Key messages

• the guidance sets out a long-term vision for delivering care closer to home through neighbourhood health services
• it proposes three strategic shifts: from hospital to community, treatment to prevention, and analogue to digital
• integrated multidisciplinary teams are positioned as the core delivery model
• equity is framed as a central outcome, with a focus on improving access in areas with low healthy life expectancy
• digital tools are presented as enablers of access, coordination and prevention.

Policy implications

• neighbourhood health and care is positioned as a core organising principle for future service delivery
• integrated working across health, social care and wider partners is expected to become standard practice
• systems may need to align workforce planning, digital infrastructure and funding to support neighbourhood delivery
• equity goals require explicit action to avoid reinforcing existing disparities.

Gaps

• limited empirical evidence on the effectiveness of neighbourhood health models at scale
• workforce shortages may constrain implementation of multidisciplinary teams
• digital readiness varies significantly, risking digital exclusion
• funding disparities and short-term investment may undermine sustainability.

Commentary
This guidance sets out a clear national direction for neighbourhood health and care, positioning integration, prevention and proximity as central to future service models. By framing equity as a core outcome, it explicitly links neighbourhood delivery to addressing unequal access and outcomes.

However, the document is primarily aspirational. While it outlines strategic shifts and desired end states, it provides limited evidence on how these changes will be implemented consistently or evaluated over time. From a care equity perspective, this creates a risk that ambition outpaces delivery.

Workforce capacity, digital exclusion and uneven local resources are identified as potential constraints. Without targeted investment, neighbourhood health models may develop unevenly, benefiting areas with stronger infrastructure while leaving others behind.

The guidance therefore functions best as a reference framework rather than evidence of impact. Its value within the hub lies in clarifying national intent and expectations, while highlighting the gap between policy ambition and the current evidence base. Understanding this distinction is essential for assessing whether neighbourhood health and care delivers on its stated equity goals.

Key messages

• pilot sites describe neighbourhood hubs co-locating diagnostics, nursing and mental health services
• early implementation focuses on integrated, multidisciplinary neighbourhood teams
• reported benefits include improved continuity of care and service user satisfaction
• some sites report reductions in A&E attendance following neighbourhood service development
• delivery models vary across integrated care systems and primary care network areas.

Policy implications

• co-location of services may support more joined-up and accessible neighbourhood care
• neighbourhood hubs can act as focal points for multidisciplinary working
• early learning may inform wider roll-out, but consistent evaluation is needed
• neighbourhood health models should be adapted to local context rather than replicated wholesale.

Gaps

• evidence is descriptive, with inconsistent metrics across sites
• follow-up periods are short, generally under 18 months
• limited evidence on long-term outcomes or impact on inequalities
• lack of comparative analysis between different neighbourhood models.

Commentary
These case studies provide early insight into how neighbourhood health and care models are being implemented in practice. By profiling sites that have co-located services and developed multidisciplinary teams, they offer practical examples of neighbourhood models working within the NHS.

Reported improvements in satisfaction, continuity and A&E use suggest potential benefits of neighbourhood approaches. From a care equity perspective, improved continuity and local access may be particularly relevant for people with complex or ongoing needs.

However, the evidence remains early and uneven. Variation in metrics and short follow-up periods limit conclusions about effectiveness or sustainability. It is also unclear how benefits are distributed across different population groups within neighbourhoods.

Overall, the case studies are useful for understanding implementation approaches and early experiences, but they highlight the need for more consistent and longer-term evaluation to assess whether neighbourhood health and care delivers equitable improvements in access, experience and outcomes.