Stage one: catalysing neighbourhood working

Neighbourhood

• Build a coalition of the willing. Work with residents, the local authority, the NHS, VCSE organisations, local businesses and other partners to map the assets, capabilities, current activities and needs in the neighbourhood, and identify where the gaps are.
• Recognise the need to engage beyond those already engaged in place and system working, including those communities at greatest risk, working through local intermediaries such as community and faith groups as appropriate.
• Work collaboratively to develop a collective approach that balances community and statutory priorities, giving equal weight to each. 
• Establish relationships of trust from the outset, building an understanding of the motivations of all involved and demonstrating how proposals reflect the shared values of the neighbourhood and its partners.
• Identify existing local data to supplement standard national data sets, combining this with community insight.
• Agree and establish clear metrics and processes for tracking progress and impact at the outset of neighbourhood work. These do not have to be fixed or complicated and are likely to evolve over time. The purpose is to start to build an evidence base for new ways of working and better understand what does and does not have the impact that you are looking to achieve.  What is important is that these reflect not just what is currently measured and managed by services and systems but are genuinely co-developed with communities themselves.
• Prioritise identifying someone to act as a point of co-ordination able to take the lead on bringing people together while willing and able to work in a new paradigm, with and not simply just within neighbourhoods and communities.
• Identify those professionals, clinicians or managers who will work alongside community groups to support and advocate for them while bringing an understanding of the existing health system, helping to navigate challenges and identify opportunities. Consider whether there is someone already in the locality with the right skills and a facilitative approach to take this on, or if not, how to support people to do this including in key areas such as relationship building.
• Find a space where people can come together. Make it as approachable and accessible as possible. People may avoid places that feel too much part of statutory systems and structures. Local venues, such as a pop-up space in an empty shop, or a local café. If possible, it is important to provide refreshments as well as comfortable and informal seating. 

System and place

• Think neighbourhood. Consider how working differently with communities to enable neighbourhood working will impact on current models of planning, delivery and assurance. Allowing neighbourhoods to define their own boundaries might feel simple but is far away from many current discussions around how different statutory footprints could be better aligned. Avoiding the temptation to duplicate or systematise initiatives that are already working at a neighbourhood level is hard but offering support to those leading these initiatives to sustain what they are doing and, where appropriate, grow their reach and impact, is critical.
• INTs and related approaches to working with communities will need to align to, but are not the same thing as, community-led development. The more that communities are involved in INT development the more likely such policy-led agendas are to succeed. But, the evidence suggests there will likely be a need in most places for spaces outside of the formal, integrated structures and delivery mechanisms to enable community innovation and empowerment to thrive.
• Community asset mapping provides one approach to understanding social networks at a neighbourhood level.  Identifying individuals and influencers is part of this process but is not a substitute for a broad-based approach to developing community power.
• Active listening is essential to understand the support needed to enable genuine partnership working in taking forward relationships, whether this is small amounts of initial funding investment, facilitation of different types of conversations, or more fundamental shifts in how current engagement within neighbourhoods is structured or delivered.
• Recognise that there are inherent power imbalances between statutory services and communities that can impact on neighbourhood working, and that it is the role of those who hold the most power to proactively address these. Even at this foundational stage there is a need to understand the role of communities in decision-making at place and system levels, if the benefits of neighbourhood working are to be scaled.
• Align existing and new statutory services, and particularly primary and community care resources, around neighbourhood priorities. This includes workforce strategies that reflect requirements for neighbourhood working and that encourage providers to include neighbourhood team working in job descriptions and job plans where possible, as well as approaches to areas such as estates that understand and respond to the gaps that have emerged in local community infrastructure.
• Agree on proportionate approaches to governance and reporting on progress and outcomes without creating administrative barriers at the neighbourhood level. This can be supported by creating a hub at system or place level capable of sharing best practice and supporting new forms of value measurement, including understanding the impact on social capital.