20 Key Points from NHS Neighbourhood Health Framework
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'Neighbourhood health will only work as a joint endeavour between the NHS and local authorities, alongside wider partners. We expect this to be a truly collaborative effort between all partners, combining the NHS’s responsibility for our health services with local authorities’ responsibility for adult and children’s social care services and public health. This will foster a true partnership for the benefit of all citizens to ensure we achieve the left shift from hospital to community, and sickness to prevention.'
The framework creates a neighbourhood health service that organises most NHS and local care around local geographic communities, with clear national goals but strong local flexibility.
Overall purpose and model
Aim is to deliver more accessible, integrated, preventative care closer to home, reduce pressure on hospitals and cut duplication.
Services are organised around neighbourhoods, not institutions, with care coordinated around the person rather than the organisation.
National goals and metrics
There are five national minimum goals: better health outcomes, improved access to general practice, better planned care experience, improved urgent and emergency care, and higher patient and staff satisfaction.
Each goal has associated objectives and metrics to 2029, with local systems required to add neighbourhood‑specific aims and outcomes via neighbourhood health plans.
Local leadership and responsibilities
Integrated care boards (ICBs) and local authorities must jointly design neighbourhood health models, working through health and wellbeing boards (HWBs).
HWBs are expected to align neighbourhood health with JSNAs, the Local Outcomes Framework and adult social care priorities such as helping people stay at home and reducing care‑home admissions.
New structures and delivery models
The framework introduces neighbourhood health centres and integrated neighbourhood teams that bring together primary care, community services, mental health, social care and VCSE partners.
Over the next three years all ICBs must implement a “minimum set of interventions” to improve routine care, strengthen proactive care for people with complex needs, and provide better alternatives to hospital care.
Primary care, data and implementation
GP practices remain central but are expected to work in multidisciplinary neighbourhood teams, with more proactive population health management and easier access to specialist advice (e.g. single points of access, virtual pathways).
The framework standardises expectations for data sharing between neighbourhood services and hospitals so patients experience joined‑up care and are not left to coordinate it themselves.
Implementation runs in two stages: immediate foundational changes in 2026/27, followed by deeper reform and locally tailored neighbourhood health plans from 2027 to 2029, supported by a National Neighbourhood Health Implementation Programme.
Here are 20 concise, policy‑relevant takeaways from the Neighbourhood Health Framework.
The framework’s core aim is to create a neighbourhood health service that delivers integrated, preventative, community‑based care for defined local populations across England.
It is a joint endeavour between NHS integrated care boards (ICBs), local authorities, and wider partners (including VCSEs), explicitly designed to achieve the “left shift” from hospital to community and from sickness to prevention.
Neighbourhood health centres (NHCs) are positioned as the main local access point for most health needs, bringing together GP, community, local authority and civil society services, with government committing to build or upgrade 250 centres nationally.
The framework sets five national goals for the NHS: improving health outcomes, access to general practice, experience of planned care, urgent and emergency care performance, and patient and staff satisfaction, with quantified metrics to 2029.
Goal 1 focuses on high‑priority cohorts (frailty, care home residents, housebound, end‑of‑life, key long‑term conditions, and children and young people), targeting around 10% improvements in clinical outcomes and reductions in non‑elective activity by March 2029.
Goal 2 requires that 90% of clinically urgent patients are seen the same day in general practice by March 2027, with new data collections to set trajectories for routine access and satisfaction.
Goal 3 uses single points of access and multidisciplinary models to divert at least 25% of outpatient referrals in at least 10 high‑volume specialties by March 2027, while shifting follow‑up activity into neighbourhoods and cutting follow‑ups by at least 10%.
Goal 4 ties neighbourhood models explicitly to UEC performance, seeking flat or reduced non‑elective admissions for priority cohorts, improved 4‑hour A&E performance to 82% by March 2027 and 85% longer term, and fewer low‑acuity ambulance conveyances.
Goal 5 introduces new neighbourhood‑level patient‑reported experience/outcome measures and staff experience metrics from 2026/27, with trajectories for improvement and an expectation that 95% of people with complex needs have an agreed care plan by 2027.
Health and wellbeing boards (HWBs) are central to neighbourhood governance, jointly leading with ICBs on neighbourhood health plans, setting local outcome measures across the life course, and aligning with JSNAs and adult social care priorities.
Local goals must dovetail with wider public service reform programmes (Best Start in Life, Family Hubs, SEND reform, Young Futures Hubs, Families First, Pride in Place, Get Britain Working, Pathways to Work and homelessness/housing reforms) to address wider determinants of health.
The framework requires HWBs, ICBs and local authorities to link neighbourhood health to specific adult social care outcomes, including enabling people to live at home, reducing care home admissions, and improving satisfaction for service users and carers.
Delivery is structured around three reform agendas: improving routine care for everyone, improving proactive care for people with complex needs, and delivering robust alternatives to hospital‑based care at neighbourhood level.
General practice is described as the bedrock of neighbourhood health, with commitments to GP access recovery, enhanced digital access, improved diagnostics, reduced bureaucracy via the “Red Tape Challenge”, and stronger primary–secondary care interfaces.
The framework promotes significant expansion of community pharmacy roles (e.g. Pharmacy First, contraception, blood pressure, smoking cessation, prescribing‑based services), leveraging the 2026 independent prescribing qualification for newly‑qualified pharmacists.
Integrated neighbourhood teams (INTs) are the main vehicle for proactive, multi‑professional, person‑centred care, locally defined but expected to focus initially on frailty/end‑of‑life, multiple long‑term conditions and children and young people.
National contracts and funding flows will be adjusted so ICBs can commission INTs at the right scale, aligning physical and mental health care, and integrating with social care and VCSE provision where appropriate.
Implementation in 2026/27 centres on establishing foundational “minimum interventions” everywhere, with local neighbourhood health plans for 2027/28 and support from a National Neighbourhood Health Implementation Programme.
A common outcomes and metrics framework, plus early financial incentives and archetype governance models, are intended to bring consistency while preserving local flexibility in delivery models.
The framework is explicitly iterative: it will be regularly updated based on learning from local systems, with an expectation that neighbourhood health becomes a primary route to regaining public confidence in the NHS through visibly improved access and continuity of care.
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