Recommendations

From the available evidence and case studies, we suggest that to enhance neighbourhood working there are three stages of foundational development.  There are different roles that participants need to play at each stage and we have therefore grouped our recommendations by stage and stakeholder group. 

These recommendations have been informed by what we have seen work well and what we have heard consistently getting in the way of progress. Alongside this, we have considered the different approaches to measuring impact observed so far. 

All the recommendations are underpinned by the six principles for neighbourhood working, outlined in the previous section.  However, it is important to note that these still only represent the first step in what, for many neighbourhoods, has been a multi-year or multi-decade journey.  This journey is often not linear and as such these stages will often need to be progressed in parallel with each other, involving different stakeholders at different times.

Three stages of neighbourhood working

• Stage 1: Catalyse
  The point at which neighbourhood working opportunities are first being identified and explored.
• Stage 2: Nurture
  The point at which neighbourhood working activities and interventions are being established and showing early promise. 
• Stage 3:Sustain
  The point at which longer-term support, investment and structural changes may be needed to maintain impactful local initiatives and create space for new initiatives to emerge.

Three key stakeholder groups

• Neighbourhood: the people directly involved in neighbourhood working. This might include residents, community groups, schools, statutory services and VCSE organisations. 
• System and place:  leaders and decision-makers at a system and place level. Given the varying sizes and structures of the 42 ICSs in England, we have not separated place and system. Who leads and owns work for neighbourhood health will need to be locally determined but we expect integrated care partnerships and place-based partnerships to play key roles.
• National:  policy and decision makers at a national level, including central government and the Department of Health and Social Care (DHSC), national statutory bodies such as NHS England, national membership bodies, charities and other VCSE organisations.