Dr Manik Arora, National Neighbourhood Health Implementation Programme, Nottingham City
Nottingham is one of 43 areas pioneering neighbourhood health as part of the NHS 10 Year Plan’s shift from hospital to community-based care. Our vision: working together as one team, we help people to live the lives that matter to them.
Neighbourhood health operates across three integration levels. Service-level integration brings together general practice, community services, mental health, acute specialists, and the voluntary sector through integrated neighbourhood teams serving populations of 30-50,000. Community-level integration mobilises assets beyond services – voluntary, community, faith and social enterprise organisations, social prescribing, peer support, and informal networks that build health literacy and self-care capacity. Civic-level integration aligns with Health and Wellbeing Board strategy, neighbourhood framework guidance, and the wider determinants agenda that local government leads.
General practice provides relational continuity essential for complex patients with multiple long-term conditions. Community nursing enables care closer to home. But sustainable neighbourhood health requires more: consistent navigation to appropriate alternatives, including community pharmacy, optometry, and dentistry; specialist services like diabetes, respiratory, and dementia care shifted from hospital to community settings; quality improvement across variable practice processes; and critically, training and support for paid and unpaid carers managing increasing complexity at home.
The model is strengths-based – recognising that voluntary, community, faith and social enterprise organisations are not gaps to be filled by services but assets that co-produce health outcomes.
Communities have capacities for connection, mutual support, and resilience that no service can replicate
Neighbourhood health builds on these strengths while improving value, supporting workforce sustainability, and enabling informal carers. The aim is population-wide coverage with a prevention focus, not just reactive care for established illness.
