Everything you need to know about neighbourhood health

In January 2025, NHS England set out plans to move to a neighbourhood health service that would “deliver more care at home or closer to home, improve people’s access, experience and outcomes, and ensure the sustainability of health and social care delivery”^​1​.

It assured that this new approach would alleviate the “fragmentation, poor communication and siloed working” experienced by patients and healthcare professionals, which resulted in “delays, duplication, waste and suboptimal care”^​1​.

The solution? Neighbourhood health, which promised to “bring care into local communities, convene professionals into patient-centred teams and end fragmentation”^​2​. NHS England reiterated this concept in April 2026 when it set out its priorities for the future and asked integrated care boards (ICBs) to outline how they intended to develop neighbourhood care^​3​.

What is neighbourhood health?

Neighbourhood health is characterised by a focus on collaborative working across the local health system, as well as strengthening prevention and community services. Each neighbourhood will have aims and outcomes specific to their local communities and the population they serve, which are to be set by ICBs between 2027 and 2029^​4​.

In its neighbourhood health framework, published in March 2026, the government said neighbourhood health providers will be incentivised to “deliver effective preventative care that reduces avoidable non-elective admissions, focusing on high-priority cohorts”^​4​.

The new system is aimed to rectify an NHS that has “significantly greater spend and investment in hospitals rather than in primary and community care,” the framework said^​4​.

How is a neighbourhood defined?

The neighbourhood health framework defined a neighbourhood as a population within a specific geographical area, the size and shape of which will be agreed with health and wellbeing boards, and local authorities, in 2026/2027^​4​.

Where did the idea of neighbourhood health come from?

In 2014, NHS England put forward the idea of localised healthcare in its ‘Five-year forward view’, which was followed a year later by guidance on moving care closer to home^​5,6​. Then, in 2019, the term ‘neighbourhood teams’ was used in the NHS long-term plan to describe multidisciplinary teams working within primary care networks (PCNs)^​7​.

Focus on local health systems was renewed by Lord Darzi’s independent investigation into the NHS in England, published in September 2024^​8​. 

Darzi noted that an ageing population with more complex health needs has created a need for the NHS to shift care for long-term conditions into primary care — accompanied by funding also shifting towards local services — and to build integrated multidisciplinary teams across providers and settings^​8​.

Building on this, the ten-year health plan — published in July 2025 — introduced the idea of the NHS as a ‘neighbourhood health service’, making care easier for patients to access and navigate^​2​.

To shift care from hospital to the community, NHS England promised patients it would “bring the NHS to you — in your community, including homes and high streets”^​2​. 

It also pledged to introduce a “neighbourhood health centre” in every community, “with multidisciplinary teams working together under one roof”^​2​.

What role could community pharmacy play?

Neighbourhood planning guidance calls on ICBs to “strengthen pharmacists’ role in delivering care, recognising that pharmacies are one of the most accessible parts of primary care”^​4​.

The guidance notes that pharmacies are becoming “increasingly established” in supporting prevention and treating minor illness, and therefore the ambition should be for pharmacies to become a “first point of contact” for more patients^​4​.

The community pharmacy contractual framework will continue to be set nationally but, according to a briefing document published by Community Pharmacy England (CPE) in April 2026, national pharmacy services “may interface with the new arrangements through delegated commissioning, subcontracting or partnership models where appropriate”^​9​.

“The overall intention is to enable systems to redesign services within existing financial envelopes, with progress driven through the reallocation of current resources rather than the creation of new NHS funding streams,” it added.

Speaking to delegates at Clinical Pharmacy Congress on 8 May 2026, David Webb, chief pharmaceutical officer for England, said: “Pharmacy activities will need to be commissioned around clear outcomes, not necessarily roles or activities.”

In its neighbourhood health briefing, CPE said: “Strong advocacy and engagement will be essential to ensure that community pharmacy is fully recognised, resourced and embedded within future models of care.”^​9​

Without this, it warned: “There is [a] risk that commissioning reforms, changes to funding flows and the drive to rebalance investment from hospitals into community-led services may not translate into sustained or equitable funding for pharmacy, unless the sector is explicitly included in local plans.”^​9​

How are pharmacies already involved in neighbourhood health?

Services commissioned by local authorities and ICBs from community pharmacies — such as blood pressure checks and contraception services — already constitute a form of neighbourhood health delivery, while the recent community pharmacy pathfinder programme, which ended in December 2025, has opened opportunities to explore how prescribing pharmacists can deliver locally integrated services.

However, commissioning varies across the country and ICB mergers and cuts have left commissioners in a state of transition. In this context, Conor Price, chief executive of Community Pharmacy London, has urged pharmacies to lay the groundwork for collaborative working. 

In November 2025, Community Pharmacy London hosted a ‘Community pharmacy x General practice summit’, about which Price wrote in The Pharmaceutical Journal.

“We heard about pharmacists working from practice rooms a few days per week, joint headache pathways redesigned by both professions, shared care models that reduced duplication and neighbourhood teams that simply stopped waiting for permission and built systems that worked for their population,” he said. 

“Relationship-based integration is not hypothetical — it is real, and it is happening quietly all over the country.” 

