Conclusion

These case studies highlight examples of good practice to learn from in developing models of neighbourhood working. They point towards robust governance, strong local relationships, and engagement with local communities as common themes. Notably, the examples show local leaders starting by engaging with patients and communities to design an effective approach and service model, later underpinning this with governance structures. This signals that not all the change required will be driven by the centre: instead, local leaders will need to be empowered to design and deliver models that work effectively for local communities. 

However, to rapidly deliver ambitions around neighbourhood working, further national support will be needed. While flexibility for local leaders to lead and make decisions is important, it can only take us so far. Clear national direction and prioritisation will be essential to build on the excellent work that already exists.    

Trust leaders agree with the government’s vision to deliver more care in and close to home. To make this a reality, the 10-year health plan will need to provide clarity on how trusts will be involved in this, and set out clear national policies, including in relation to the financial system, to make this is a reality. As these case studies show, the foundations of a neighbourhood health service are already being developed across the country, and national policymakers can, through the 10-Year Health Plan, grasp an opportunity to build on this for the benefit of patients.