Delivering the 10 Year Health Plan in south east London
A neighbourhood approach to health and care
The South East London Integrated Care System (SEL ICS) welcomes today’s publication of the 10 Year Health Plan, which sets out a bold and ambitious vision for improving health and wellbeing, tackling inequalities, and transforming the way care is delivered. It has been shaped by the experiences and expectations of members of the public, patients, partners and the health and care workforce across the country, reflecting the changes that people wanted to see. Through the ‘three shifts’ – from hospital to community, from analogue to digital, and from treatment to prevention – it aims to personalise care, give more power to patients, and ensure that the best of the NHS is available to all.
We are committed to working with partners across south east London to realise the full ambition of the 10 Year Health Plan. Over the summer and autumn, we will begin reviewing and aligning our medium-term strategic plans to ensure we are well placed to deliver on all aspects of the Plan in a coordinated, locally meaningful way.
In south east London we are making good progress on developing a neighbourhood health service, which is a key part of the Plan.
As set out in the recently published A Neighbourhood Health Service for London – Target Operating Model and Case for Change, neighbourhood working marks a decisive shift from fragmented care to a proactive, person-centred model based in local areas.
Building on strong partnerships between the NHS, general practice, social care, local government and the voluntary sector, neighbourhood working will support south east London in delivering the three shifts.
1. Moving care from hospitals to communities
We are redesigning services around local neighbourhoods, supporting people earlier and closer to home. In Southwark, teams are delivering proactive care for older residents with frailty, reducing outpatient appointments by 27%. Lambeth’s CHILDS model is helping children manage conditions like asthma through earlier, community-based care. The Connecting Greenwich Programme brings integrated, community-based health and care services closer to residents’ homes, improving access and outcomes through collaboration with local partners and tailored support across a wide range of needs.
2. Transitioning from analogue to digital
We are using digital tools to support faster, safer and more connected care. The south east London hub of the London Care Record gives professionals secure access to vital patient information, like medications, allergies and care plans, no matter where someone is treated. It makes care more joined up, reducing the need for patients to repeat their stories.
3. Focusing on prevention, not just treatment
We are investing in helping people stay well for longer. In Bexley, older residents are offered Functional Fitness MOTs to prevent frailty and support healthy ageing. In Bromley, the new One Bromley Health and Wellbeing Hub is tackling the top five causes of poor health, offering services like smoking cessation, cost-of-living advice, and support for carers. In Lewisham, the Waldron Health Centre and Community Hub provides access to both clinical services and social support in one community space.
Sir Richard Douglas, Chair of NHS South East London ICB, said: “We welcome the ambitions set out in the 10 Year Health Plan. If we want to reduce inequalities and improve people’s health, we must start with communities. Health is about more than healthcare. It is also about housing, employment, education, and social connections. Neighbourhood working brings these elements together to deliver real change.”
Andrew Bland, Chief Executive of NHS South East London ICB, added: “We are building a joined-up health and care system that’s shaped around people’s lives, not around organisations. This is about doing things differently, using technology and community-based prevention to deliver better outcomes, and working together across sectors to improve everyday experiences of care.”
As we continue to deliver the 10 Year Health Plan, neighbourhood working will remain central to our approach. We will listen to local people, learn from their experiences, and design services that reflect their lives.
Dr George Verghese, Lambeth GP and member of the SEL ICS Board said, “Neighbourhood working is about building a health and care system that doesn’t just treat illness, but helps people live better, healthier lives in the communities they call home.”
For more information, please visit selondonics.org/neighbourhoods
How we are delivering neighbourhood working in south east London
Whilst it is still early days, across south east London, the benefits of neighbourhood working are already being felt.
The Connecting Greenwich Programme. This is a collaborative initiative co-designed with local health and care partners and community groups to strengthen neighbourhood health and wellbeing. Since its launch in April 2024, the programme has supported a wide range of projects aimed at improving access to vital services, from increasing childhood vaccination uptake and enhancing GP communication with underrepresented communities, to supporting frail and elderly residents, improving mental health, improving the management of chronic kidney disease and delivering integrated care for children and young people. Gabi Borland, Place Executive Lead for Greenwich, said: “Connecting Greenwich is about more than just delivering services, it’s about building trust, listening to communities, and creating health solutions that are inclusive, accessible, and sustainable. By working together, we’re making real progress in tackling inequalities and improving outcomes for everyone in Greenwich.”
Health, wellbeing and community in Lewisham. The Waldron Health Centre and Community Hub has become a vibrant community space where residents can access clinical services, peer support groups and social advice under one roof. From mental health groups and diabetes care to midwifery and local advice services, the hub embodies how health and community support can come together. Lewisham Mayor Brenda Dacres, who formally opened the hub said: “The Waldron has been a real cornerstone of our community since it opened in 2008, bringing lots of health and social care services together under one roof. The addition of the new neighbourhood community hub is important for all of us who care about health, wellbeing, and community here in Lewisham”.
Proactive neighbourhood care for older residents in Southwark: A new neighbourhood-based model to support older people with frailty is providing early, proactive care in areas of high need. The approach brings together professionals from across sectors to support residents at home, reduce hospital use, and plan ahead for care. In its first three months, the service undertook medication reviews for all assessed residents, completed advance care plans for 89% and saw a 27% reduction in the need for hospital outpatient appointments due to more appropriate community care. Dr Nancy Kuchemann, Southwark GP and Co-Chair of Partnership Southwark, “Learning from this small-scale model is shaping our borough-wide approach to earlier support for those at risk, better coordination of services and how we respond to the wider determinants of health such as housing, income and isolation”.
Helping residents stay stronger for longer in Bexley: Older residents are being supported to stay healthy and independent through Functional Fitness MOTs delivered by Age UK Bexley and commissioned by the Bexley Wellbeing Partnership. These assessments help people over 50 improve mobility, build strength and prevent future frailty. Deborah Travers, London Borough of Bexley’s Associate Director of Adult Social Care & Health and Bexley Care Lead for the Frognal Neighbourhood said, “Supporting older people living with frailty is a Bexley priority given that 40% of residents are over 50 and 27.4% are estimated to have some form of frailty. Age UK aim to have completed Functional Fitness MOTs with 200 residents by the end of the year and are well on the way to doing so. Of those that have undertaken a first assessment, 92% report that they are more aware of what actions they can take to prevent falls, and 67% have started a new fitness activity as a result.”
Reducing health inequalities in Bromley: Launched in July 2024, the One Bromley health and wellbeing hub, located in the borough’s large town centre shopping centre, offers a range of services targeting the five leading causes of poor health, known as the Vital 5. Also on offer are essential services such as support for carers, befriending services, smoking cessation, and cost-of-living advice and support. Dr Angela Bhan, Place Executive Lead for Bromley, said: “The hub offers such a vital range of services to help improve the health of our residents, especially those who are more likely to develop long-term health conditions. These services are designed to address both health and socio-economic challenges, which are often linked. For instance, stopping smoking not only improves physical health but also reduces financial strain. Similarly, cost-of-living advice can alleviate stress and improve mental wellbeing. “
Providing innovative support for children, young people and families in Lambeth. The CHILDS service brings together GPs, paediatricians and nurses to provide early support for children and young people with conditions like asthma and eczema and supports their emotional wellbeing. The approach is reducing hospital visits and providing more responsive care to families. Dr George Verghese, GP Partner at the Waterloo Health Centre “Our integrated approach to supporting young people in Lambeth is leading to fewer emergency visits, hospital admissions and outpatient appointments. By integrating emotional wellbeing services with physical health, children are getting help earlier and through the use of population data, the service can focus on children most at risk”.