines management
- providing rapid access to advice or care when someone’s symptoms or circumstances change.
How we will use these groups in neighbourhood care
Neighbourhood care brings colleagues from different professions and organisations together. PNGs will help each neighbourhood team to:
- understand the needs of their population
- identify people who would benefit from proactive care
- plan multi-disciplinary conversations and review people who may benefit from different care offers
- spot patterns or gaps in the support available locally
- work with partners, including primary care and the voluntary sector, to coordinate care.
The groups will not replace clinical judgement. Instead, they offer an additional framework to help us reshape our services, so that we can prioritise and act early.
What does my number mean?
You may see your number appear in your NHS app and wonder what it is and what it means for your care.
A helpful way to explain it is:
- the tool helps us understand who might need more joined-up support
- it does not change your entitlement to any care
- it helps us work more closely with other services in the neighbourhood
- it allows us to spot early signs when you might need extra help, so we can support you to stay well.
- It is not a label which defines you or your care.