A Realist-Informed Evaluation of Camden's East Integrated Neighbourhood Team Pilot
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Authors
Cassie Moore
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Issue Date
06-May-26
Type
Conference Abstract
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Keywords
Neighbourhood health & place-based working
Alternative Title
Abstract
Background:
Integrated Neighbourhood Teams (INTs) are posited as the cornerstone of neighbourhood working, intended to deliver joined-up, person-centred care and the shift “from hospital to community”. Camden Council launched the East INT pilot (October 2024) as a “test and learn” model to strengthen collaboration between adult social care and NHS community services through co-location and facilitated neighbourhood partner forums. This evaluation explored staff experiences of integration, and how leadership, professional boundaries and culture shaped enactment in the INT.
Methods:
A realist-informed service evaluation using embedded ethnographic fieldwork, including non-participant observations of INT activity (May – Aug 2025). Semi-structured interviews were conducted with 12 staff across roles and partner organisations in two recruitment waves to test and refine programme theories. Reflexive thematic analysis was combined with realist logic to develop context–mechanism–outcome configurations (CMOCs) and refine Camden's programme theory for the INT.
Results:
Four themes shaped staff experience of the INT (vision and strategy, leadership, infrastructure and institutional maintenance) and informed a refined programme theory for neighbourhood working, specifying six intended outcomes and the contextual conditions required to achieve them. Change was driven less by co-location alone than by boundary-spanning leadership, goodwill and tangible micro-interventions that legitimised collaboration, reduced psychosocial and knowledge barriers, and supported timelier discussion and referrals across teams. Integration was largely confined to facilitated forums and a small group of engaged staff, rather than becoming day-to-day practice across teams. Integration was constrained by staff turnover and capacity pressures, persisting professional and organisational boundaries, estate and digital barriers, lack of shared mandate and accountability, and insufficiently resourced cross-cutting leadership to embed change.
Learning:
Co-location alone cannot facilitate integration. A clear, realistic vision must translate into day-to-day objectives that staff can enact, supported by visible, resourced boundary-spanning leadership with cross-organisational mandate. Relationship-building and culture change are fundamental, but insufficient without “hard” enablers: estates and digital access, information governance, and shared processes and accountability. Expectations should be realistic within constrained resources and timescales; evaluation should track relational and cultural change (trust, information flow, cross-service understanding and joint problem-solving) as early signals of progress, alongside activity and longer-term outcomes.