What is neighbourhood health?

The government has put a ‘neighbourhood health service’ at the heart of its vision for the NHS, aiming to help people to live well in their local areas and reduce their need for care delivered in hospitals. This ambition echoes Labour’s election manifesto, which committed to shifting resources to community-based services and delivering care closer to home. It was also reinforced in the 10 Year Health Plan as a way to provide ‘convenient care, at a time and place that fits around people’s lives’.

Across the health and care system, from leaders to local teams, there is lots of enthusiasm for the idea of working differently at neighbourhood level to improve health and care. However, it is clear that the concept of neighbourhood health encapsulates many different ideas and approaches to delivering health and care services. It also means different things to different people and in different contexts.

This explainer summarises some of the features that often characterise neighbourhood health, and highlights the various ways it is being understood and implemented in different contexts.

What is neighbourhood health?

Neighbourhood health encompasses many different ideas, policies and approaches to delivering health and social care. These include:

• Integration: bringing together services across the NHS, social care, and community organisations to work as a co-ordinated whole rather than in isolation. By aligning services and sharing information, integration aims to help ensure joined-up care for patients and improve health outcomes.

• Prevention: a focus on maintaining health and preventing illness from developing or worsening through clinical services such as vaccinations, screening, management of risk factors, and early interventions. In addition, by working closely with local authorities and others, neighbourhood health services can also address the wider determinants of health (such as housing, education, employment and social support), which significantly influence people’s wellbeing and risk of illness. From a population health perspective, these efforts also aim to reduce health inequalities across communities, ensuring that interventions are equitable and responsive to the needs of different population groups.

• Personalised care: an approach that tailors health and care services to an individual’s needs, preferences and circumstances, giving people more choice and control over their care. It assumes that care is not one-size-fits-all but reflects what matters most to each person. This approach aims to improve health outcomes, enhance patient experience, and help to reduce inequalities by addressing diverse needs and barriers to care.

• Care delivered closer to home: a longstanding policy ambition, which aims to provide more services within the communities where people live. Achieving this requires a fundamental shift from a hospital-centric model to one that prioritises primary, community and voluntary sector care. It involves rethinking how care is best delivered locally, through services such as general practice, pharmacies, community-based teams (including mental health services), and voluntary, community and social enterprise (VCSE) organisations, such as hospices.

• Community-led approaches to care: making the voices of people and communities central to how health and care services are designed, delivered and evaluated. This requires genuine partnership, recognising that communities hold insights and solutions essential for tackling challenges such as poor co-ordination, access issues and health inequalities.

• Place-based care: an approach to organising care around a specific geographic area, based on the belief that place matters in health creation. By devolving budgets, service planning and decision-making to a local level, place-based approaches are well able to respond to local needs and build partnerships that go beyond traditional health care to address the wider determinants of health.

These underlying ideas and approaches are well-established, meaning that some aspects of neighbourhood health have been put into practice for a long time already, and in many different ways. Below we highlight a few examples.

There are different interpretations of neighbourhood health

Given that neighbourhood health encompasses a variety of ideas and approaches to care, it is not surprising that the term is used in different ways by different people and in different contexts.

To help make sense of this variation, it can be useful to think about a typology of approaches to neighbourhood health. Based on The King’s Fund’s work across the health and care system, we have identified three broad ways the term is commonly used. They each focus on a different way of approaching neighbourhood health:

• The way health care services are delivered to patients. Central to this approach is identifying those most in need and proactively supporting them to promote health and prevent hospitalisation. This kind of care and support might be delivered by a team-based approach that brings together a range of health care professionals in a single location, either virtually, in existing buildings or in new neighbourhood health centres.

• The way wider services come together at local levels to improve health and wellbeing. This also has multi-agency working at its heart but may include a broader range of professionals and advocates, including representatives from housing and employment welfare services, the police, and voluntary sector organisations. This approach often focuses on addressing the wider determinants of health and supporting those people who are experiencing the worst health outcomes or deprivation.

• The way communities play central roles in the design and delivery of services. This is less about co-ordinating the work of professionally led services and more about people and communities themselves – focusing on what they want and need, working with them, recognising their strengths and building on local assets. In terms of organisational culture, this involves a different way of working based on ‘doing with’ rather than ‘doing to’, with professionals acting as facilitators of changes led by local people and communities.

