Right at the heart of it: Your local GP
GPs are integral to neighbourhood health, helping teams work together smoothly.
Here, Dr Vijay Koshal, Medical Director for West Kent Health and Care Partnership reflects on working as one team.
Q: What do we mean when we talk about neighbourhood health?
A: When we talk about neighbourhood health, we mean bringing together the services that already support people in a community. It is not a new organisation or structure. It is a way of strengthening relationships between community services, GP practices, mental health teams, social care and the voluntary and community sector. This helps us understand local needs and respond earlier.
Q: How are GPs like yourself involved?
A: We often see people early, sometimes before other services. By working more closely together, we can share insights sooner and make sure people get support at the right time. What is important is that this is a partnership. No one organisation is leading or taking over. We each bring something essential.
Q: How has working in an integrated neighbourhood team (INT) changed the way you work?
A: I am no longer trying to solve complex problems on my own. Before INTs, I might have been the only professional who knew about a patient's new symptoms or changes at home. It could take time to connect with other teams. Now, I can reach the right colleagues much more quickly. We talk, agree a plan and act together. It means decisions are safer, faster and based on a fuller picture of what is happening in someone's life.
Q: Can you give an example of this in practice?
A: Yes. I saw someone recently who had fluid on her lungs and was becoming increasingly breathless and anxious. She was regularly attending A&E. Under the old system, she would have been referred into separate services and waited a long time for several appointments.
Because we work as a neighbourhood team, I was able to speak straight away with the community respiratory team and community nursing colleagues. In one conversation, we agreed the tests she needed, the support she should have at home and what she needed to do if her symptoms changed.
She felt reassured because everyone was working together in the background and she was regularly in contact with a care coordinator who was at the centre of it all.
Q: Why is this approach becoming so important now?
A: Demand for healthcare is rising and the needs of our population are becoming more complex. We are seeing more long-term conditions, more frailty and more people who need support from several services at once. None of us can meet that need alone. Working at neighbourhood level helps us plan around people's real lives, not organisational boundaries. This is the biggest shift I have seen in my 20-year career as a GP in Kent and, this time, it is backed and funded to make real change.
