The publication of the Neighbourhood Health Framework in March 2026 marks a decisive shift in how England intends to deliver health and care services – moving activity out of hospitals and into community settings through new models of integrated, preventative, resident‑centred care.
At its heart, the Framework sets clear national expectations for improved access, reduced waiting times, and redesigned pathways that minimise unnecessary referrals and avoidable outpatient activity, among other targets. For providers and partners across the NHS ecosystem, this is both a challenge and a moment of enormous opportunity.
Feedback Medical is positioned to support this transformation. Both through our role in the national neighbourhood health simulation in partnership with PPL, Optum and NHS Providers; and through our work redefining the outpatient model that meets some of the Framework’s ambitions.
National targets: reducing outpatient referrals and expanding single points of access
Among its most significant delivery expectations, the Neighbourhood Health Framework commits to a major shift in how people access routine healthcare. NHS England has set a target for 25% of outpatient activity in ten specialties to be diverted away from traditional hospital-based clinics by March 2027, driven in part by the expansion of single points of access that streamline referrals and reduce duplication. The national neighbourhood health simulation, for which Feedback Medical’s Bleepa® platform was used for clinical collaboration, demonstrated that this 25% reduction is achievable.
This approach reflects a wider move to reduce fragmentation across care pathways. It supports faster triage, more appropriate routing to neighbourhood‑based teams, and fewer avoidable first outpatient appointments – an area long identified as a source of inefficiency, delay and unnecessary hospital dependency. The Framework emphasises integrated data, digital tools, and shared clinical decision‑making as essential enablers of this shift.
Targeting fewer follow‑up appointments: a shift to proactive, preventative care
The Framework’s second major outpatient‑related ambition centres on reducing follow‑up appointments across secondary care. This is critical: the traditional outpatient model – referral, first appointment, tests, review – has been widely recognised as outdated, inefficient, and unable to cope with population demand. By diverting follow‑ups into neighbourhood‑based multidisciplinary teams, integrating diagnostics earlier, and using virtual decision‑making processes, the NHS aims to eliminate unnecessary repeat visits while providing more timely and coordinated care closer to home.
Evidence from national programmes shows why this matters. A redesigned pathway with tests delivered upfront can significantly shorten time to diagnosis and drastically reduce the number of outpatient touchpoints required. Feedback Medical’s own work with Queen Victoria Hospital NHS Foundation Trust (QVH) demonstrated how asynchronous, digitally enabled collaboration can remove entire cycles of outpatient activity while improving clinical decision‑making.
What we learned from the national neighbourhood health simulation
In late 2025, PPL, NHS Providers, Optum and Feedback Medical delivered the first national neighbourhood health service simulation – an immersive, system‑wide exercise involving clinicians, managers, system leaders and people with lived experience. Over two days, participants explored how neighbourhood‑based working could transform activity across a fictional local system.
The results were significant:
- 25% reduction in outpatient appointments, equivalent to avoiding 119,600 appointments per year in a borough of 290,000 residents.
- 14% drop in unplanned inpatient admissions – demonstrating the real‑world potential of preventive, coordinated care.
- 11% reduction in GP appointments, enabling improved GP access, supported by better use of community resources.
Bleepa played a key digital‑enablement role during the simulation, supporting rapid communication, streamlined referrals and shared decision-making across integrated neighbourhood teams.
The simulation demonstrated that digital infrastructure is essential – but cultural change matters just as much. Teams initially defaulted to traditional referral patterns, even when better tools were available. By day two, however, participants reorganised around resident need, dramatically reducing duplication and improving care coherence.
These findings directly support the Framework’s national targets: fewer referrals, fewer outpatient attendances, and faster, more coordinated care.
How redesigning the outpatient model supports national delivery targets
Feedback Medical has long advocated for a radical redesign of outpatient care. Our approach is grounded in two of the shifts aligned with NHS England’s ambitions: moving from analogue to digital and hospital to community.
1. Reducing referrals through single points of access
Our technology enables clinicians across primary, secondary and community care to communicate rapidly, share images and diagnostic information, and collaborate asynchronously. This directly supports the creation of single points of access – ensuring referrals into symptom-based pathways are appropriate, routed correctly, and often resolved without an outpatient appointment at all.
2. Eliminating unnecessary follow‑ups
By integrating diagnostics earlier and enabling virtual multi-disciplinary review, our model removes the need for traditional first and follow-up outpatient appointments. The QVH digital breathlessness pathway, enabled by Bleepa, is a clear example: diagnostics are completed upfront, clinicians collaborate virtually, and many patients receive a management plan without attending a single outpatient clinic.
3. Supporting neighbourhood‑based care delivery
Feedback Medical solutions enable the decentralised, multidisciplinary working that the Neighbourhood Health Framework requires. Shared digital infrastructure, asynchronous decision-making, and improved care coordination make it easier for neighbourhood teams to take on activity previously delivered in hospitals – directly contributing to the Framework’s target of diverting 25% of outpatient activity.
Conclusion: A moment of alignment and opportunity
The Neighbourhood Health Framework presents a clear vision for shifting care into communities, reducing unnecessary hospital activity and delivering a more coordinated, preventative model of care. The evidence – from national policy, the PPL simulation and our work with QVH on digital pathways – shows that this transformation is achievable.
Feedback Medical is committed to playing its part. By redesigning the outpatient model, enabling integrated digital pathways and supporting neighbourhood‑based care, we stand ready to help systems meet, and exceed, the national targets that will shape the next decade of NHS reform.