Neighbourhood health: we have the tools to make it happen. Now we need to use them.
05 November 2026
Having worked in health technology for more than 40 years, I've seen numerous attempts to change how care is delivered. I've been advocating a shift away from hospitals and towards prevention for well over a decade, so it's encouraging to see neighbourhood health becoming a central part of national policy.
There is now widespread recognition that the NHS cannot continue operating in the way it does today. Hospitals are already working at capacity, growing numbers of people are living with complex conditions, and demand will continue to increase as the population ages. The direction of travel is right, although we have been here before, with successive initiatives promising more integrated services, earlier intervention and better use of the information already held across health and social care.
My concern is that we could spend another decade designing programmes and commissioning technology when much of what we need is already available. Delivering neighbourhood health need not be as difficult as it is sometimes made out to be, although it does require focus, local ownership and a willingness to change how services operate. Rather than waiting for another national programme to provide the answers, we should be looking at how existing capabilities can be used to identify people who would benefit from earlier support and give local teams the means to provide it.
Organising care around people rather than institutions
Much of the NHS's investment in digitisation has understandably focused on electronic patient records and systems supporting individual hospitals and other organisations. This has been necessary work, but neighbourhood health requires something broader because the services involved extend across primary care, community services, hospitals, mental health, social care and the voluntary sector.
What we need is a Care System Platform that brings together four complementary capabilities. Connected Care makes relevant health and social care information available to professionals across organisational boundaries, while Coordinated Care enables multidisciplinary teams to work from shared care plans and understand what other services are doing. Intelligent Care uses population health analytics to identify unmet need, target interventions and measure outcomes, and Engaged Care gives people a more active role in managing their health through digital tools, supported self-management and remote patient monitoring.
These capabilities need to work together if they are to make a meaningful difference. Identifying someone at risk of deterioration achieves very little unless there is a clear route into appropriate support, just as multidisciplinary working becomes unnecessarily difficult when professionals have no shared understanding of a patient's circumstances or the interventions already underway.
The emphasis should be on connecting information, care planning and ongoing support so that neighbourhood teams can work effectively across organisational boundaries without expecting patients to navigate those boundaries themselves.
