Over the past 12 months, neighbourhood health has shifted from policy ambition to practical delivery. What began as a core principle within the NHS's long-term direction is now being tested at scale, supported by national frameworks, structured improvement programmes and a growing number of early adopter sites. Emerging evidence suggests neighbourhood-based models are improving co-ordination of care, supporting more proactive management of patients and reducing reliance on hospital services. The challenge now is embedding neighbourhood health as a core component of system delivery, rather than treating it as a pilot or add-on.

Experience from early adopter sites across the Midlands, London and the South West highlights three critical enablers: workforce, data and culture.

Using people differently

Workforce is often seen as the biggest constraint to neighbourhood health. We cannot expect large numbers of additional staff to appear in an already stretched system. The more realistic opportunity is to use existing people differently, reduce duplication and stop work that no longer adds value.

In Nottingham City, no new staff were recruited to establish integrated neighbourhood teams (INTs). Instead, existing geriatricians, community nurses, social workers, social prescribers and GPs redesigned how they worked together. The result has been more co-ordinated, patient-centred care that makes better use of existing capability rather than relying on workforce expansion. Leadership no longer defaults to the most senior clinician; where a patient's needs are primarily practical rather than medical, a social prescriber or social worker may lead the multidisciplinary team (MDT) discussion, with clinical oversight always available.

Staff surveys indicate higher levels of engagement and professional recognition, with multidisciplinary working increasing confidence, job satisfaction and opportunities for development. Expertise is valued regardless of organisational background or professional hierarchy, helping to create a more rewarding working environment and supporting retention. Sustaining this approach, however, requires organisations to stop or redesign lower-value activity rather than expecting staff simply to absorb additional work.

Using and sharing data effectively

Data and digital capability are central to making neighbourhood health operational: identifying the right patients, understanding their needs and co-ordinating interventions across organisational boundaries.

In Nottingham, analysis of local data identified a cohort of people with frailty repeatedly cycling through the emergency care system, experiencing repeated admissions and discharge. Understanding this cohort has enabled a different response. Structured multidisciplinary triage, co-ordinated follow-up and shared records are helping keep more care within the community, while supporting the case for a community frailty hub where patients without acute needs can be assessed and managed by a full MDT.

Patients benefit from more co-ordinated care delivered closer to home and family, while the system benefits from fewer GP appointments for people with frailty, fewer emergency attendances and reduced reliance on costly acute beds. These improvements are enabled by co-ordinated multidisciplinary working, shared information and a greater focus on prevention and early intervention.

Shared records are fundamental to this approach, allowing professionals across health and care to work from the same information rather than isolated organisational datasets. Realising these benefits depends on consistent use of shared records and proportionate information governance that enables, rather than inhibits, collaboration.

Yet workforce redesign and digital capability alone are not enough. To realise the full potential of neighbourhood health, professionals also need to think differently about how care is delivered and what matters most to patients.

A shift in mindset as much as model

Neighbourhood health asks professionals to think differently about what good care looks like: moving away from overmedicalising problems and towards understanding the broader circumstances that affect health and wellbeing. For some people, the most effective intervention may not be another prescription or referral, but action on housing, isolation, mobility or daily routine. The question shifts from ‘What's the matter with you?' to ‘What matters to you?' Patients are often present when their MDT discusses their care, helping to shape decisions around their own priorities, such as remaining independent at home. Early patient-reported outcomes and experience measures suggest this more collaborative approach is strengthening both engagement and confidence in care planning.

Neighbourhood health also gives local teams greater flexibility to design solutions rather than simply deliver predefined services. National priorities remain important, but providers are increasingly able to determine how those priorities are achieved within local resources and partnerships. This encourages local solutions to local problems and ensures services are designed with communities rather than for them. The proposed community frailty hub in Nottingham is one example: a locally developed response to a locally identified need, shaped collaboratively across health, care and voluntary sector partners.

Early success has encouraged wider adoption. Nottingham expects up to six of its nine integrated neighbourhood teams to be operational within months, with the remainder planned by next March.