Building the Neighbourhood Health Service - What Needs to Happen Next

The Neighbourhood Health Framework is a detailed plan of how to move healthcare out of hospitals and into local communities. It’s about working with the needs of local populations to provide a more personalised service, as well as easing demand on centralised services, like hospitals and care homes, where possible.

According to the government: “Neighbourhood health puts the person at the centre of how we deliver their health and care by organising services so they can work together to serve a defined population.”

It has three main aims:

1. To devolve power and care to local areas
2. To move towards increasingly digital services
3. To operate in preventative health, rather than being reactive to illness

It’s hoped that the framework will contribute to:

• Better health and care outcomes
• Reduced health inequalities
• People staying well at home
• Convenient, personalised and joined up care
• Reduced pressure on hospitals and care homes
• A reduction in duplicated services

For patients, it will provide them with easier access to diagnostics, blood tests and specialists as well as preventative and proactive care management.

The Neighbourhood Health partnership is designed to positively impact a number of healthcare services, including GPs, some urgent care, outpatients, adults’ and children’s social care and public health services.

In order to achieve this, integrated care will need to be strengthened at a local level. Services will need to work in collaboration as well as receive the right funding to deliver care. Neighbourhood care will be heavily supported by Integrated Care Boards (ICBs).

There are 42 ICBs across England which have been present since July 2022. They currently exist for the purpose of allocating NHS spend, improving the health of the population they serve and working alongside local authorities, among other responsibilities.

As part of developing Neighbourhood Health, the government states that “changes will be supported by the development of integrated care boards (ICBs) into strategic commissioners and this new collaborative way of working with local authorities.”

The rollout will also rely heavily on building out the appropriate workforce, a task which is set to take the NHS 10 years to complete. The aim is to upskill teams in more proactive, preventative and personalised care as well as developing strong clinical leaders and system leaders to support innovation and transformation.

Data and digital transformation will be crucial for delivering on the government’s promise to reduce avoidable health inequalities. The government hopes that an improved and more effective use of data will support equitable healthcare by effectively managing risk and preventing escalation. Which means that digital infrastructure must be in place and fit for purpose if Neighbourhood Health is going to be a success.

Strong digital infrastructure is essential for coordinated care. Disconnected and paper-based solutions do not support the NHS’ aims.

For multidisciplinary teams (MDTs) to work cohesively depends on how streamlined their tools are. For example, where teams are using electronic patient record systems or prescribing software, having a single system will ensure better continuity of care and reduced duplication of records. It will provide one single source of truth and allows teams to service the local community while updating records in real time. Handovers between teams and service providers become more efficient and care for staff becomes more person-centred and less admin heavy. Without the right digital systems, risks are missed and care is fragmented.

Digital systems are one part of the transformation, but data is another. With high-level insights and personalised dashboards, ICBs will be better poised to:

• Identify people at risk of hospital admission
• Pinpoint communities facing health inequalities
• Intervene earlier
• Understand which communities may be suffering from a high prevalence of disease, hospital admissions or who need more support in preventative care

Over the long term, the government and NHS will also be able to identify whether Neighbourhood Health is working.

It’s undeniable that in theory Neighbourhood Health will have a positive impact on the transformation of how healthcare and social care is delivered in England. But a lot of that depends on funding and trust building.

The scheme will need carefully allocated investments that match the needs of the ICBs who will be spreading the funding across services in their population. The government understands that “developing early financial incentives to support local systems to accelerate change” is an essential step in the process of making neighbourhood health a success. And when this funding is allocated to MDTs as a collective, there is more incentive for them to come together and work cohesively.

Understanding local needs will also be integral to building trust and engagement within the community. With the NHS’ long-standing ways of working, communities will need to adapt to these new changes - albeit that the changes are positive.

Over the next 0 - 12 months

The first requirement for the rollout of Neighbourhood Health is developing strong MDTs to ensure that staff are focused and ready to work in a cohesive manner.

For this to happen, data sharing needs to be stronger. It needs to be accessible for all, especially considering that many teams within the community will be spread out of travelling. The success of the Neighbourhood Health model will, in part, include real-time, synced data systems that are fit for multiple users across multiple purposes. 

Armed with this type of technology, the first pilot neighbourhood models can begin to take shape in priority areas. Those with the highest identified need per population. The success of which will dictate how further rollouts will happen.

Over the next 1 - 3 years

Once the pilot projects have been reviewed and refined, they can be scaled into fully-functional units across all neighbourhoods managed by the ICBs - but not before funding has been reviewed.

The NHS currently operates on a model of reactive medicine, where it's responding to hospital admissions and procedures, rather than preventative care. For example, the NHS reports to have spent £21.6 billion on medicines in 2024/25. But with the Neighbourhood Health Framework so focused on preventative care, that will have to change. Funding will need to be prevention-focused from now on.

Digital infrastructure will also need to be scaled. This step will be about optimising the data systems rolled out within the first year to ensure that they can meet growing demand, are fit for purpose and are measurably impact the NHS’ key goals in the Neighbourhood Health model. Rather than just painting a picture of as-is functioning, systems should evolve into more predictive models.

Over the next 3+ years

3 years on from the initial rollout, neighbourhood teams should be working well together and nearing full integration. Over this time, teams will have developed structured and sustainable ways of working, adhering to the needs of their population, and have built trust among the workforce and their communities.

The results of their efforts should now be measurable in terms of health inequalities across their area.

The Neighbourhood Health framework creates an opportunity to drastically improve care delivery, at all levels. Being prepared for the transformation is key, with digital infrastructure being a critical part of the change. Getting on top of unified data systems that deliver real-time workflows and present reliable statistics is one of the ways that systems leaders and their partners can get ahead now.