Neighbourhood health: what we know so far

Neighbourhood health is one of those phrases that seems to be everywhere at the moment. It appears in strategy documents, policy discussions, and conference agendas with increasing frequency, yet for all its visibility it still feels slightly out of reach, understood in principle but not always in practice. 

 

At its core, the model for neighbourhood health is built around care being organised at a local level for defined populations. As Community Pharmacy England have outlined in their brief, Neighbourhood Health Centres (NHCs) are intended to act as hubs within communities, bringing together a range of services closer to where people live. These are supported by Integrated Neighbourhood Teams (INTs), made up of professionals from across health, social care, and community services, working more collaboratively to manage patient needs. The focus is on delivering more preventative, population-based care, identifying need earlier and reducing reliance on hospital services. The aim is to create a model that is more accessible, more coordinated, and better able to respond to demand within the community. But it is also a model that depends heavily on strong local relationships and leadership, rather than a single, standardised blueprint. 

That shift is already beginning to move beyond theory. Government plans for a first wave of neighbourhood health centres, with 27 sites identified across England, signal a clear intent to turn the model into something tangible. These centres are expected to bring together a range of services within local communities, from general practice and diagnostics to preventative and support services, with the aim of making care more accessible and reducing pressure on hospitals. While the detail of how they will operate is still emerging, their rollout suggests that neighbourhood health is no longer just a strategic direction, but an active area of development. 

 

For community pharmacy, the direction itself is not unfamiliar. Over the past few years, the role of the pharmacist team has been steadily evolving, shaped by new services, rising patient demand, and a wider shift across the NHS towards care delivered closer to home. What was once seen primarily as a dispensing function, now increasingly sits within a broader clinical and preventative context with developments such as Pharmacy First, emergency contraceptive services, and expanded vaccination programmes. Against that backdrop, neighbourhood health feels less like a stop-start and more like a continuation, albeit one that brings greater expectation and visibility to a role that has been quietly expanding for some time. 

Where things begin to feel less settled is the transition from concept to delivery. Recent commentary from the King’s Fund highlights a number of unresolved anxieties. These include questions around how neighbourhood teams will be structured in practice, consistency in implementation across different areas, and the timelines that these developments will be stretched across. Community Pharmacy England has raised similar concerns, noting that while the direction of travel is clear, the operational detail, particularly around funding, capacity, and system design, remains lacking.  

This creates a more complex picture than the headline vision might suggest. On one level, neighbourhood health aligns closely with community pharmacy’s strengths: pharmacies are embedded in their communities in a way few other healthcare settings are. They are accessible, familiar, and becoming increasingly equipped to deliver clinical care. Increasing collaboration seen in the improved relationships between pharmacies and general practice is also evolving, moving beyond transactional interactions towards something more integrated. Referral pathways are becoming more established, and there is a clearer recognition of where pharmacy can add value. Neighbourhood-based working has the potential to build on this, turning local progress into something more consistent across the system, although the pace of that change is likely to vary significantly between areas. 

 

However, the constraints facing the sector remain significant. Funding is the most immediate. The expectation that more care will move into the community is clear, but the mechanisms for supporting that shift is less so. Community Pharmacy England has been explicit in highlighting the gap between increasing workload and available resource, and the risk that additional responsibilities are being layered onto an already stretched system without the necessary support. 

Workforce pressures add another layer of complexity. The arrival of newly qualified independent prescribers has the potential to reshape how care is delivered in community settings, but it also raises practical questions around training, supervision, and integration into existing teams.  

Integration itself, while central to the model, is not straightforward. Bringing together different parts of the system requires more than shared intent. Differences in IT systems, communication pathways, and organisational priorities continue to create friction, hindering progress. As the King’s Fund suggests, building effective neighbourhood teams depends as much on relationships, trust, and time as it does on formal structures, making it a gradual rather than immediate shift. 

 

So, what do we know so far? Neighbourhood health is beginning to take shape, and the direction is clear, with early rollout signalling real intent. What is becoming increasingly clear is that community pharmacy is expected to play a meaningful role within it. What remains less clear however, is how that role is defined, supported, and sustained in a system that is still working out exactly how it will function in practice. 

 

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