Community Care

Community Care Services in Your Area

The BHNC team works with GP practices, Primary Care Networks, community providers, local authorities and voluntary organisations to support people in accessing care closer to home and within their local communities. We provide a community phlebotomy service from a number of GP practices across the borough, enabling patients to attend a convenient local location for blood tests and supporting improved access to care. We also support practices by delivering long-termcondition annual reviews for housebound patients, including phlebotomy and other tests where required, in the comfort of their own homes.

Alongside these services, BHNC supports a neighbourhood-based approach to care that brings organisations together to provide more coordinated, personalised and proactive support for local residents. This helps ensure people receive the right care, in the right place, at the right time, while promoting independence, prevention and improved health outcomes.

Local Care Networks and Integrated Neighbourhood Teams

Bexley is organised into three Local Care Networks (LCNs): Clocktower, Frognal and North Bexley. Local Care Networks bring together NHS organisations, social care, community services and voluntary sector partners to better understand the
needs of local populations and coordinate services around the communities they serve.

Within each LCN, Integrated Neighbourhood Teams (INTs) bring together GPs, community nurses, pharmacists, social prescribers, mental health professionals, adult social care teams and voluntary sector organisations to work collaboratively around the needs of patients. Rather than operating as separate services, these multidisciplinary teams provide a joined-up approach that focuses on prevention, early intervention and personalised care.

This neighbourhood model supports the NHS ambition to deliver more care within communities, helping people to live healthier and more independent lives while ensuring support is coordinated around their individual needs. Integrated Neighbourhood Teams play an important role in supporting people living with frailty, multiple long-term conditions and complex health needs, helping them access appropriate support earlier and reducing avoidable hospital attendances and admissions

How We Support Community Care

BHNC works with practices, Primary Care Networks and local partners to provide:

Support for Local Care Networks across Clocktower, Frognal and North Bexley.
Support for Integrated Neighbourhood Teams delivering proactive, coordinated and person-centred care.
Community phlebotomy services delivered from GP practices across Bexley.
Long-term condition annual reviews for housebound patients (including phlebotomy and other tests where required).
Neighbourhood-based programmes focused on prevention, frailty and long-term condition management.
Collaborative working that improves access to services and supports care closer to home.

Creating Better Outcomes Together

Through strong partnerships with GP practices, Primary Care Networks, community providers, local authorities and voluntary sector organisations, BHNC is helping to build a more integrated model of care across Bexley.

Together, we are supporting the NHS ambition to deliver more care within neighbourhoods, improve prevention and address health inequalities. By bringing services together around local communities, we are helping people access care closer to home, remain independent for longer and receive coordinated support when they need it most.

Additional improvement suggestion: Rather than referring to “annual reviews” generally, using the phrase “Long-term condition annual reviews for housebound patients” throughout the page is more specific and better reflects the scope of the service. This also aligns with NHS terminology used across primary care.

Long-Term Condition Visits

BHNC delivers a home visiting service for patients who are housebound and require regular reviews for long-term health conditions. Our trained healthcare assistants and phlebotomists visit patients at home to carry out essential checks — including blood pressure, weight, waist measurement, and, where needed, blood and urine tests. This service currently supports patients living with type 1 and 2 diabetes, asthma, COPD, coronary heart disease, and dementia. Referrals are made directly by the patient’s GP, and our team then contacts the patient to arrange a convenient appointment. All results are sent back to the GP for ongoing care and follow-up.

Phlebotomy

BHNC works with GP practices across Bexley to provide phlebotomy services for registered patients. For convenience, blood test appointments are available within GP surgeries and can be booked directly with the practice reception team. A walk-in service is also available at Erith Hospital, Monday to Friday, with Saturday appointments available in some areas. These local options help patients access the tests they need without needing to travel far or visit a hospital unnecessarily.

NHS Health Checks

Since January 2023, BHNC has been working with the London Borough of Bexley and local GP practices to support the invitation process for NHS Health Checks. We manage the distribution of text message and letter invitations to patients who are eligible, encouraging them to book directly with their GP practice. This collaborative approach helps increase uptake and ensures more people benefit from early detection of conditions like heart disease, diabetes, and stroke.

INT (Integrated Neighbourhood Team)

We support the development of Integrated Neighbourhood Teams across Bexley, bringing together health, social care, voluntary sector and community services to provide joined-up care for local residents. By working closely with GP practices and partner organisations, we help coordinate services, improve access to support, and ensure people receive the right care, at the right time, closer to home.

Neighbourhood Health & Care in Bexley | Bexley Wellbeing Partnership