Key points

Neighbourhoods and communities are difficult to define and can range from a few houses to a population of around 50,000, but they are critical to the future of our health and wellbeing.This report, alongside our case for change, outlines where we are now and what initial steps can be taken to create new, more effective and sustainable solutions for neighbourhood health. 

Working at the neighbourhood footprint is not new but there is a long way to go across most parts of the country to create genuine neighbourhood health models. This means neighbourhoods harnessing the assets valued in a local area, with statutory services’ operating models proactively wrapping around those communities and their needs.

Integrated neighbourhood teams (INTs) play a part in bringing statutory services together to work more effectively with voluntary and community organisation and citizens, but this is only one part of a bigger model for neighbourhood health. 

Integration isn’t always the answer. For community-led organisations, high levels of integration with statutory partners can risk breaking trust with communities, especially in deprived areas, where their value comes from not being part of a system that citizens feel they have been let down by previously.

This work requires a shift in funding, culture and service models at national, system and local level and the scale of challenge should not be underestimated. 

Several core areas had the biggest impact on the ability to develop these models: Existing relationships; the variation/short-termism and often lack of funding; Leadership from within the community with management support to coordinate initiatives; Data sharing; Resilience of the voluntary workforce and ability to build share goal/purpose between organisations and the community.

There is a role for neighbourhood, place/system and national leadership in taking the initial steps to catalyse, nurture and help sustain neighbourhood health models. This report provides recommendations on how system/place can unlock capacity and capabilities in communities and neighbourhoods on how to harness local people and ideas for those delivering this change locally. 

The government must recognise that the shift to a community-first approach is one of the most significant changes in the statutory sector. It means working within the existing systems that are set up to support this way of working but unlocking its ability to work in this way. The government must:

• put neighbourhoods and devolution at the centre of the new ten-year plan for the NHS

• reform payment mechanism in the NHS and local authority to create greater flexibility 

• reform the GP contract to enhance primary care’s role in neighbourhood health.