Place Based Partnerships


Place based partnerships made up of local health and care organisations, borough and district councils and voluntary and community organisations. Most places cover a population of around 250 – 300,000 people.

Place partnerships provide the local leadership, and framework, to support the delivery of integrated care at the local level, bringing all the organisations that can make this happen together around the same table.

Each partnership is developing its own priorities, reflecting the different needs of their local communities, and thinking about how they will work together to improve and join up care for local people.

We have four partnerships across Surrey Heartlands:

  • East Surrey
  • Guildford and Waverley Health and Care Alliance
  • North West Surrey Alliance
  • Surrey Downs Health and Care Partnership

These local partnerships are responsible for the planning and delivery of services at a local level. Each place has its own board with representation from local partners and sets its own local priorities.

Place partnerships are not statutory organisations so the accountability for decision-making sits with the CCG’s Governing Body. This is done through a delegated local committee for each partnership. Each committee consists of one or two locally elected Governing Body GPs, the Place Based Leader and a Lay Member, who sit on the local Place Board, with delegated authority from the Governing Body to make commissioning decisions. This ensures each place is able to reflect the priorities and needs of its local area.




Thank you to everyone who took part in the above workshop at the beginning of March 2020. A lot has happened since then and our thoughts are with all those impacted by the coronavirus pandemic. We wanted to make sure that we reported back on your contributions to this event. The Guildford and Waverley Alliance Board has reviewed the feedback and is keen to move forward with establishing a Citizen Reference Group, to support its commitment to involve citizens and patients in imaginative and innovative ways with the ICP and its programmes.

  pdf 22 June 2020 - Feedback from ‘Shaping Patient & Citizen Engagement in Guildford and Waverley’ (189 KB)

If you have any questions about next steps, please contact This email address is being protected from spambots. You need JavaScript enabled to view it. (further contact details are in the report).  


Adults with Complex Needs and Frailty

Across North West Surrey there have been a number of initiatives developed which support the improvement in the quality of care for adults with complex needs and or at risk of, or living with frailty. As these have developed there is an appetite and ambition to:

  • Align these initiatives with national priorities and best practice
  • Provide consistency in the quality and delivery of services and
  • Support more community based, integrated initiatives to reduce the number of adults with frailty being admitted to hospital.

This document describes the approach, and care model, which underpins this ambition and aligns with the 3 key priorities of the Surrey Health and Wellbeing Board 10 year strategy.

  1. Helping people in Surrey to lead a healthy life
  2. Supporting the mental health and emotional wellbeing of people in Surrey
  3. Supporting people to fulfil their potential

and the Department of Health and Social Care white paper Integration and innovation: ‘ Working together to improve health and social care for all’.

pdf Adults with Complex Needs and Frailty Summary Strategy rev March 2022 (852 KB)



Model Publication Scheme Class: Not part of the MPS

Primary Care Networks


Since the NHS was created in 1948, the population has grown and people are living longer. Many people are living with long term conditions such as diabetes and heart disease, or suffer with mental health issues and may need to access their local health services more often.

To meet these needs, practices have begun working together and with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas in primary care networks.

Primary care networks build on the core of current primary care services and enable greater provision of proactive, personalised, coordinated and more integrated health and social care. Clinicians describe this as a change from reactively providing appointments to proactively care for the people and communities they serve. Where emerging primary care networks are in place in parts of the country, there are clear benefits for patients and clinicians.

Primary care networks are based on GP registered lists, typically serving natural communities of around 30,000 to 50,000. They should be small enough to provide the personal care valued by both patients and GPs, but large enough to have impact and economies of scale through better collaboration between practices and others in the local health and social care system.


Working better together

Surrey Heartlands CCG is proud to be part of the wider Surrey Heartlands Health and Care Partnership, working closely with our partners in local councils and the wider community to improve health outcomes for our population.

Here, we have put together a series of short videos that show just how different parts of our health and care system are coming together in new and exciting innovative ways.

Note: all video links below open in the Surrey Heartlands Health and Care Partnership YouTube channel.


Urgent Care - a new approach in Surrey Heartlands       Transforming Community Mental Health services in Surrey Heartlands
Surrey Heartlands - Together for Carers   Surrey Heartlands scheme brings GPs, hospitals and children together   Surrey Heartlands - helping older footballers 'walk on' with a healthier heart



Primary Care Networks in Surrey Heartlands

Below is a list of the primary care networks and their GP practices within the Surrey Heartlands area.


