Integrated Neighbourhood Teams are not new in concept, but they are new as a requirement. The NHS Neighbourhood Health Framework, published on 17 March 2026, places INTs at the centre of how neighbourhood health services will be delivered between now and March 2029. For Practice Managers and PCN Clinical Directors, that means one thing above all else: your demand management model needs to match the MDT you are now expected to operate.
This post explains what INTs are, how they change the logic of patient routing, and what your triage infrastructure needs to do to make the model work.
What Is an Integrated Neighbourhood Team?
An Integrated Neighbourhood Team is a multidisciplinary clinical team that serves a defined neighbourhood population. The framework does not set a national template for what an INT must look like. Instead, it sets population cohorts and outcomes, then expects local systems to build the right team around those needs.
In practice, most INTs will include some combination of:
- GPs and practice nurses
- Clinical pharmacists
- Community and district nurses
- Mental health practitioners
- Social care workers
- Physiotherapists and occupational therapists
- Health and wellbeing coaches
The framework focuses INTs initially on four priority cohorts: people over 75 with moderate to severe frailty, care home residents, housebound patients and those at end of life, and people with multiple long-term conditions. These patients represent roughly 3 to 5% of any registered population but account for a disproportionate share of emergency admissions, A&E attendances, and unplanned activity. The logic of neighbourhood health is that proactive, coordinated management of this cohort prevents acute demand rather than reacting to it.
For PCNs, the Fuller Stocktake already signalled this direction. The 2026 Framework makes it structural.
The Demand Management Problem INTs Are Designed to Solve
General practice has operated, for most of its existence, on a reactive model. A patient contacts the practice. A clinician responds. There is rarely a systematic view of who is about to need care, which patients are deteriorating, or how demand will distribute across the week.
INTs change this in two ways.
First, they shift the focus from reactive to proactive. Rather than waiting for a frail 84-year-old to call at 8am in crisis, an INT is supposed to have already identified that patient through risk stratification, assigned them a named contact, and have a care plan in place that prevents the crisis from happening in the first place.
Second, they widen the team that can respond. A patient contacting the practice with a medication query does not need to see a GP. A patient with a musculoskeletal problem can go directly to a physiotherapist. A patient managing a long-term condition can be supported by a health coach or clinical pharmacist. The INT model only works if the right patient reaches the right professional every time.
Both of these shifts depend on the same thing: a triage system that knows who is calling, why they are calling, and where they should go.
Why Traditional Triage Cannot Carry the INT Model
The majority of GP practices still triage reactively. A receptionist takes a call, makes a judgement call about urgency, and books an appointment. Or a patient completes an online form, a GP reads it, and allocates it manually.
Neither approach generates the structured, consistent data that INT working requires. You cannot measure population risk without data. You cannot route patients to pharmacists, physios, or health coaches without a system that codes presenting problems clearly enough to match them to the right professional. You cannot demonstrate to your ICB that you are managing your priority cohort proactively without an auditable record of who was identified, when, and what happened next.
The NHS Neighbourhood Health Framework explicitly names AI-assisted triage and online consultation as part of the digital infrastructure required to support the GP access goal. But the implications run deeper than the access target. AI triage generates the structured demand data that makes INT working visible, measurable, and improvable.
How Structured Triage Enables INT Working in Practice
When a practice operates a total triage model, every contact arrives through a consistent system. Whether a patient calls by phone or submits online, their presenting problem is captured in structured form, coded for urgency, and routed to the appropriate team member. The result is not just a managed queue. It is a data set.
That data tells you things that matter for INT working:
- What proportion of your contacts are from patients in your high-priority cohorts?
- How many contacts in the past month were from patients who have already been seen three or more times with the same presenting problem?
- What is the split between contacts that genuinely require a GP and those that could be handled by another member of the MDT?
- On which days and at which times does demand peak, and from which patient groups?
Klinik’s platform captures all of this as a byproduct of the triage process. Practices using total triage via Klinik do not need to go looking for this data. It is produced every day as patients contact the practice. At Priory Medical Group in York, implementing structured triage led to a 256% increase in pharmacist consultations, with pharmacist and nurse appointment slots running at 99% utilisation compared to 88% before. Pharmacists were not suddenly more available. Patients were simply being routed to them reliably for the first time.