These three approaches to neighbourhood working are not mutually exclusive or hierarchical. In reality, places are likely to draw from all three depending on their context and needs. Each place will require a tailored approach, potentially starting in different ways and taking varied routes towards achieving their objectives, which may evolve over time.

Although the flexibility of different approaches to neighbourhood health helpfully allows for local adaptation, it can also lead to a lack of shared understanding. Clear communication about the approach being adopted in any given context is essential.

Navigating this complexity also demands strong and collaborative leadership, capable of fostering effective partnership working across sectors. Our experience at The King’s Fund shows that the foundation for developing this kind of leadership lies in building a clear and shared purpose among all stakeholders involved.

What is the current national policy on neighbourhood health?

Below we outline some of the key current policies and strategies on neighbourhood health.

The neighbourhood health guidelines and planning guidance

Ahead of the publication of the 10 Year Health Plan, NHS England published its neighbourhood health guidelines to accompany the 2025/26 NHS planning guidance. These set out a clear framework for how health and care services should work together at the neighbourhood level to improve outcomes, reduce inequalities, and make care more accessible and person-centred.

The guidelines outline six core components of neighbourhood health:

Although none of these components are entirely new, the guidelines aimed to bring them together under a single vision for neighbourhood working. They also reinforced the idea that neighbourhood health is not just about clinical care; it is about connecting people to wider public services and community support to address the broader factors that affect health, such as housing, employment and social isolation. However, the guidelines suggested that this way of working should be considered a mid- to long-term goal, as opposed to a short-term priority.  The immediate focus on the urgent health care needs of ‘high priority cohorts’ (people who have moderate to severe frailty, people living in a care home, people who are housebound or at the end of life) was reiterated in the medium term planning guidance published in October 2025. A Model Neighbourhood Framework is expected to be published in November 2025.

The 10 Year Health Plan

The 10 Year Health Plan for England, published in July 2025, sets out a long-term vision for transforming the NHS, with neighbourhood health playing a central role in its delivery. The plan is structured around three major system shifts, all of which neighbourhood health can help to deliver:

• From hospitals to communities: the plan commits to moving more care into community settings, with neighbourhood teams delivering integrated support for people with long-term conditions, frailty and complex needs. This includes expanding services such as urgent community response, virtual wards and home-based care.

• From analogue to digital: digital tools and data will be used to support neighbourhood teams in identifying at-risk individuals, co-ordinating care, and improving access. This includes better use of shared care records, remote monitoring, and digital triage systems.

• From treatment to prevention: the plan emphasises early intervention and tackling the wider determinants of health (such as housing, employment and social isolation) through local partnerships. Neighbourhood teams are expected to play a key role in delivering this preventive approach.

The plan outlines several specific policies that will enable the delivery of a neighbourhood health service. The aim is for these policies to help reduce hospital admissions and emergency care use, address health inequalities by reaching under-served groups, and enable people to live independently for longer in their own homes and communities. Some of the key policy and structural developments include: 

• Integrated neighbourhood teams: multidisciplinary teams that typically serve populations of 30,000 to 50,000 people, aligned with primary care networks (PCNs). They bring together professionals from across health, social care and the VCSE sector. They are designed to support people with complex needs through proactive, co-ordinated care; to deliver urgent community-based services, such as hospital-at-home and virtual wards; to strengthen continuity of care; to improve access to general practice; and to use population health data to identify and support people at risk earlier. These teams already exist in various forms in several parts of England but there is not universal coverage. The significance of their inclusion in the 10 Year Health Plan is the proposal for scaling up this way of working.

• Neighbourhood health centres: envisioned as multi-service facilities that bring together services from across health, social care and the VCSE sector. They are intended to co-locate services that are often fragmented, making it easier for people to get the help they need without navigating multiple systems or locations. Again, neighbourhood health centres are not new, and there are many examples of places taking this approach already. What is new is the proposal to scale up this way of working.

• Community health and wellbeing workers (CHWWs): non-clinical, community-based staff who work closely with individuals and families, supporting households to manage their own health and wellbeing, and connecting them to local services such as housing, employment and social support. CHWWs are recruited from the communities they serve, which helps to build trust and cultural understanding. They act as trusted links between communities and the wider health and care system. CHWWs are expected to be embedded within integrated neighbourhood teams, working alongside GPs, nurses, social care professionals and voluntary sector partners. The prominence of CHWWs in the 10 Year Health Plan stems in part from the success of Brazil’s community health agent programme. Their inclusion also builds on the success of social prescribers and other related roles, such as care co-ordinators. The inclusion of CHWWs in primary care teams is now being piloted in 25 locations in England.

