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Welcome to the third blog in our Neighbourhood Health series, which have previously covered an introduction to INTs and creating the conditions for INTs to flourish. Here, our Senior Evaluation Manager Camille Aznar discusses how we might most usefully evaluate existing and emerging INTs.

In line with the priorities set out in the 10 Year Health Plan for England, the emergence of integrated neighbourhood teams (INTs) represents a significant and promising shift towards a more person-centred model of care, driven by collaboration between the many and varied stakeholders who can influence health at a local level. Building and sustaining these relationships will be essential to achieving meaningful impact and improved health outcomes.

While there will rightly be a strong emphasis on measuring impact and embedding learning within these teams, it is important to move beyond only tracking data and patient outcomes.

A comprehensive evaluation of INTs will require us to understand the factors underpinning the successful implementation of these models and the intricacies of how these partnerships function in practice. This includes exploring the enablers and barriers to collaboration, the extent of genuine co-production of new approaches to improving health outcomes, and the factors that contribute to more efficient and effective workforce models.

As stated in NHS England’s 2025 Neighbourhood Health guidelines:

“Systems are supposed to be rigorously evaluating the impact of these actions, ways of working and enablers both in terms of outcomes for local people and effective use of public money.”

Ultimately, it is crucial to adopt a broader perspective, shifting the focus from isolated project-level activities to neighbourhood-wide outcomes and programme-level learning. A systems-level view will help us better understand and navigate the complexity of integrated neighbourhood working. Developing a common evaluation ‘framework’ that includes a core set of metrics, will help to ensure that there is consistency in our approach and increase our ability to share learning effectively. In developing our approach, we need to draw on existing work, for example Iqbal et al. (2025).

The guidelines further emphasise:

“Local systems will need to consider each component within the context of the needs of their local population and the current configuration of services. They will also need to evaluate how effectively individual interventions link together to improve the way services are delivered for their local population and the outcomes people achieve.”

The welcome emphasis on a ‘test and learn’ approach in the Neighbourhood Health guidelines highlights the importance of iterative improvement. Our recent evaluations (such as our evaluation of the Health Equity Team programme in Lewisham, or our evaluation of the Rough Sleeping and Mental Health Programme) have prioritised collaborative working with partners, capturing learning as it emerges. We aim to act as both a learning partner and a critical friend – providing targeted, co-produced, and actionable recommendations to support service improvement.

At the HIN, our evaluation approach is grounded in:

As part of our South London Evaluation Advice Clinic’s pilot, delivered in partnership with King’s Health Partners and King’s Improvement Science, we advised Sutton INTs’ Outcome Framework. Nadine Wyatt, Health and Care Integration Programme Lead at London Borough of Sutton said:

“Developing an effective evaluation approach for Integrated Neighbourhood Teams (INTs) requires a combination of strategic alignment, robust data infrastructure, and collaborative culture. Key enablers for us include a shared outcomes framework which we co-produced with partners, aligned data systems across organisations, and mixed-methods evaluation approaches that reflect the complexity of local systems. We learnt that challenges such as fragmented data, varying partner priorities, and limited analytical capacity can be addressed through joint ownership, investment in shared analytics platforms, and partnerships with academic institutions. Embedding realist and developmental evaluation methods allow our teams to understand what works, for whom, and in what context – which is critical for continuous learning.

Although we have limited evaluation capacity, Sutton received excellent guidance and feedback on the Sutton INT Outcome Framework which will be incorporated in our future work. Our philosophy is an informed approach to: Keep doing what is working and stop what is not working!”

A key challenge we anticipate is the variability of INTs in practice. Teams are likely to differ in workforce models, and priority areas. The lack of standardisation will complicate evaluation efforts, underscoring the importance of a scoping and formative approach that values real-world context and data over rigid evaluation frameworks. We are looking forward to the challenge.