Neighbourhood Health – what does it mean for VCFSE organisations?

There is a lot of noise and activity around Neighbourhood Health within the health and social care system with a draft Neighbourhood Health Plan being produced by the Public Health Team at Lincolnshire County Council, a Neighbourhood Health Transformation programme led by the ICB, Neighbourhood Health Centres and multiple meetings about how this is put into action for the health and wellbeing benefit of the people of Lincolnshire. All of which will be overseen by the Health and Wellbeing Board (you can read the papers for the Health and Wellbeing Board meeting where much of this was discussed). This is driven by the Neighbourhood Health Policy Framework, published by the Department of Health and Social Care and NHS England on 17 March 2026. 

Importantly for LVET and our members there is explicit recognition that to be effective ‘neighbourhood health… requires the NHS and local authorities to fundamentally transform how they work together, collaborating closely with organisations such as the voluntary, community, faith and social enterprise (VCFSE) sector to build resilient, connected and vibrant communities.’ 

Figure 1:Proposed Governance Arrangements in Lincolnshire for Neighbourhood Health 

The three shifts in the 10 Year Health Plan are welcome and there is little question that there is a need for a different approach to delivering health and social care. There are many people out there offering their opinion and an ‘industry’ of transformation experts that are turning their attention to this. The ones that are of most interest to me, and probably to you, are those that are concerned with how these changes have the potential to shift power and truly transform the design and delivery of health and social care. For example, Cormac Russell & Lisa McNally, produced for NewLocal ‘Putting the Neighbourhood Back into Neighbourhood Health’ and four guides on Neighbourhood Health. 

Russell and Mcnally highlight that ‘the foundation of good health and good lives lies… in communities and neighbourhoods themselves: from informal relationships to networks of action’ and that services need to be ‘good guests’ in that community. 

So the questions we need to ask ourselves include What difference will Neighbourhood Health make to VCFSE organisations? What are the opportunities that the focus on neighbourhoods presents? How can we take advantage of the changes? And how do we prevent health and social care organisations taking over and medicalising existing, strong, community provision and activity?  

• Local – there seems to be a growing importance of the role of GPs and Primary Care Networks (PCN) in coordinating and linking to wider support. We encourage all of our members to connect with your local PCN – make sure they know what you do, when and if you can provide evidence of the difference it makes to the health and wellbeing of people even better. Know how the work you do contributes to health outcomes. We will also be doing some more work over the next year to understand just how our members support the health of our communities.  

• Teams – there is a strong focus on an approach to support that involves multiple organisations and people – Integrated Neighbourhood Teams (INTs). If you are contracted to deliver services, you are a vital part of these teams… and even if you are not contracted it is important that these teams know about what you do. The non-clinical support provided by VCFSE organisations has a direct impact on how health and social care is received community transport can help someone get to an appointment, digital support can help someone book an appointment, and social groups can encourage people to recognise they might need an appointment in the first place.  

• Places and buildings – new Neighbourhood Health Centres, typically serving a population of around 50,000 people, are the shiny new opportunity – they may be useful places for you to provide wider support to people, there may be shared workspace for your teams and, if it means other buildings are being vacated it might mean that there are buildings you may want to rent or buy. Will this help you to find spaces to bring you even closer to your community?  

• System change – VCFSE organisations can, and should, be a voice for the strengths and power of community relationships – challenging when services overstep and try to medicalise community activity. We should be highlighting what is already strong in an area in terms of creating health in a neighbourhood. We should be asking difficult questions like is money flowing with the change and is funding truly accessible? Some of this may be achieved through stories that demonstrate how, when people and place are connected through a strong relationship, they are healthier and better able to find the right support when they need it. We can do more together and by connecting with each other – community groups can do more to support each other and share resource and knowledge through place-based initiatives and organisations like LVET. This is, at least in part, about changing the power in the health relationship and supporting the individual and the community to take ownership of their communities and their own wellbeing. The changes that may come from Citizens Assemblies or changes in local democracy through Local Government Reorganisation (if or when it happens) might also be important here. 

Neighbourhoods as defined by NHS England are essentially ‘units of delivery’ – a contracting and management model of health delivery and are centrally driven by system measures of success such as waiting times, improved access, patient satisfaction, admission rates and productivity. The activity is in many cases targeted on people who experience the highest level of health inequalities. However the plans and programmes proposed locally by statutory partners do acknowledge the need for an increase in commissioned prevention and health promotion activity at a local level and seek to go beyond the centrally directed targets and performance indicators. We can all continue to press for local ambition.  

Figure 2: Illustration highlighting the proposed operating model for Neighbourhood Health 

It can be argued quite easily that the ‘unit of delivery’ neighbourhoods bear little relationship to the everyday lives of people and the places they identify as their neighbourhoods and that the target populations are not distinct communities in their own right – people can live their lives across multiple neighbourhoods. A small success from LVET’s involvement in the development of the Neighbourhood Health Plan was the inclusion of reference to what we called ‘natural neighbourhoods’ – the places we go and which aren’t defined by artificially drawn administrative boundaries and there is a commitment to ‘meaningful units of organising and accessing services’. 

It is also worth noting something else that has grown throughout the conversations and development process of the Neighbourhood Health Plan. There has been a growing commitment from statutory partners to Vibrant and Resilient Communities – there is a recognition that the changes signalled in the 10 Year Health Plan for England and subsequent announcements need a strong voluntary and community ecosystem to succeed. This is backed up not only by the proposed structure of the Health and Wellbeing Partnership but also by social investment to support VCFSE organisations develop further their capacity and capability to support system partners.