Neighbourhood Health in London: Joint Update and Response to National Guidance
Since July 2024, the London Health & Care Partnership (including London Councils, NHS England, the London Integrated Care Boards, the Greater London Authority, the Office for Health Improvement & Disparities, UK Health Security Agency, Londonwide Local Medical Committees, and representatives of London’s voluntary and community sector) have been working in partnership to improve health and wellbeing for all Londoners.
This work builds on previous deliberative engagement with Londoners from across the capital; the opportunities and challenges identified across all communities and parts of London, including growing pressures on primary care, social services, urgent and emergency care and London’s hospitals; and the learning from existing neighbourhood working in the capital.
Since May 2025, when we jointly published our Case for Change and Target Operating Model for delivering neighbourhood health in London, colleagues and teams across local government, NHS commissioners and providers, the voluntary, community, faith and social enterprise (VCFSE) sector and wider partners have been working together to develop and implement these models.
As demonstrated in the first ever simulation of neighbourhood health at scale in London, conducted over two days at London Councils’ offices last year, neighbourhood health done well,
- as a whole population model, supporting babies, children and young people, working age adults and older people
- as a whole-needs model, from preventing ill-health to supporting people with long-term health conditions to live independently and in line with their priorities
- as a whole system model, bringing together health, local government, VCFSE and wider partners
delivers better outcomes for individuals, families, professionals, communities and the services and systems that support them.
We welcome the latest neighbourhood health guidance from NHS England and the Department of Health & Care and are clear on its alignment to our work in London. See our update on delivery – one year on.
Inevitably, we see a focus in health guidance on what this means for the NHS. But equally importantly, the guidance:
- explicitly recognises that the NHS cannot deliver neighbourhood health alone and that success requires close partnership with local authorities, VCFSE organisations and communities.
- acknowledges that improving health and wellbeing depends heavily on housing, education, infrastructure, public health and social care, areas where local government leads;
- supports existing place-based approaches and the role of Health and Wellbeing Boards (HWBs) as a key locus for planning neighbourhood health;
- focuses support on priority cohorts which align with many of our shared priorities in London, including improving health and care for residents who are living in care homes, people with complex long-term needs or who are at high risk; all whilst leaving room for us to continue to develop whole-population models;
- increasingly links neighbourhood health to the development of necessary shifts in funding and resources to enable better care in the community and closer to people’s homes; and
- explicitly emphasises scaling what already works – “rapid evolution not revolution.”
Londoners want and deserve good quality care at all stages of their lives.
We are in a process of moving from a set of service “silos” which have delivered significant benefits over many decades but which increasingly failed to adapt to individual needs (and failing most often for those communities already most in need); to a shared approach which will improve population health and wider socio-economic outcomes for our whole population.
To do this, we will need to reduce activity in the places where we spend most public money today, and where people do not want to be – including in a hospital bed – if there is a better alternative; and open up access and support from a range of different professional and volunteers, which means re-investing in our voluntary and community sector as well as primary care and other services. This is our shared responsibility, in responding to specific guidance, national priorities and our accountability to all Londoners.
We know:
- We cannot deliver improved health and wellbeing for London without a strong and sustainable NHS, which means a strong and sustainable set of acute, community, mental health and primary care services.
- We cannot deliver improved health and wellbeing for London without local government, including the active involvement of adults and children’s services, public health, housing and wider services.
- And we cannot deliver improved health and wellbeing without our communities, including being able to show how we are responding to their priorities and needs, building social infrastructure and equity.
The neighbourhood guidance validates our direction of travel, but also challenges us to show how this is impacting on the sustainability of health and care locally and nationally. London embraces that challenge, as we continue to work jointly towards our ambitions for better care and better outcomes for our whole population.