Blog | Data and insight to transform neighbourhood care

Our Population Health Management (PHM) Analytics team took part in the national simulation of neighbourhood health, providing technical expertise and supporting planning discussions among interagency teams. In this penultimate blog of the series, we share what we learned from an environment purposely designed to strengthen neighbourhood working through data, technology and human insight.

People powered by data

At the heart of the 10 Year Plan sits a commitment to neighbourhood working — bringing together data, technology and human insight to support community-based health and social care. The simulation gave us a unique opportunity to observe decision makers using tools designed to improve outcomes through better data accessibility and collaboration.

Multiagency teams were able to partner with citizens in real time, exploring needs, testing ideas and co-creating solutions. This space to collaborate — with citizens firmly at the centre — proved invaluable.

Our analytics platform, PHM Pathfinder Analytics was a key enabler. It allowed teams to overlay clinical, social and demographic data, including factors such as housing, employment and fuel poverty. These richer insights sparked meaningful conversations about the social determinants of health and underscored how crucial they are when designing whole person care.

Senior leaders also valued the tool’s high-level infographics and single page trend summaries, which made it easier to understand the potential impact of interventions and make informed decisions about scaling them across delivery teams.

Accessibility and simplicity

A major takeaway from the simulation was the importance of accessible, visually engaging tools that help frontline teams understand the whole person — and the wider segments of the population they belong to. Data is only the starting point, its value comes from combining it with engagement and human insight.

Across the two day event, frontline workers and citizens showed a strong appetite for tools that make complex information actionable. Their feedback was clear: ongoing engagement and iterative development with interagency teams must remain central if we want these tools to drive meaningful change.

PHM Pathfinder Analytics’ impact: Evaluation and engagement

For many participants, PHM Pathfinder Analytics’ evaluation module was a highlight. It made it possible to compare interventions against control groups, bringing a new level of rigour and clarity to assessing impact.

Bringing this capability into a room filled with NHS, voluntary, community and social enterprise (VCSE), local authority and community leaders, created a rare opportunity to see how data could genuinely shape real world discussion. We want to build on that momentum — helping systems strengthen data driven decision making as a foundation for long term neighbourhood working.

Navigating complexity: Lessons from the planning layer

The simulation reflected the reality of NHS decision-making: complex, multilayered and full of competing priorities. Reaching consensus on actions, responsibilities and funding was challenging, but participants told us they found the experience energising. It gave them space to explore barriers they face in real life and consider how they might be overcome.

We also heard important feedback about limitations in existing data categorisation — particularly the difficulty of separating social and clinical conditions in datasets like emergency department records. These discussions highlighted the need for improved coding, greater interoperability and ongoing refinement to accurately capture the full range of health determinants.

Looking ahead: The future of PHM Pathfinder Analytics

The simulation reinforced an important lesson: powerful analytical tools must be intuitive and inclusive. There’s a growing appetite for insights that help tackle pressing social challenges. Our focus now is on:

Streamlining how PHM Pathfinder Analytics is presented and onboarded
Tailoring resources for non-specialist users
Strengthening collaboration between technology partners and frontline teams
Continuing to democratise data across neighbourhoods and systems

Events like this provide invaluable feedback. They help connect analytics to real world outcomes and shape the evolution of our tools to better support neighbourhoods, ICBs and Systems.

Unlocking the value of analysts

One of the standout reflections from the simulation was the value of having analysts directly involved in delivery and planning conversations. Our partners — including PPL and Feedback Medical — emphasised how much momentum was gained simply by having analysts in the room.

This raises an important question for all of us: when should we bring our BI and analytics colleagues out from behind the dashboards to support planning and commissioning directly?

Their presence enabled teams to move beyond data and into action — reinforcing that analytics is not just about numbers, but about insight, interpretation and wisdom.

Lessons learned and next steps

PHM Pathfinder Analytics received positive feedback for making complex data more understandable and actionable. But we know there’s more to do to ensure it works just as well for analysts as for non-analysts. As strategic commissioning priorities evolve, usability — along with costing and evaluation insights — will become increasingly important.

We remain committed to working with systems to refine our PHM tools and support the next phase of neighbourhood development.

Read our reflections on the neighbourhood simulation report

About the author

Kris Stone

Product Director for PHM

Kris Stone is a healthcare data and analytics leader currently serving as a Director at Optum | EMIS, where he focuses on integrating data to support population health outcomes. With over a decade of experience across the NHS and commissioning support services, he has built a career in using information and performance insights to improve healthcare delivery