Local care networks
We are working together in Lambeth and Southwark to develop a new way of working across health and care.
Local care networks bring together a range of health, care and wellbeing services. By being more joined-up services can be more responsive, ensuring people have the help and support they need to keep themselves as healthy and well as possible.
Why are we doing this?
We have lots of great services in Lambeth and Southwark, with a range of world-class services available across our major hospital sites and in our community, supported by a strong, committed workforce.
However, people tell us they sometimes find the health and care system difficult to navigate and it does not always respond to their needs. Different parts of the system do not always communicate as well as they could and people can feel unsupported and isolated.
We want to move towards a system which arranges services around the individual and provides the support they need to stay or get well – whether physical, emotional or social. Local care networks will help us do this by supporting the different parts of the system to work together better.
What are local care networks?
Local care networks are a new way of working together across a local community. They involve health and social care providers, voluntary sector services and local people working together to better coordinate and improve care for local people. This includes self-care, wider informal family and carer support, and broader issues affecting people’s health and wellbeing, such as housing and employment.
Local care networks cover a population of 100,000-200,000 people and 15-20 GP surgeries. In Southwark there are two local care networks, covering the north and south of the borough. In Lambeth there are three, in the north, south-east and south-west of the borough.
The local care network model was developed with clinicians, health and social care staff and patients.
Who will this affect?
Local care networks are starting to implement a new way of working to improve coordination of care for adults with three or more long-term conditions. This approach will:
- Identify and work with people with three or more long term conditions
- Look at all of a person’s physical, emotional and social needs
- Plan care with the individual and their family member or carer (where appropriate) to agree how to best support their health and well-being
- Improve team working, involving all the professionals looking after a person (for example GP, community nurse, hospital specialists, social care providers and care navigators) and reduce duplication – for instance so people don’t have to repeat their story to multiple health and care professionals
People identified through local care networks will still access services in the same way, either through their local GP or another professional. However, care will be better planned and co-ordinated around the person. Care should be easier to access, with less repetition, better communication and with a continual review of the person’s needs.
As the care networks develop, this type of working will be extended to improve care for more residents.
How will this affect staff?
Organisations are changing the way they work to align themselves with the local care networks and improve the experience of local people. For instance, Southwark Council social care teams have reorganised themselves as south/north teams to mirror the local care networks. This will enable better working across the organisational boundaries.
Who is involved in local care networks?
Local care networks involve all the staff, agencies and organisations that can care for a person, such as:
- GP surgeries, including GPs, practice nurses, and care coordinators
- GP Federations, which represent GP surgeries and provide some services on their behalf
- NHS provider trusts:
- Guy’s and St Thomas’ NHS Foundation Trust (acute hospital and community)
- South London and Maudsley NHS Foundation Trust (acute hospital and community mental health)
- King’s College Hospital NHS Foundation Trust (acute hospital)
- Voluntary organisations such as Community Southwark, Age UK, local settlements and community groups
- Healthwatch Lambeth and Healthwatch Southwark
- Community services such as pharmacies
In Southwark there are two local care networks, mirroring the geographies of GP Federations in the north and south of the borough. A joint Local Care Network Leadership Group has been established, which includes representatives from a range of organisations who work together and with other local stakeholders for the benefit of the population.
Southwark local care networks are looking at how the range of teams that deliver community based services can work together at a neighbourhood level (30,000-50,000 population) or at a local care network level (150,000 population). This will include primary care, district nursing teams, community mental health, adult social care, and the voluntary and community sector working together across organisational boundaries.