To ask the Minister of Health to outline how the Neighbourhood Model of Care will bring care closer to home for under-served communities.

Mr Nesbitt (The Minister of Health)

I made a commitment in the reset plan to developing a neighbourhood model to deliver greater levels of care to our citizens in their local communities. The model will see community pharmacies, GPs and their federations, voluntary and community organisations, trusts and independent providers working closely together in formal partnerships to provide integrated care. It is an important enabler for my commitment to shift left. Building a neighbourhood model will require providers to work in new ways. It will be built around 17 integrated neighbourhood teams, which will act as provider alliances. They will operate within trusts or within an area-integrated partnership board footprint at GP federation level. They will serve an average population of 115,000 people. Integrated neighbourhood teams will know the populations that they serve and will work together as a team of teams, leading and driving the delivery of the neighbourhood's core functions and priorities for care closer to home. They will work with smaller neighbourhoods within the footprint, which are the communities to which people feel they naturally belong. We will take a phased approach to developing and implementing the model. The design phase has involved significant research, stakeholder engagement and launching a call for evidence to identify existing good practice. In addition, learning from my Live Better initiative will be taken into account. We are about to move into phase 2, which is the build phase, identifying neighbourhood sites and activities and establishing systems for delivery, as well as the funding arrangements. Implementation will commence from April 2026, when we will have worked through the operational details and will move into the delivery phase.

Mr Nesbitt

I thank the Member for her observation. Of course, I want patients and communities to be involved in the model. Without their buy-in, it will be very difficult to achieve. For me, the starting point has to be talking to the experts who know how to deliver a neighbourhood scheme. I will take you back to what Professor Bengoa said to me when he was last here: "Be very tight on your outcomes but very loose on how you achieve them, because you are not a nurse, a doctor, a GP, a clinician, a surgeon or, indeed, a health service administrator. I mentioned my Live Better initiative to look at health inequalities, which began in two demonstration areas. Those models were based on liaison with populations that we were there to serve. Those two different populations — one urban population in Derry/Londonderry and one urban population in Belfast — came up with different desires. It is my desire that rolling out the neighbourhood model will not be a one-size-fits-all but will, indeed, reflect the desires of local populations.

Mr McGuigan

In your response, Minister, you mentioned the importance of GPs, pharmacies, the independent sector, domiciliary carers etc, and I wholeheartedly agree with that. It will be no surprise to the Minister that, when some of those groups come to the Health Committee, they express their unhappiness and dissatisfaction with the current levels of core funding, which have caused issues. In your engagement with those groups, have you found that current issues are creating obstacles? What is the level of engagement to ensure that your proposed model will be a success?

Mr Nesbitt

The core funding budget is not satisfactory for anybody, including me and the Department. When you break it down into GPs, community pharmacies or the hospital trusts, which are having to save hundreds of millions of pounds in this financial year, as they did last year, that is at the core of the problem. I have a number of concerns, but at the top of my list is the shortfall in next year's budget to do everything that I want to do. When you look at what we must do, which is to keep the current health service functioning, the question is this: how much money can we release for this "save to shift" rather than "spend to save"? Can we spend to move to the shift left model? That will be incredibly challenging in the next year, but the idea is to try to get everybody, or, at least, as many people as possible, to the starting line for 1 April. Rolling out a neighbourhood model will not be done in a month or a year or even in this mandate. It could be a five- to-10-year project, but the idea is to start it on 1 April in certain areas at least and prove evidentially that it works, so that we create the desire around the rest of the country to be next in line to join the model.

Mrs Dodds

Minister, I have said many times that the neighbourhood model, which delivers healthcare closer to people in their communities, is the right way forward. However, it will take a lot of time, and we need a health service that is working and functioning for patients in the here and now. I really would like some clarity on a message that I got earlier today, which told me that the Northern Ireland Ambulance Service is about to call a critical state and that there are currently 160 emergency and critical calls from those who are waiting for ambulances that cannot be answered. Can you provide clarity for the House?

Mr Nesbitt

I am unaware of those details, but, obviously, I will check that as soon as I am able to leave the Chamber.

Mr Durkan

My supplementary question relates to the original question on the neighbourhood model. That model sounds fantastic in theory and looks great on paper, but I refer to Mr McGuigan's point: are you convinced that the agencies on which you are dependent to deliver it are all on board? What funding has been identified or earmarked to roll it out?

Mr Nesbitt

I am certainly not aware of any partnership or organisation that is not up for looking at it. Since I took up post, right from the get-go, everybody whom I have spoken to who is involved in delivering health and social care in any way, including those in the voluntary and community sector, has been up for a reset, for reform and for a shift left, because I think that everybody realises that the current model is not sustainable. The question of finance remains the critical one. Can we release enough money to make a significant impact in the next financial year and set a direction of travel by the end of the mandate that the next Minister of Health feels compelled to follow? To be honest, that has to be an open question, but it is one that I am determined to try to close.

Mr Speaker

Moving on, I call Maurice Bradley.

Mr Bradley

Minister, you said that 17 —.

Mr Speaker

Question 2, Mr Bradley.

Mr Bradley

I thought that you were calling me for a supplementary question. My apologies.

Mr Nesbitt

Was "moving on" the clue?