Beyond the hospital walls: How the neighbourhood health service will shape a future for resilient, connected communities
We understand that the fundamental drivers of health and wellbeing are not found in hospitals or clinics, but in the everyday places where people live, work, and connect.
Across the UK, a quiet but powerful transformation is underway. Neighbourhood health services, anchored in local partnerships, digital innovation, and cross-sector collaboration, are redefining what it means to care for communities.
By placing people, place, and prevention at the heart of service design, these models are tackling health inequalities and laying the groundwork for resilient, thriving communities.
This article explores how neighbourhood health creation is delivering real impact, and what it will take to scale this whole-system, place-based, cross-sector transformation in our local communities.
Shane Dineen, Commercial Executive
Why neighbourhood health, why now?
Communities across the UK face a perfect storm: rising demand, persistent inequalities, and the legacy of a system designed for a different era. The World Health Organization and leading UK reviews agree that social determinants, such as housing, employment, education, and environment, shape the majority of health outcomes. In the most deprived areas, major illness is diagnosed a decade earlier than in the most affluent.
Over half (53%) of public spending in the final year of life is allocated to healthcare, while only 11% is spent on primary and community care. This imbalance highlights the urgent need to rebalance investment towards prevention, population health management, and neighbourhood health services.
The neighbourhood health service: a model for community wellbeing
We have been among the early champions and shapers of the neighbourhood health service concept, helping define its practical application through strategic partnerships, national debates, conference contributions, and innovation programmes. This is not a rebranding of existing provision, it is a fundamental shift:
Creative health: Arts-based, VCSE-led approaches that use culture, creativity, and social connection to address isolation, mental health, and chronic conditions.
Health creation: Whole-system, place-based transformation that aligns health, housing, education, digital, and voluntary partners to address the root causes of poor health.
National charity Humankind exemplifies this approach, supporting over 106,000 people annually across the North and Midlands. Their integrated support model, spanning housing, lived experience leadership, and regional partnerships, has been recognised as best practice by the government.
West Yorkshire Creative Health
West Yorkshire's ambition to become the UK's first Creative Health System is already delivering results. With life expectancy gaps of up to 10 years between the richest and poorest wards, and a 35% rise in mental health referrals since 2020, the region is embedding arts and VCSE partners into the heart of community wellbeing.
Healthcare as a collaborative ecosystem
System leaders are co-designing neighbourhood care ecosystems that bring together health, housing, digital, and voluntary partners. These pilots aim to deliver more accessible, preventative, and equitable support, with anticipated outcomes including reduced isolation, improved mental health, and better service integration.
Midland Metropolitan University Hospital
Our work as PMO for the new hospital in Birmingham supported the transition to a state-of-the-art acute facility that integrates diagnostics, digital innovation, and community regeneration. With over 70% of the Trust workforce recruited locally, 800 new affordable homes planned, and active transport infrastructure underway, this hospital is a catalyst for regeneration in one of the UK's most deprived areas.
Learning from South East London ICB
South East London's integrator model, where hospital trusts host neighbourhood health teams, highlights the importance of infrastructure, data sharing, and partnership across primary, secondary, and community care. Early learning points to the need for clear governance, investment in digital and estates, and a focus on outcomes for frailty, long-term conditions, and children's health.
The social and economic value
The evidence base is clear:
- According to analysis by NHS Confederation and Carnall Farrar, the top 20 interventions by return on investment were all community-based, covering areas such as housing improvements, smoking prevention, and exercise initiatives, with returns ranging from £6.90 to £34.75 for every £1 spent, (NHS Confederation & Carnall Farrar, 2023)
- Social prescribing demonstrates a favourable social return on investment (SROI), particularly in reducing pressure on primary care and improving wellbeing. National Academy for Social Prescribing (2022).
- In deprived areas, community-led investment has led to greater improvements in self-reported health than national averages. The Big Local programme, for example, saw increased rates of residents reporting “very good” health and decreased rates of “bad” health between 2011 and 2021, (New Local, 2023).
- Creative health approaches are linked to improved mental health, reduced loneliness, and increased community resilience, National Centre for Creative Health, Creative Health in Adult Mental Health (2023).
What it takes: Scaling the neighbourhood health service
1. Integrated, data-Driven planning
To deliver meaningful change, we must align clinical, digital, estates, and community priorities. This requires using data and equity analysis to target investments where they will have the greatest impact.
2. Co-design with communities and anchor Institutions
Transformation must be co-designed with communities, anchor institutions, and representatives of underserved groups. Participatory planning, listening sessions, and workshops ensure services reflect lived experience and local need.
3. Cross-sector collaboration
Councils, health providers, VCSE organisations, housing, education, leisure, public health, and business must work together. Shared resources and accountability are key to building integrated systems that support prevention and resilience.
4. Sustainable funding and evaluation
Long-term impact requires ringfenced funding, blended finance models, and robust evaluation frameworks. These are essential to demonstrate value, attract investment, and drive continuous improvement.
5. A shared commitment to community care
The neighbourhood health service is more than a policy ambition, it's a shared commitment to reimagining care. It's about creating health in the places people call home, through collaboration, innovation, and a relentless focus on health equity and wellbeing.
We invite system leaders, partners, and stakeholders to join the conversation. Whether you're leading neighbourhood transformation or just beginning the journey, your insights and energy are vital.
Let's build a future where health is created in the places people call home.
If you'd like to find out more about our approach to neighourhood health join us for our webinar.
Delivering neighbourhood health in practice. Archus' six-step framework
Thursday 9 October, 12:30-13:00
