Written by Kate Leggett (Account Manager at Incisive Health) based on an interview with Ruth Rankine (Director of the Primary Care Network at NHS Confederation)
Neighbourhood health services are emerging as a critical lever for transforming healthcare delivery in the face of mounting system pressures. Rising demand, constrained resources and widening health inequalities have exposed the limits of a reactive, hospital-centric model. The neighbourhood approach offers an alternative: care that is proactive, locally tailored and rooted in public sector collaboration.
In this second part of our ‘neighbourhood health’ blog series, we speak to Ruth Rankine, Director of the Primary Care Network at NHS Confederation, to explore how the vision of neighbourhood health is being interpreted on the ground – and what it will take to move from concept to implementation.
Defining neighbourhood health: beyond geography
A neighbourhood is not a fixed concept. As Ruth highlights – for some, “it’s a postcode; for others, their street or the area around their local school”. This variability underscores a key principle: health services must start by listening to communities. Understanding how people define their neighbourhood – and what matters most to them – shapes the design of interventions that are relevant to meet their needs.
Current NHS priorities understandably focus on reducing GP waiting times and A&E backlogs. But as Ruth notes, this reactive model risks trapping the system in a “hamster wheel” of managing demand. Breaking that cycle means starting from the ground up: engaging communities in their own health and designing services that anticipate needs rather than simply respond to crises.
This is not a new concept – Ruth described it as an “evolution” of what is currently being done – but highlighted that the focus needs to shift to combining existing efforts to drive forward the change being signalled at the national level.
Social determinants: the missing data
An overriding theme of our discussion was the need to look beyond headline metrics. Traditional NHS datasets highlight referral timelines and attendance rates, but rarely capture underlying drivers – for example, GP closures forcing patients to attend A&E, or rural residents facing long journeys on unreliable transport. These factors, which can vary from place to place, are powerful predictors of health outcomes, yet they remain invisible in most datasets.
To address this, neighbourhood health services need to know and understand their local population. Nuanced, locally relevant data will be fundamental to this, pinpointing unmet local need and enabling services to be designed to reflect this. To that end, Ruth outlined that neighbourhood health services should aim to “understand the needs of communities and collaborate with the right partners to respond to those needs, whether it's a health response or [a local authority response to issues such as] housing” which may be impacting an individual’s health and care needs.
Partnership over prescription
If care is to be joined up, the teams delivering it must be too. Ruth pointed to East Staffordshire as an example of best practice: during the Covid-19 pandemic, the local football club became a hub for social prescribing. She described the importance of “galvanising opportunities presented by the community”, evidenced by the partnership evolving into a model where local issues trigger community-led solutions – such as self-help groups formed by residents, enabling service users to become part of the solution.
Scaling this type of approach requires a shift from centralised control to collaborative, place-based delivery. Local authorities, social services and charities must be integral partners, not peripheral players. To achieve this, Ruth stated that the infrastructure “needs to enable collaboration in a way that people don't feel that someone else is doing it” for them. This is not just a healthcare model – it’s a whole-system approach to wellbeing.
Looking forward, services will need to ensure they are compatible to be delivered via a multi-disciplinary team and optimise community-based pathways, a marked shift from the current, more traditional, hospital and GP-led service delivery. Ruth highlighted two key enablers for this approach:
Policy infrastructure: Financial frameworks, contracts and regulations must support integrated working, freeing staff to focus on care rather than bureaucracy and encouraging collaboration over competition
Digital innovation: Tools such as remote monitoring and virtual group consultations can extend healthcare access and reduce pressure on frontline services. But digital tools must be deployed thoughtfully to avoid widening inequalities. As Ruth notes, for those who can use it, digital frees up capacity for those who cannot – creating a more balanced system
From vision to action
Our conversation with Ruth highlights a clear message: neighbourhood health services are not a peripheral initiative – they are a strategic pivot for the NHS. Ruth’s emphasis on community engagement, recognising nuances in data and partnership over prescription signal a future where success depends on collaboration and adaptability.
For industry partners, this means rethinking traditional engagement models:
Design for prevention and early intervention: Ruth’s call to break the “hamster wheel” of demand management highlights the need for solutions that anticipate health needs rather than react to crises
Bring local intelligence to the table: As Ruth noted, headline metrics miss the real drivers of health outcomes. Industry can add value by providing granular insights that link social determinants to clinical and financial impact
Champion digital equity: Ruth stressed that digital tools free up capacity but risk widening inequalities. Industry must innovate responsibly, ensuring technology enhances access rather than creating new unintended barriers