Neighbourhood Health Optimisation Service (NHOS)

Description

The Neighbourhood Health Optimisation Service (NHOS) is proposed to test a standardised, at-scale primary care led approach to identifying and addressing reversible risk of unplanned admission to hospital, initially in patients aged 65 and over, while their risk is still modifiable. By using Population Health Management to identify people with medium/high rising and reversible risk, the NHOS can intervene before people deteriorate, become frail or deconditioned, present in crisis, or require avoidable acute, ambulance, primary care and social care input.