Integrated neighbourhood health and care models

Key messages

• the review synthesises evidence mainly from the UK, with additional studies from Canada, Germany and the USA
• several key domains underpin effective integrated neighbourhood models
• the domains include the integrator host, integrator enablers, partnership principles, integrated workforce, core areas of work and services provided
• integrated neighbourhood models support multidisciplinary collaboration, improved resource use and community engagement
• funding constraints, digital exclusion and inconsistent evaluation frameworks limit scalability and sustainability.

Policy implications

• implementation of neighbourhood models requires clarity on leadership, hosting and accountability arrangements
• workforce integration and partnership principles should be explicitly designed rather than assumed
• digital inclusion must be addressed to avoid widening inequalities in neighbourhood-based models
• consistent evaluation frameworks are needed to assess impact and support scale-up.

Gaps

• limited evidence on long-term sustainability of integrated neighbourhood models
• lack of standardised evaluation approaches across settings
• limited insight into how neighbourhood models affect inequalities across different population groups.

Commentary
This systematic review provides a structured framework for understanding how integrated neighbourhood health and care models are designed and implemented. By identifying seven core domains, it moves the evidence base beyond descriptive accounts towards clearer principles that can guide practice and policy.

From a care equity standpoint, the focus on multidisciplinary collaboration and community engagement is particularly important. Integrated neighbourhood models aim to align health, social care and wider services around local populations, with the potential to improve access and responsiveness for people whose needs span multiple systems.

However, the review also highlights structural risks. Funding limitations and digital exclusion threaten the reach and sustainability of neighbourhood approaches, particularly in more deprived communities. Without deliberate action, these barriers may reinforce existing inequities rather than reduce them.

The lack of consistent evaluation frameworks further limits understanding of impact. Without robust and comparable evidence, it is difficult to determine whether integrated neighbourhood models improve outcomes equitably or which components are most effective.

Overall, the findings suggest that neighbourhood health models hold promise as a place-based approach to integration, but their contribution to equity depends on how they are resourced, evaluated and adapted to local context. Ensuring that implementation addresses digital access, funding stability and inclusive evaluation will be central to delivering equitable neighbourhood health and care.