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A Shared Endeavour Across the System
The framework is explicit that neighbourhood health only works as a genuine partnership between the NHS and local authorities, alongside VCSE and civil society partners. Minister of State for Care Stephen Kinnock frames this as ending the experience of people being passed from pillar to post in a fragmented system, with local authorities and health and wellbeing boards holding joint responsibility for shaping local plans.
This collaborative framing runs through the entire document. Integrated Care Boards (ICBs) are being repositioned as strategic commissioners, working alongside local authorities rather than around them, with new joint working arrangements designed to hard-wire integration into the system.
Setting the Bar for National Success
The framework sets clear national minimum goals for the NHS, each with specific metrics tracked against a 2025 to 2026 baseline and measured through to March 2029:
- Improve health outcomes for priority cohorts including frailty, care home residents, end of life care and long-term conditions, with targets such as reducing non-elective admissions and bed days by 10 percent
- Improve access to general practice, aiming for 90 percent of clinically urgent patients seen the same day by March 2027
- Improve experience of planned care, including a diversion rate of at least 25 percent from outpatient referrals by March 2027
- Improve urgent and emergency care performance, supporting a 4-hour A&E trajectory of 85 percent
- Improve patient and staff satisfaction, including 95 percent of people with complex needs having an agreed care plan by 2027
Local systems will layer their own outcomes on top through health and wellbeing boards, informed by joint strategic needs assessments and the Local Outcomes Framework.
Integrated Neighbourhood Teams and New Contracting Models
Integrated neighbourhood teams sit at the centre of delivery, bringing together GPs, community services, mental health, social care and VCSE partners around defined populations. Rather than mandate a single model, the framework allows local systems to shape INTs around their own populations, with an initial national focus on frailty and end of life care, long-term conditions, children and young people, and cancer.
The framework also introduces three new contracting models: single neighbourhood providers, multi-neighbourhood providers, and integrated health organisations. These are designed to give providers population-based budgets and greater flexibility to redesign care around outcomes rather than organisational form, while general practice and hospital contracts remain nationally determined as the primary delivery vehicles.
250 Neighbourhood Health Centres by 2035
The government is committing to building and upgrading 250 neighbourhood health centres, with 120 delivered by 2030. These will bring together GP services with community, local authority and civil society provision, co-locating healthcare with services such as Best Start Family Hubs, housing support and employment services where it makes sense locally. Wave one, covering 2026 to 2027, will focus on repurposing existing NHS estate in areas of highest deprivation.
Two Stages of Delivery
The framework sets out delivery in two stages. Stage one, running through the 2026 to 2027 financial year, asks ICBs to agree foundational plans covering urgent and community capacity, general practice access, INT footprints, elective pathway reform and Better Care Fund alignment with local authorities. Stage two, from April 2027 to March 2029, moves systems towards locally owned neighbourhood health plans, formally incorporated into the five-year strategic commissioning framework plans.
What Will Make the Difference
The framework is candid that similar ambitions have been set out over the past 15 years without shifting the balance of the system. What gives this attempt a stronger footing is the detail sitting underneath it: named funding mechanisms, data-sharing expectations and a workforce plan all designed to support delivery rather than leave it to local systems to work out alone.
On funding, ICBs are being asked to actively move resource from acute services into neighbourhood care over the Spending Review period, backed by changes to block contracts and payment flows from 2026 to 2027. Rather than waiting for new money, the approach is designed to help systems rebalance what they already have, with a permissive stance towards local proposals for new payment models where these are backed by credible plans.
Data sharing is treated as a foundation rather than an afterthought. Standardising expectations between hospitals and neighbourhood services, including social care, is intended to let neighbourhoods manage risk proactively rather than waiting for people to present in crisis. Digital workforce transformation follows a similar principle: most of the change is expected to come from existing staff working differently and collaboratively across boundaries, with the NHS 10-Year Workforce Plan set to provide fuller modelling and assumptions to support local planning.
Taken together, this points to a shift that's being resourced and measured rather than simply encouraged. For local leaders, the opportunity now is to use the flexibility the framework offers to shape delivery around what their communities actually need, while drawing on the national goals, funding levers and evidence base to keep pace with the ambition the framework sets out.
