Akeso welcomes the government’s ten-year vision for neighbourhood health and integrated care. However, as Sir John Oldham powerfully stated in HSJ, “you can’t just take a hospital trust board and management and think that it will be able to run population health, because the skill set and knowledge set is really quite different.” This sentiment was echoed throughout our recent Population Health Management (PHM) roundtable. The UK cannot achieve this vision through NHS-led delivery alone. Prevention, public health and population management will only succeed if local authorities, community providers and voluntary sector partners are empowered as equal leaders, not as consultees or delivery arms.
The decision to bring NHS England into the Department of Health and Social Care presents a rare and critical opportunity. This structural change should not simply realign reporting lines, it should catalyse a transformation in how we define and deliver population health. Without bold policy action now, England risks falling permanently behind international comparators, countries that achieve better population outcomes despite having less sophisticated health systems.
Akeso’s ӔgelEye: Translating Population Insight into System Change
Akeso’s ӔgelEye is a ready to deploy solution designed to help systems turn the theory of population health into practical, measurable action. It is not a consulting framework or pilot approach, but a mature, tested product built in partnership with Integrated Care Systems and providers. The tool brings together linked data from NHS Digital, the Office for National Statistics and local sources to deliver real time, actionable population segmentation that supports planning, delivery and service transformation.
ӔgelEye has already been adopted by systems with varying levels of internal PHM capability, helping them move at pace without needing to build new infrastructure or expertise. For example, at a large integrated care board in the South, the ӔgelEye enabled rapid evaluation of out of hospital care, highlighting variation in outcomes and cost effectiveness across community pathways. The resulting changes, including a central hub and spoke model involving primary care, community teams and voluntary partners, are forecast to release £4.4 million in benefits. At a major Midlands trust, ӔgelEye supported the redesign of virtual ward services into a generalist model tailored to a diverse, digitally variable population. This model, underpinned by a central coordination hub, with the ability to deliver over 2,000 admissions annually and forecasted to save more than 2,300 bed days a year.
These are not pilots. They are working demonstrations of what the government’s Ten-Year Health Plan envisions: population health delivered through integrated neighbourhood ecosystems, underpinned by data, trust and cross sector working. But these outcomes were not easy to achieve, precisely because most existing governance structures are not built for this kind of work.
As Sir John Oldham noted, hospital trusts were never designed to lead population health. The skillset, mindset and mandate are different. In both examples above, progress was slowed by fragmented governance, lack of shared digital infrastructure, limited engagement with local authorities and community partners, and poor access to primary care data. These barriers were not caused by local reluctance, they were symptoms of a system built around institutional delivery, not community coordination. They required persuasion, persistence and political capital to overcome, and that is not scalable. If national reform does not address these structural mismatches, success will remain the exception, not the norm.
National Imperatives for Reform
Insights from our April 2025 PHM roundtable were clear. PHM cannot be delivered by the NHS alone, and the current procurement, funding and governance environment is not fit for purpose. To realise the full potential of PHM and neighbourhood health, we recommend:
- Use the DHSC and NHS England integration to redefine system leadership
- Establish a dedicated population health function within the Department of Health and Social Care or an arm’s length body, tasked with aligning policy, funding and accountability across health, local government and the community sector.
- Fund place-based leadership and infrastructure
- Population health budgets should flow to neighbourhood and place footprints with flexibility to commission multiagency teams, not just NHS services. Fund digital infrastructure regionally; fund action and coordination locally.
- Reform procurement to enable innovation and inclusion
- Move beyond institution-based procurement towards outcome based commercial models. Create open innovation environments, including test beds, simplified frameworks and routes to market that work for smaller suppliers.
- Shift from dashboards to action
- Prioritise real time, predictive tools that support decision making, co-management and integrated working, not just reporting. Support systems to embed PHM into service design, not into insight teams alone.
- Build the system architecture for prevention
- Support new provider forms, governance models and contracts that include primary care, social care, voluntary and community partners and digital health innovators as core contributors to health outcomes.
Our Offer
Akeso is already supporting systems across the UK to deliver population health through a proven, ready to deploy tool, ӔgelEye. The platform works by bringing together disparate national and local datasets, including from NHS Digital, the Office for National Statistics and local providers, in a structured, consistent way. This enables the creation of unbiased population comparators that support targeted, equitable interventions and accelerate system improvement.
Crucially, the ӔgelEye does not require systems to build new infrastructure or deep in-house analytics capability. But while it has delivered measurable benefits in diverse geographies, it is increasingly clear that tools like this cannot be deployed at the scale and pace the Ten-Year Health Plan demands unless national reforms are made. Specifically, we need changes to the infrastructure, the flow of funding, and the distribution of authority between government departments and agencies that work with the NHS, including local government, public health and wider community partners. Without this, population health will remain technically possible but institutionally blocked.
We are ready to work with government, the Department of Health and Social Care, NHS England, providers, local leaders, and national suppliers to:
- Co-develop a population health maturity framework
- Influence the reform of procurement and funding mechanisms
- Scale proven neighbourhood led delivery models and the policies across government needed to achieve them
If we act now, the UK has the opportunity to lead the world in embedding population health as the foundation of integrated care. If we do not, we risk institutionalising a vision we are structurally unable to deliver and weakening our ability to build a more cost effective and equitable NHS for the future.
