Harpreet Sood, a practising GP in London and advisory member for The Access Group, discusses the factors that determine whether neighbourhood health succeeds or stalls.
Twelve months ago, neighbourhood health largely existed as a policy ambition in the 10 Health Year Plan. Today, the operating model is starting to take shape on the ground, and the expectation is that we deliver it at scale. I recently co-chaired a roundtable with Minal Bakhai, former NHS England national director of primary care and community, joined by senior leaders from across health and social care, local government and parliament. The conversation surfaced the delivery factors that, in my view, will determine whether neighbourhood health succeeds or stalls.
Rowan Sil, chief clinical information officer, Leicester, Leicestershire and Rutland Integrated Care Board, spoke about the health campus model in Leicestershire: a weekly, open-door neighbourhood hub where residents access support for health concerns, housing, debt, mental health pressures and wider family needs in a single place. It sounds straightforward. In reality, it has taken years of relationship building across general practice, local authorities and community organisations, with a local community interest company absorbing 350,000 contacts that would ordinarily have sat with primary care.
Flagship example
Minal shared a flagship example from her time as senior responsible officer for the Neighbourhood Health model at NHS England: Morecambe Bay. Barrow is one of the most deprived communities in the area, with a life expectancy roughly 20 years shorter than neighbouring towns and a long-standing burden of childhood ill health.
Through community activation, encouraging neighbours to look out for one another, and supporting parents to take a more proactive approach to lifestyle and wellbeing, family outcomes have improved markedly. Suicide rates in the targeted cohort have fallen to zero, with very limited clinical intervention. That sustained focus has also reduced pressure on acute services, allowing Barrow to shift funding left, away from traditional secondary care.
These models are fragile. Their success is rooted in trusted relationships between professionals in primary care, community services and local government. Delivery at scale cannot be built on relationships alone. We need operational infrastructure that survives leadership changes, organisational churn and workforce pressures.
Technology is often described as the glue that allows health and care professionals to share information across very different environments. That is true, and with the pace of AI advancement, frontline staff are increasingly looking to these tools to solve workflow challenges in real time. As one guest put it: once you free up clinical time through workflow optimisation, teams can start looking for the people falling through the cracks. The question is whether the system creates the conditions for it to happen at scale.
The real risk sits in the gap between the pace of adoption and the maturity of governance. Clinicians reaching for consumer AI tools, without understanding what happens to the data or whether the model has been tested for clinical use, creates genuine exposure. A GP using AI carefully under organisational oversight, and a GP using shadow AI on their personal phone, are doing fundamentally different things.
Vendors have a critical role to play: providing governance layers, clinical guardrails and the accountability structures that make safe deployment possible. That means building on the infrastructure we already have, including shared care records, and making fuller use of the sovereign vendors we are entrusting with patient data.
Data is abundant: accountability is not
We are still operating with data locked in silos, sitting in multiple small boxes, which limits its ability to drive clinical and population impact. This fragmentation creates inefficiency, but it also creates ambiguity around ownership. When multiple organisations can each see part of the problem, but nobody clearly owns the response, responsibility drifts back towards general practice by default.
Social care remains one of the clearest examples. Domiciliary care providers collectively see huge numbers of vulnerable people every day and often spot deterioration long before a hospital admission occurs. Yet many remain largely excluded from the information flows shaping neighbourhood health delivery. The NHS often talks about interoperability as though it is purely a technology problem. In practice, accountability is frequently the bigger issue.
The NHS now risks entering a difficult middle phase on neighbourhood health: enough policy momentum to create expectation, but not yet enough operational change to translate that into impact. The danger is that the model becomes trapped between national frameworks and a handful of isolated local success stories.
The focus now needs to be on delivery discipline. That means making decisions earlier, devolving accountability locally, and accepting that some experimentation and iteration are unavoidable. It also means recognising that neighbourhood health cannot sit solely within NHS structures. Social care, voluntary organisations and community services are not adjacent to the model. They are central to whether it succeeds.
Ultimately, patients will not judge neighbourhood health by the quality of the framework documents or the number of pilot sites announced. They will judge it, as Minal so aptly put it at the roundtable, on whether they can “live gloriously ordinary lives”. On whether care and support feel easier to access, better connected, and more responsive to the reality of their daily lives.