Integrated Neighbourhood Teams

This ‘team of teams’ includes the GP practices with patients in the East neighbourhood, along with mental health colleagues and voluntary sector partners. CHP has been closely involved in planning to set up such teams in all five Camden neighbourhoods.

CHP plays a central role in the Camden local partnership. CHP's chair, Dr Alex Warner is Vice Chair of the Camden Integrated Care Executive, the integrated steering group and plays a pivotal role in the coordination of the East INT Group, Camden’s first test and learn integrated neighbourhood team.

Achievements between April 2024 and March 2025 included:

• Bedding down the five aligned neighbourhood teams of adult community nursing and social care
• An estates strategy for the five neighbourhoods recognising the challenges of very limited available community space in Camden
• Four primary care clinical champions to neighbourhoods: East, North, South, and West Camden
• Working with Camden council to establish new joint health improvement clinical leads starting with stop smoking

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East INT: progress between April and March 2025 included:

• Identifying change champions in all the organisations coming together as the East Integrated Neighbourhood Team, preparing colleagues from different backgrounds and organisational cultures and agreeing opportunities for change, in readiness for;
• Launching as the East INT in the Kentish Town Health Centre in October 2024
• Using a ‘test and learn’ process to establish which interventions were helpful bringing the new team of teams together and in improving the efficiency and staff satisfaction in working together
• Facilitated discussion about residents of the neighbourhood who were in contact with multiple teams or who the teams had found it hard to coordinate their care
• Starting to use localised data analysis from Camden public health colleagues to identify areas of unmet need and where best to target new approaches.

Paediatric Multidisciplinary Team Meetings

Multidisciplinary team meetings (MDMs) provide paediatric advice, guidance and learning once a month to discuss case referrals with a consultant paediatrician and team of multi-disciplinary professionals from health and social care, which currently includes Paediatrics, GPs, CAMHS, Health Visiting, Therapies, Asthma, Early Help and Children's Centres. The MDMs can now be accessed by all Camden GPs and are also accessible to other professionals who work and provide services in the borough for Camden children.

There is a redesign currently underway linking the paediatric MDMs with Neighbourhoods to integrate social workers and education, as long-term conditions affect many other aspects of CYP welfare. Bringing MDMs into a neighbourhood footprint places this well for a truly enhanced and joined up service. We will report once this redesign has been completed, Range of priority cohorts affected – SEN, young carers, and eligibility for pupil premium. The Start Well project aim to pilot this approach within schools.