Neighbourhoods…..why they matter

By Dr Ollie Hart

This month saw a number of commentaries from the Kings fund on the back of NHS England’s Neighbourhood framework. Boring, boring, boring, I hear many of you cry…..why does it matter? Not another dull attempt to reshuffle the deck chairs! But we think Neighbourhoods are important, it matters that we get this right.

There is a huge amount of evidence from health and care systems across the world that if you want to create the best health for populations you need to align health, social and self care in local places, led by local people. Articulating this as ‘Neighbourhood Approaches’ is a massive step in the right direction we think.

But it seems all we really have so far is bold words, and some new proposed structures. We think what is really missing is a commitment to properly scale up, and get serious about the ways of working , the teams and skills need to create a robust system where the medical model is equally matched by a social and self-care approach to health and wellbeing. Dr Minal Bakhai the program lead for National Neighbourhood Health Implementation Program, calls this ‘People Activation’…….more engaged public, people and places.

PCNs have made a good start in many places, piloting using health coaches, and care co-ordinators to empower and involve people, and building social prescribing offers to help people navigate their social context. But these are tiny in comparison to the well-established and resource consuming hospitals, and traditional medical services. We’re not saying these aren’t important (we are doctors ourselves), but It’s time to realise the value of a truly integrated, proactive and preventative, personalised system. We need to balance up investment and development.

We discuss this in episode 19 of our Health Coaching and Beyond podcast. Do listen and tell us what you think. Of course we are biased…….but for good reason!!