We have previously reported on the growing impetus towards shared health and social care initiatives; moving healthcare away from specialist settings and into the community. That move has been generally welcomed by clinicians and patients alike; with prevention and early interventions seen as helping to improve health outcomes.

However, as with any new system there are still some issues to iron out. One of these is the role which medical specialists will play in the future. This uncertainty has been highlighted by a report by the Royal College of Physicians (RCP) which revealed that 48% of clinicians were either not very clear, or not clear at all, about how their specialist role could integrate with a neighbourhood health team. Moreover, 42% of respondents were concerned about the way in which a move to neighbourhood health would affect their clinical work. Key areas of concern here include the impact of virtual or remote consultations, including whether consultations outside of a hospital base could lead to a reduction in timely diagnostic procedures. Responders were also concerned about escalation routes available for patients with complex needs.

In response to the concerns raised, the RCP has made a number of recommendations aimed at providing integrated pathways and training. These include the need for integrated systems which include electronic patient records to enable “joined-up care and shared decision-making across traditionally siloed teams.”

This call from medical specialists to deliver integrated health systems may also go some way towards solving administration and communication issues identified by patients. A report by The King’s Fund has revealed a level of concern about health communications and the way in which poor communication can impact patient outcomes. And whilst the headline rate of 66% of patients and carers experiencing at least one administration problem in 2025 is unchanged from the previous year, other results are even less encouraging.

For example, whilst in 2024 52% of people thought the NHS was good at keeping them informed about their appointments and test results, in 2025 this had fallen to 43%. Similar falls were seen in the communication of care and treatment plans; whilst a significant 23% commented they had received appointment communications after the appointment date had passed. And sadly, those with long-term health conditions seemed to be experiencing the worst level of service, with 45% of those with long-term healthcare needs reporting poor communication levels compared with 36% of those with more short-term healthcare needs.

Summarising the report The King’s Fund commented that “The results overall make for difficult reading.” In response they have put together a ten-point action plan starting with making admin a national priority. As with the RCP report, The King’s Fund also highlights the potential benefits of a digital process recommending that when designing digital processes all potential users are considered and supported and that digital pathways are straightforward, easy for patients to navigate and enable two-way communication. Prompt referral confirmations should also be given including an indication of expected treatment waiting times and with patients being offered a choice of time and date for appointments.