In Greater Manchester, which has had a devolved responsibility for health since 2015, more structured arrangements show how integration could be developed more formally.

A Community Pharmacy Provider Board, which consists of local pharmaceutical committee board members, forms part of the Greater Manchester primary care provider board (PCB).

Established in 2015, the PCB is aimed to bring together the four primary care disciplines of community pharmacy, dentistry, general practice and optometry.

According to Community Pharmacy Greater Manchester (CPGM): “The PCB works to transform and develop new models of care to meet local health population needs and improve patient outcomes in collaboration with the Greater Manchester Integrated Care System and Integrated Care Partnership, and wider health and social care partners, operating at three levels; neighbourhood, place (ten Greater Manchester boroughs) and system.” 

The local pharmaceutical committees in Greater Manchester have also supported the creation of a provider company: CPGM Healthcare Ltd — “a vehicle that enables commissioners to contract with a single organisation for innovative services and that also enables individual pharmacy contractors to compete for contracts on a level playing field with any other qualified provider”, according to the CPGM website.

What is a neighbourhood health centre?

Neighbourhood health centres (NHCs) “will be the place to go for most health needs in every community”, NHS England guidance says, as “a key physical and operational tool to support the neighbourhood health model, alongside care delivered in people’s homes, digitally and in general practice, pharmacies and other community settings”^​10​.

They will serve a population of around 50,000 people each, must include an on-site general practice and be open at least 6 days a week for 12 hours a day^​10​.

According to the neighbourhood health centre guidance, NHCs could be purpose built or housed in upgraded or refigured GP centres with the addition of mobile units or small satellite sites. They could also be based in repurposed community or civic spaces, such as leisure centres and libraries, or high street retail units^​10​.

The UK government is aiming for the first 27 NHCs to be open by 2027 in areas of England most affected by deprivation. By 2030, it says 120 should be ready, rising to a final total of 250 by 2035^​11​.

How will neighbourhood health be commissioned?

While NHS England has said that “care will continue to be delivered by those who know their communities best, such as… pharmacists”, current proposed commissioning of neighbourhood health systems seems centred around GP providers and hospital trusts^​4​. 

In the neighbourhood health framework, NHS England said: “Hospital standard contracts and general medical service contracts will remain the primary vehicles of delivery for the two biggest groups of NHS providers.”^​4​

However, it also announced that several new contract and organisation types will be introduced (see Figure)^​4​:  

Integrated health organisations

Integrated health organisations (IHOs) will take on “whole population health” contracts – potentially the evolution of advanced foundation trusts^​12​. NHS England’s guidance on population health delivery models states that ICBs will oversee these contracts, setting population health outcomes, monitoring delivery against agreed outputs and ensuring quality, choice and waiting lists are maintained^​13​. Over time, IHO providers will take on more responsibility for planning care and resource allocation. 

Multi-neighbourhood providers

Multi-neighbourhood providers (MNPs) will be responsible for more than one neighbourhood — likely a population of 250,000 or more, the neighbourhood health framework suggests^​4​. 

“MNPs will use their scale to design and co-ordinate the neighbourhood health services in their footprint, which may include delivering services directly at a larger scale than a neighbourhood, or ‘filling in’ services where it is locally agreed to be more appropriate for an MNP to deliver,” the government says in its neighbourhood health framework^​4​.

Single neighbourhood providers

Single neighbourhood providers (SNPs) are aimed to deliver new services through integrated neighbourhood teams (INTs) within a defined single neighbourhood — likely to be around 50,000 people, the neighbourhood health framework suggests^​4​. They must deliver care to the population within the neighbourhood and may be an evolution of PCNs, able to take on contracts outside of nationally determined general practice contracts.

Figure: How the new population health models will sit within integrated care boards

What are integrated neighbourhood teams?

NHS England planning guidance has described INTs working across multiple settings delivering patient-centred care for complex conditions, although the specific shape and aims of INTs will be decided locally^​4​. To achieve this, “95% of people with complex needs will have an agreed care plan by 2027, these teams will deliver assessment, care planning, co-ordination and follow-on support”, the guidance states.

Initially, INTs will focus on people with frailty and those who need end-of-life care; people with multiple long-term conditions, such as CVD, diabetes, COPD and dementia; people with cancer; and children/young people.

What still needs to happen?

In its briefing, CPE raised concerns that local pharmaceutical committees have limited resources to engage with local neighbourhood discussions. It warned there were “unanswered questions about how pharmacies will be positioned within emerging neighbourhood governance structures and new provider models”^​9​.

In January 2026, the Health and Social Care Committee also advised in a letter that lower pay and a lack of career progression for pharmacists and other allied healthcare professionals in the community sector may put the shift to neighbourhood health at risk.

The letter referenced evidence presented to the Health and Social Care Committee by Amandeep Doll, director for England at the Royal College of Pharmacy, who said: “We know that a third of pharmacists are currently prescribers, and that less than 10% of them are working in community pharmacy.”

As a result: “The upcoming [NHS] ten-year workforce plan must contain clear and concrete proposals to address these challenges and make the community a more attractive place for staff to work and build a career,” the letter said.