What it really takes to deliver neighbourhood care at scale
Transforming Care
9 February 2026
By Louisa
Interview with
Nick Harwood,
Director of Operations – Adult Community,
Lincolnshire Partnership NHS Foundation Trust (LPFT)
Integrated Neighbourhood Teams (INTs) are reshaping how health and care is delivered. INTs promise joined-up, community-based support that meets people where they are. By bringing together NHS, social care, mental health and voluntary sector professionals, these teams will focus on the whole person, not just a single condition, using shared insight and proactive support to prevent illness, reduce hospital admissions and help people live well and independently.
But turning this vision into reality requires new ways of working, shared responsibility and the right systems to support collaboration on the ground.
“Health and care services are navigating rising demand, increasing productivity and efficiency pressures alongside intense financial pressures”, explains Nick Harwood, Director of Operations for Adult Community services at Lincolnshire Partnership NHS Foundation Trust (LPFT). “And, for LPFT more specifically, all of this is coupled with the practical challenges of delivering care across one of the country’s largest and most geographically dispersed regions”.
“Moving care closer to home is a sensible concept”, Nick says, “but it can only succeed if digital tools genuinely work for communities and the people delivering care within them”.
From tackling digital poverty and cultural resistance to embedding patient engagement portals, translation services and early uses of AI for administrative tasks, Nick sees technology as a critical enabler of more connected, efficient and accessible neighbourhood care.
Maximising existing resources to meet people’s needs
Productivity and efficiency
For Nick, the challenge facing INTs isn’t a lack of ambition, it’s the reality of meeting demand with limited capacity and finite resources.
“There’s no escaping the financial pressure the NHS is under,” Nick explains. “But external factors compound pressures outside of our control. The NHS is not immune to cost of living increases, including inflation, it inevitably tightens the system even further.”
Against this backdrop, Nick notes that the focus has shifted towards productivity and efficiency.
“Teams need to ask themselves”, he suggests, “are we maximising existing potential and the resources we already have, to continue to meet people’s needs in the most efficient way?”
Geography matters
As a large and geographically dispersed county, Lincolnshire brings a unique mix of challenges.
“We’ve got significant rurality, coastal communities with some of the highest levels of deprivation nationally, alongside a city with its own inner-city pressures,” Nick says. “Transport links can be difficult, and the demographics vary hugely, depending on where you are. Designing services that work across all of that isn’t straightforward.”
Therefore, the principle of moving care closer to home makes sense, Nick notes, and mental health services have often been ahead of physical health in this shift. But translating that ambition into practice takes more than intent.
“Geography really matters,” he explains. “Defining what a ‘neighbourhood’ looks like in a county this large is challenging”.
For many people, care has long meant inpatient or outpatient appointments at one of Lincolnshire’s main hospital sites. Moving services into the community requires rethinking workforce models, staffing and, perhaps most difficult of all, existing organisational structures.
“It’s not just about relocating services,” Nick concludes. “It’s about reshaping how we use the resources we already have, so care is safe and consistent.”
Technology must enable neighbourhood care
“If you assume everyone is connected, you’ve already lost them”
Digital tools only deliver value when people trust them, understand them and feel supported to use them. So, without that, transformation can stall or deepen existing digital divides.
“If we don’t invest in training, support and engagement, digital becomes something that’s imposed rather than embraced,” Nick argues. “That’s when you see resistance, workarounds, or complete disengagement.”
Nick is clear that relying solely on digital platforms, without alternatives, risks excluding the very populations neighbourhood teams exist to serve.
“Neighbourhood care is supposed to bring services closer to people. If your model assumes everyone is digitally connected, you’ve already lost a significant proportion of your community.”
Making digital work for real communities
“The pandemic showed us that the system can move quickly when it has to,” Nick reflects. “Remote consultations and virtual working happened almost overnight. However, we learned that digital works best when it expands choice, not when it replaces human contact altogether.”
That principle now underpins LPFT’s approach. Community-based digital hubs, supported access to online services, and tools like local service directories are designed to enable engagement, not force it.
“We need to stop thinking in terms of whole counties and start understanding people at smaller, neighbourhood-level footprints,” he says. “That’s how you design a digital approach that actually targets need, rather than amplifying inequity.”
In Nick’s view, technology should act as a bridge. “If certain groups aren’t engaging digitally, the answer isn’t to wait for them to catch up,” he says, “it’s to go to them.”
Looking to the future
“Digital has taken us a long way,” he concludes. “But neighbourhood teams will only succeed if technology is used deliberately, inclusively and alongside real human connection, not as a substitute for it.”
Finally, Nick believes mental health providers are uniquely placed to support this next phase of neighbourhood working. With long-standing experience delivering care in communities, navigating complexity, and supporting people beyond traditional clinical settings, they can play a pivotal role in shaping integrated, community-based models of care.
Media Contact:
Louisa
Marketing & PR
hi@mayden.co.uk
01249 701100
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