Health inequalities remain one of the most persistent and complex challenges facing the NHS and wider society. They shape outcomes across communities, contribute to avoidable morbidity and mortality, and reflect deep-rooted social, economic and structural factors. As 2026 unfolds, there is an opportunity to regain momentum and refocus collective effort on improving equitable access, experience and outcomes for all.

Efforts to reduce health inequalities have historically moved in political and social cycles. Since the late 1970s, policies such as the Black Report have highlighted the relationship between deprivation and health outcomes, though early recommendations were sidelined. 

In the 2000s, renewed national attention through programmes such as Sure Start and Health Action Zones resulted in measurable impact. More recently, Covid exposed the disproportionate impact of ill health in deprived areas, lower-paid roles, ethnic minority groups and those living with disabilities.

This catalysed a strategic NHS response, including the Core20PLUS5 framework – focusing on the most deprived 20% of the population, alongside specific underserved groups and five high-impact clinical areas. Supporting initiatives followed, such as accelerator sites, digital inclusion frameworks and health inclusion programmes. 

As 2026 brings a fresh wave of system reform, including shifts towards prevention, community-based care and digital transformation, the need to maintain energy around tackling inequalities is more pressing than ever. Despite progress, inequalities remain entrenched, and without intentional focus, there is a risk of losing hard-won momentum.

Health inequalities are not simply variations in outcomes – they are avoidable, unfair and systemic differences that shape communities over generations. Their impact is profound: poorer health outcomes, reduced life expectancy and increased service demand. Addressing them is both a moral and practical imperative. Improving equity strengthens system resilience, reduces avoidable demand, aligns with national ambitions and supports sustainable population health management.

At NHS South, Central and West, our experience shows scale enables relationships to flourish, trust to develop and hyper-local interventions to be tailored to meet differing needs within relatively small geographies. These local approaches make inequalities visible and actionable, shifting the conversation from broad strategy to practical delivery where it matters most – within communities themselves. 

By working directly within communities, neighbourhood teams can better understand lived experience, build trust across partners and tailor interventions to address specific barriers. Crucially, reducing health inequalities is not an add-on for neighbourhood teams, it is central to their mission.

Key to this approach is deep collaboration with voluntary, community, faith and social enterprise organisations. These groups are embedded in their localities and often hold the relationships needed to reach underserved populations. 

However, the sector requires equitable partnerships, respect and appropriate funding to ensure long-term sustainability. Meaningful involvement must extend beyond community engagement to genuine co-delivery, ensuring interventions are grounded in local insight and capacity.

#Through shared priorities, co-designed solutions and aligned resource allocation, integrated neighbourhood teams can serve as practical vehicles for joined-up action. This approach supports continuity, promotes prevention and enables system integration to translate into improved outcomes on the ground. Data remains fundamental to understanding and addressing inequalities.

Neighbourhood approaches encourage the use of granular, real-time insight to identify variation, target interventions and measure impact. Integrating quantitative data with qualitative community intelligence enables neighbourhood teams to plan effectively and adjust approaches as population needs evolve. This combination of clinical, digital and social insight is critical as systems shift towards prevention and personalised care. 

Our learning highlights the importance of building on what already works to minimise the risk of fragmentation and duplication. This includes existing frameworks, national programmes, inclusion health resources and established expertise in population health management. Consolidated learning from successful models – such as Core20PLUS5, accelerator sites and community-led programmes – can evolve with wider system reforms. 

As the NHS navigates the opportunities and pressures of 2026, health inequalities must remain a central focus. The collective learning from recent years provides a strong foundation for renewed energy and impact, but recapturing momentum will require sustained commitment, collaborative leadership and alignment between national ambition and local delivery.

By reinforcing hyper-local approaches, strengthening community partnerships, leveraging insight and building on proven models, we can take meaningful steps towards a health and care system that is fairer for all.