Neighbourhood health increases the number of handovers across organisations — and handovers are where risk concentrates.
ICBs remain accountable for safety, governance, and outcomes across place, without owning operational delivery.
Inference Clinical provides governance infrastructure that makes handovers explicit, auditable, and visible at system level — without pulling care back to the centre.
Neighbourhood delivery distributes responsibility across PCNs, community providers, mental health, acute trusts, social care, and the voluntary sector.
System accountability does not distribute with it. ICBs remain responsible for safety, governance, and outcomes — even where they do not own operational delivery.
When handovers are implicit, risk is invisible until harm occurs — and accountability is only discovered after the fact.
At any point in a neighbourhood pathway, system leaders must be able to answer:
Clear ownership at each handover point. Named teams or individuals — not assumptions, not inboxes.
Consent and lawful basis evaluated at the moment of exchange, not inherited from previous encounters.
Provenance and confidence visible. Source known, transformations understood, currency explicit.
Acknowledgement and outcome closure. Sent is not received. Received is not actioned. Completion is explicit.
The Seven Flows formalise the oversight questions into governance invariants.
They define the minimum conditions that must hold whenever care moves across organisational boundaries. They do not centralise care. They standardise what safe handover means — and make it auditable. Without them, handover safety is assumed rather than assured.
When governance is explicit, the work becomes calmer. Not faster in a rushed sense — but clearer, more predictable, and safer.
This is what changes when handovers are designed as first-class clinical events — not side effects of organisational boundaries.
Governance infrastructure produces assurance as a byproduct of safe handovers — not as an additional reporting burden placed on neighbourhood teams.
ICBs gain visibility and evidence without pulling care back into central control.
Handover risk visibility across neighbourhood pathways
Escalation ownership audit — sent, acknowledged, actioned
Consent scope and access audit by purpose, role, and organisation
Provenance trace for shared datasets and AI-assisted outputs
Exception reporting where governance invariants failed
Neighbourhood outcome closure rates — did episodes actually complete?
Clinical safety evidence support — DCB 0129 / DCB 0160 ready posture
Assurance stops being a periodic exercise — and becomes the natural exhaust of safe, everyday work.
Neighbourhood health cannot be transformed in a single programme or procurement. It requires integrating existing partners, systems, and ways of working — without increasing clinical or regulatory risk.
We start with governance, not transformation. Clinical impact and regulatory scope expand only when evidence supports it.
Map handover risk before touching systems
Pick one pathway with high handover risk. Identify where responsibility, consent, escalation, or closure currently fail — across organisations. No system changes. No new workflows.
Introduce one governance invariant where it breaks
Implement a single flow at a specific handover point. This can be non-clinical, read-only, shadow-mode, or advisory. Prove governance works before expanding scope.
Add flows, partners, and pathways based on evidence
Only once the first flow is working do we add additional invariants, integrate further organisations, or widen clinical relevance. Each extension is evidence-led.
Governance becomes reusable infrastructure
Governance is no longer a project. It becomes shared infrastructure that every neighbourhood pathway can rely on — regardless of who delivers care.
Regulatory scope and clinical influence expand in phases — never ahead of evidence.
Participate in integrated care without inheriting unmanaged risk.
How providers protect handovers →Monitoring without escalation ambiguity.
How monitoring handovers stay safe →Make integration safe without rebuilding the estate.
How digital teams govern handovers →We work with ICBs who recognise that distributed delivery requires explicit governance infrastructure. Start with a conversation.
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