North West Surrey Alliance


CoCo   Weybridge and Hersham   West Byfleet
  • Chertsey Health Centre
  • Crouch Oak 
  • Ottershaw
  • Rowan Tree Practice
  • Church Street Practice
  • Hersham Surgery
  • Fort House Surgery
  • Ashley Medical Practice
  • Yellow Practice
  • Red Practice
  • White Practice
  • Parishes Bridge
  • Wey Family Practice
  • Madeira Medical
SASSE Network   SASSE Network 2   SASSE Network 3
  • Upper Halliford
  • Sunbury Practice
  • Studholme
  • Shepperton
  • Fordbridge
  • Knowle Green
  • Orchard Surgery
  • Staines Thameside
  • Grove Medical Centre
  • Packers
  • St Davids
  • Hythe Medical Centre
  • Staines Health Group
  • Stanwell Road
Woking Wise 1   Woking Wise 2   Woking Wise 3
  • St John's & Greenfield
    (The Family Practice)
  • Chobham & West End
  • Pirbright Surgery
  • Greenfield (The Family Pracitce)
  • College Road
  • Hillview Medical Centre
  • Maybury Surgery
  • Southview Surgery
  • Sunnymeed Surgery
  • Heathcot Medical Practice
  • Goldsworth Medical Practice
  • Sheerwater Medical Practice


Guildford and Waverley Health and Care Alliance


North Guildford   West Waverley   East Waverley
  • Fairlands
  • Guildowns Group Practice
  • Woodbridge Hill
  • Dapdune House
  • Witley Surgery
  • Chiddingfold Surgery
  • Haslemere
  • Guildford Rivers
  • Grayshott Surgery
  • Springfield Surgery
  • Binscombe
  • The Mill
  • Wonersh
  • Cranleigh
Guildford East        
  • Horsley
  • Merrow Park
  • Austen Road
  • St Lukes
  • Shere Surgery
  • Villages Medical Centre


Surrey Downs Health and Care Partnership


Dorking   East Elmbridge   Epsom
  • Brockwood
  • Dorking
  • Leith Hill
  • Medwyn
  • Capelfield
  • Esher Green
  • Glenlyn
  • The Groves
  • Littleton
  • Thorkhill Surgery
  • The Vine
  • Ashley Centre
  • Derby
  • Fountain Practice
  • Shadbolt 
  • Spring Street
  • St Stephens
  • Stoneleigh
Banstead Healthcare   Leatherhead   Integrated Care Partnership
  • Heathcote
  • Longcroft Clinic
  • Nork Clinic
  • Tadworth
  • Tattenham
  • Ashlea Surgery
  • Cobham
  • Eastwick Park
  • Fairfield
  • Molebrige
  • Oxshott
  • Integrated Care Partnership practice


East Surrey


South Tandridge   North Tandridge   Horley
  • Lingfield Surgery
  • Oxted Health Centre
  • Pond Tail Surgery
  • Caterham Valley
  • Elizabeth House Medical Practice
  • Townhill Medical Practice
  • Warlingham Green Practice
  • Birchwood Medical Practice
  • Smallfield Surgery
  • Wayside Surgery
Redhill Phoenix   Care Collaborative    
  • Hawthorns Surgery
  • Holmhurst Medical Centre
  • Woodlands Road Surgery
  • Greystone House Medical Practice
  • Wall House Surgery
  • Moat House Surgery




Review Date: 2020-08-25
Review Due: 2021-08-24
Model Publication Scheme Class: Class 1: Who we are and What we do

Working in Partnership


NHS organisations and local councils are starting to work more closely together to coordinate services around the needs of individuals. Working together means we can focus on keeping people well and living healthier lives, as well as making sure everyone gets the care and treatment they need, in the right place, at the right time.

This requires a new way of working, with health and care organisations collaborating rather than operating independently. For example, with health and social care staff working together in mixed teams, where they can put individuals at the centre of decisions about their care. This is explained in more detail in the NHS Long Term Plan which was published in January 2019. You can access the plan here.

All local partners across Surrey have signed up to the Surrey Health and Wellbeing Strategy. This over-arching strategy describes how partners will work together with local communities to improve health and wellbeing across the county. This includes health and care organisations as well as other public sector partners such as education and the Police.

Importantly, NHS Surrey Heartlands CCG is part of the wider Surrey Heartlands Health and Care Partnership which brings together all the local health and care organisations, including Surrey Council, who work together to improve local services and health outcomes.



Model Publication Scheme Class: Not part of the MPS
Surrey Heartlands Integrated Care System

Surrey Heartlands Integrated Care System


Surrey Heartlands is also the name given to our local partnership of health and care organisations which covers the majority of the county of Surrey. NHS Surrey Heartlands CCG is one of 10 organisations that make up the partnership, including Surrey County Council, along with local GP practices. The partnership also works closely with local community, voluntary and faith sector organisations and the borough and district councils.

All the organisations in the partnership are working together to improve services and health outcomes for local people as we know we can achieve more together than we can individually.

Importantly we are doing this in partnership with local people and staff.

Visit the Surrey Heartlands Integrated Care System website for more information.



Review Date: 2020-12-15
Review Due: 2021-12-15
Model Publication Scheme Class: Class 1: Who we are and What we do