Half of physicians ‘unclear’ on how their role will fit in neighbourhood health

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By Daniel Pye

Nearly half of physicians don’t fully understand how their role will work within a neighbourhood health team, according to a medical college.

The Royal College of Physicians (RCP) published its View on neighbourhood health report, which features a member snapshot survey of 414 doctors.

More than two-fifths (42%) expressed concerns about how it will affect their day-to-day clinical work.

The college called for clarity to avoid patients experiencing fragmented care.

Neighbourhood health centres were outlined by the government in its 10 Year Health Plan for England. The centres will house multi-disciplinary teams working together under one roof as the core of the government’s plan to shift care into the community and out of hospitals.

The RCP said the most frequently cited concerns were increased workload without protected time in job plans, unclear clinical responsibility, reduced time for specialist work, increased reliance on remote consultations, reduced access to hospital-based infrastructure and workload pressures contributing to burnout.

“While there are strong examples of planned specialist care being delivered in community settings, the physician workforce remains predominantly hospital based, and integrated neighbourhood teams will need reliable access to specialist care, advice, supervision and system leadership,” the report stated.

Integrated care boards should explicitly define the role of physicians when developing their neighbourhood approach to planned care, it added.

The government and NHS England “should ensure the workforce is equipped for a new approach to planned care” by expanding opportunities for doctors to gain practical experience of the skills needed for neighbourhood working.

Dr Charlie Sharp, a consultant in respiratory medicine, said “it can be extremely difficult” for doctors to balance contributing to community-based care with the relentless pressure of acute services.

The RCP clinical vice president, Dr Hilary Williams, said physicians are excited about the opportunities of neighbourhood health but they are unclear about their role.

“The challenge of modern healthcare is managing complexity and comorbidity – and this is what physicians’ medical training equips them to do. Our report today lays out the RCP’s vision for how neighbourhood health must use that expertise if patients are to see real benefits from these new models of care.”

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