As described in the 10 Year Health Plan, neighbourhood health policy has been deliberately designed to focus first on populations with multiple and complex needs, recognising that these individuals often experience the greatest challenges in navigating fragmented services. By starting with those who have the most complex needs, the policy seeks to demonstrate the value of joined-up working, reduce avoidable hospital use, and improve quality of life, while laying the foundations for broader transformation across the health and care system.

The National Neighbourhood Health Implementation Programme (NNHIP)

Whereas the neighbourhood health guidelines (see above) are a strategic framework intended to help the health and care system prepare for and implement neighbourhood health models, NNHIP is the implementation arm of the neighbourhood health vision. It is a large-scale change programme launched by the Department of Health and Social Care (DHSC) and NHS England to accelerate the rollout of neighbourhood health services into communities across England, with a focus on prevention, integration, and tackling health inequalities.

In September 2025, DHSC announced the 43 local areas selected as the NNHIP wave 1 test sites. These cover areas from Cornwall to Sunderland, and regions with the greatest need have been prioritised. They vary greatly in size and approach to delivering neighbourhood health.

Test sites will not receive any additional funding but will be supported through coaching, expert guidance and collaborative learning – all of which will be funded nationally. The sites will build on existing good practice in their area to deliver a neighbourhood health service, initially focusing on supporting people with long-term conditions such as diabetes, arthritis or epilepsy, and in areas with the highest levels of deprivation.

The programme aims to strengthen and scale up good practice, strengthen local partnerships, and ensure that neighbourhood health models are co-designed with communities and sustainably resourced.

The Pride in Place Strategy

The Pride in Place Strategy, launched by the government in September 2025, is a national initiative aimed at revitalising communities by empowering local people to shape the future of their neighbourhoods. Backed by a £5 billion investment over 10 years, the strategy focuses on three core objectives: building stronger communities, creating thriving places, and empowering residents to take control of local decision-making. Targeting more than 300 of the UK’s most disadvantaged areas, the programme supports the creation of neighbourhood boards – locally led groups responsible for developing and delivering regeneration plans.

The Neighbourhood Health Framework 

The Neighbourhood Health Framework, published in March 2026, sets out in new detail what neighbourhood health aims to do and how this will be achieved, building on the 10 Year Health Plan and the neighbourhood health guidelines and planning guidance. Although the framework includes a few elements that had not been announced previously, it primarily brings clarity on the priorities for systems over the next three years to 2029. The framework describes integrated care boards (ICBs) and local authorities working together with health and care providers and other partners, including the VCSE sector, to: 

• make care more efficient, joined-up and personalised 

• improve health outcomes with a greater focus on prevention 

• reduce pressures on acute services like hospitals and care homes 

• ensure the NHS meets its core targets. 

To do this, every local system must produce a locally owned neighbourhood plan agreed through its Health and Well Being Board, to drive improvements across primary care, proactive care and alternatives to hospital care. Systems will agree neighbourhood footprints defined around communities and use these as the basis for integrated neighbourhood teams, and align with other initiatives such as family hubs, mental health hubs and Pride in Place. The success of neighbourhood health will be measured nationally in improvements to health outcomes, access to general practice care, patient experience of planned care, urgent and emergency care performance, and patient and staff satisfaction. They will also work to develop new neighbourhood approaches to elective pathways including a reform of outpatient services. 

Although neighbourhood health will be delivered largely by the current workforce, the framework states that a ‘fundamental reimagining’ of roles and ways of working across the health and social care system will be needed. Care will be delivered in existing care locations, online or in one of the 250 neighbourhood health centres that will be operational by 2035. The framework also provides further information on the forthcoming additional contracting models including the single- and multi-neighbourhood provider contracts and the integrated health organisation contract.  

Our reflections

Neighbourhood health is central to the government’s vision for the future of care. In this final section, we set out our reflections on the key considerations and challenges that will need to be navigated to make the government’s vision a reality.

