Higher ambition, faster pace,
greater co-ordination:
The political imperative of delivering a
neighbourhood health service
Executive summary
The Government’s recently published ten year health plan places a central importance
on delivering a new operating model for the NHS, moving from a national to a
neighbourhood health service.1
Health inequalities between the most deprived neighbourhoods and those in the rest
of the country are stark. The number of people reporting that they have a long term
illness is on average 14.5% higher in the 150 neighbourhoods with poorest health when
compared to the average across all neighbourhoods in England. The number of people
reporting that they are in bad or very bad health is also 8% higher.
The Secretary of State for Health and Social Care, Rt Hon Wes Streeting MP has set
welcome ambitions for rolling out neighbourhood health centres in communities
across the country, starting with those with the greatest health need. Streeting has also
set out aims for reviewing funding formulas so that more investment goes to areas with
the poorest health.2
This research highlights the political imperative of now acting quickly and with ambition
on this agenda.
For the Government, close to nine in ten of the 150 neighbourhoods with the poorest
health are within parliamentary constituencies currently held by Labour MPs. When
looking at the parties who came second in these seats in July 2024, two thirds were
from Reform UK, which now regularly leads in the opinion polls.3
If the Government is to get re-elected it will need to show voters in these
neighbourhoods that reforms to the health service are working, helping accelerate
access to care and supporting improvements in wellbeing and health outcomes.
But delivering on a neighbourhood health model is not easy.
It requires new ambition, investment, bolder action on upstream prevention and a
revised operating model away from the traditional state and hierarchical models in the
NHS to a more collaborative, partnership and community based set of approaches.
The Government’s Ten Year Health Plan starts the process of change, but a year in
Ministers now need to move far more quickly to make voters feel the benefits of
this new service. Plans for 40-50 neighbourhood health centres by the end of the
Parliament should be raised, broader cross Government action to tackle the wider
determinants of health as part of a mission based approach to governing enacted,
funding reviews to tackle health inequalities expedited and guides published that
support and enable neighbourhoods to build the new service in collaboration with
partners quickly – learning from what is working already in different parts of the
country.4
Getting this right could be the difference in the Government being re-elected or
returning to Opposition. A neighbourhood health service is the right model for
changing our health service, but voters need to experience and feel the change.
The clock is ticking and there is no time to lose.
Conclusion
The Government has rightly put neighbourhood health at the centre of its reforms
to the NHS.
However as this research shows, the need for action to improve health in the
neighbourhoods with the poorest health is urgent. Public services such as the NHS
are under huge pressure and growth in the economy remains sluggish. There are
wide health inequalities across the country, impacting on people’s quality of life.
Positive steps have been taken to realise this agenda through both the Plan for
Neighbourhoods and the Ten Year Health Plan. However as yet action does not
appear to be co-ordinated.
Change will only be fully realised if clear funding is in place, Government agencies
work more closely together and if an operating model is allowed to germinate
which – as New Local sets out – moves from traditional top-down hierarchies to a
more devolved and collaborative approach.
The Government has spent a year formulating its plans for neighbourhood health,
it now needs to move more quickly and with greater ambition to implement it.
Pulling this off will not only be good for local people and local economies, but also
for the Government’s political fortunes as it looks towards the next election.
1 https://assets.publishing.service.gov.uk/media/6866387fe6557c544c74db7a/fit-for-the-future-10-year-healthplan-for-england.pdf
2 https://www.gov.uk/government/news/landmark-plan-to-rebuild-nhs-in-working-class-communities
3 https://yougov.co.uk/topics/politics/trackers/voting-intention
4 https://hansard.parliament.uk/commons/2025-07-03/debates/DC09ACAA-D05F-4BE8-9517-16A2D53DA49E/NHS10-YearPlan
This report was commissioned by the Independent Commission on Neighbourhoods (ICON) as part of its call for evidence. The work has been undertaken independently by Future Health and the views and conclusions in the report are those of Future Health and should be attributed as such.