That is what INT demand management looks like in practice. Not a new team on paper, but a routing system that actually connects patients to the right professional every time.
ARRS Roles and the Routing Problem
The Additional Roles Reimbursement Scheme has put pharmacists, physios, paramedics, social prescribers, and a range of other professionals into PCNs. Many practices will tell you those roles are underutilised. The reason is almost always the same: demand is not reaching them.
If every contact is being triaged manually by a receptionist or reviewed by a GP before being allocated, the natural default is a GP appointment. Not because the GP is the right clinician, but because the triage system cannot confidently route elsewhere.
A structured AI triage system removes that bottleneck. When a patient submits a contact about a skin condition, the system codes it, flags it as appropriate for a clinical pharmacist prescriber review, and allocates accordingly. The GP never touches it. This is not a hypothetical. It is the operating model at practices where total triage is functioning properly.
The INT model assumes your ARRS roles are carrying appropriate demand. Getting to that point requires a triage system that can route confidently. Without that, your INT is a team in name only.
What Your Practice Needs to Do Now
Map your current routing. What proportion of your contacts actually reach pharmacists, physios, social prescribers, and other ARRS roles? If you cannot answer that question with data, your starting position for INT working is unclear.
Audit your coding. Under the Neighbourhood Health Framework, ICBs will monitor urgency data and outcomes at neighbourhood level. Urgency coding in your clinical system needs to reflect what is actually happening clinically. Practices that are compliant but poorly coded will appear non-compliant in reporting.
Identify your priority cohort. Risk stratification for the four national priority groups should be running now. Your INT cannot begin proactive care management without a clear, up-to-date list of who your highest-risk patients are.
Align your triage system with your MDT. If your online or telephone triage cannot currently route to anyone other than a GP or a duty clinician, it is not fit for INT working. A system that captures presenting problems in structured form, codes them, and routes to the appropriate professional is what the INT model requires.
Start generating neighbourhood-level data. ICBs will be measuring access, demand, and outcomes at neighbourhood level from 2026/27. Practices that are already producing this data are ahead of the commissioning conversation.
Frequently Asked Questions
What is an Integrated Neighbourhood Team?
An INT is a multidisciplinary clinical team serving a defined neighbourhood population. It brings together professionals from general practice, community health, mental health, pharmacy, and social care. INTs focus initially on patients with the highest risk and complexity, including frail older people, care home residents, and those with multiple long-term conditions.
Are INTs mandatory under the Neighbourhood Health Framework?
Yes, in the sense that ICBs are required to establish INT working across their systems. Individual practices will participate in their local INT as part of the requirements flowing from their ICB’s neighbourhood health plan. The specific composition and governance of your INT will be determined locally.
How does ARRS link to INT working?
ARRS roles — pharmacists, physios, social prescribers, paramedics, and others — are expected to be core members of INTs. The INT model is designed to make full use of this wider workforce. Getting ARRS roles to appropriate levels of utilisation depends on triage systems that route accurately, rather than defaulting every contact to a GP.
What data does an INT need to function?
INTs need shared care records, risk stratification data on priority cohorts, and real-time demand information to manage their caseloads proactively. They also need a triage system that generates structured presenting-problem data, so that demand can be distributed across the right professionals in the team.
What is the link between INT working and the 90% same-day access target?
The 90% target applies to clinically urgent patients. A well-functioning INT that is managing its priority cohort proactively, with appropriate demand being absorbed by pharmacists, physios, and other ARRS roles, creates the GP capacity to see 90% of urgent contacts on the same day. The two goals are connected, not separate.
How does Klinik support INT demand management?
Klinik captures every contact, whether by phone or online, in a structured format, codes urgency using AI-driven assessment, and routes to the appropriate team member. This generates real-time analytics on demand patterns, presenting problems, and outcome distribution across the MDT. Practices using Klinik have the data infrastructure that INT working requires.