Local flexibility is essential

Delivering care in communities is inherently local. Clear national guidance and definitions are essential but must be balanced with flexibility for local adaptation. Many areas have already developed effective, locally tailored approaches over time, and replacing these organically grown arrangements with a single national model would be counterproductive. Neighbourhood health cannot be imposed through a rigid top-down approach. Instead, a ‘do with’ approach is needed – one that co-designs and co-delivers solutions with communities so that services reflect their unique contexts and build on existing strengths.

Meaningful transformation will come from multiple co-ordinated efforts, but this will be challenging for a system under pressure

Transformation requires multiple co-ordinated changes in how care is organised and delivered. Neighbourhood health approaches require effective collaboration between health, social care, community organisations and communities themselves. The emphasis on neighbourhood health comes at a time when the very structures that enable it – such as integrated care boards (ICBs) – are facing deep cuts. With reductions in budgets and headcounts, the capacity for strategic co-ordination and partnership working is under strain, potentially undermining the foundations needed to deliver neighbourhood health effectively.

Effective implementation will require a greater share of resources to be directed to communities and community-based organisations

For decades, investment and focus has favoured acute hospitals over primary and community services, creating a ‘cycle of invisibility’ for community care. To break this pattern, the system needs a deliberate and sustained shift in financial priorities. This means differential funding growth, with new investment directed towards primary and community services rather than expecting savings from hospital closures – which are unlikely to materialise. The government’s commitment to increasing the proportion of health spending allocated to community services over the next 3–4 years is commendable. However, a key question remains: will this additional funding be sufficient not only to maintain business-as-usual services but also to deliver the scale of transformation required? This kind of concrete financial shift is essential to making the transition from hospital-based care to neighbourhood-level support a reality.

Cost savings are unlikely in the short term

Shifting care into the community is often framed as a cost-saving measure, but such savings are unlikely in the short term. Community-based models demand significant upfront investment in workforce, infrastructure and technology, and hospitals cannot simply scale back overnight, which creates a period of duplicated costs. The motivation for developing neighbourhood health services should be to improve the delivery of care for staff and patients, and not primarily to achieve financial efficiencies. This should be reflected in how success is measured.    

Success depends on strengthening core community health services and wider community-based support

The reality on the ground is that many of the core services expected to underpin neighbourhood health are already overstretched. Workforce shortages, underfunding and service fragmentation (for example, in community nursing, mental health, primary care, social care and VCSE organisations) pose serious challenges, leaving those working in these roles and organisations with little-to-no bandwidth to drive major transformational change effectively. Without reversing trends in staffing and investment, achieving the vision for neighbourhood health will remain out of reach.

Health care and other professionals need support to work in new and different ways

There are significant implications for health and care professionals working in neighbourhood settings. Most of these professionals have not been trained to operate in community-based, multidisciplinary environments, which require different skills, mindsets and approaches to care. There is a pressing need to rethink professional development and training pathways to support this shift.

The approach must avoid being NHS-focused and instead promote shared budgets, joint decisions and shared accountability

A major concern is that the current framing of neighbourhood health risks being too narrowly focused on NHS services, particularly as a way to relieve pressure on hospitals. True neighbourhood health must go beyond simply relocating services into communities; it requires the active involvement of local government, voluntary organisations and communities themselves to address the wider determinants of health, such as housing, employment and social connection. Achieving this demands significant changes in commissioning and provider approaches – sharing power for decisions and accountability with partners and communities in ways that organisational siloes and traditional transactional contracts do not allow.

Conclusion

Neighbourhood health is a broad and evolving concept, rooted in decades of local practice and increasingly supported by national policy. In some respects, its strength lies in its flexibility, enabling local adaptation while building on proven approaches that bring together health services, wider partners and communities. Although the diversity of interpretations can introduce complexity, it also creates space for innovation and genuine community-led approaches. Yet without a clearer shared understanding, this conceptual ambiguity risks slowing progress. To move from isolated successes to consistent system-wide impact, a clearer sense of purpose for neighbourhood health is now needed, backed by national leadership and sustained support for locally driven change. Crucially, this must be underpinned by better alignment across the various strategies and policies focused on neighbourhood health and community-building, ensuring that they work together to support a coherent and cross-government approach. Only with this clarity and commitment can neighbourhood health fulfil its promise of improving care and outcomes for people in every community.