The Fuller Stocktake (2022) called for “integrated neighbourhood teams” to be the new default, delivering proactive, personalised, and joined-up care so it was no surprise to see the 10-year health plan set out an ambitious vision for integrated, community-based care, with neighbourhood health centres (NHCs) playing a pivotal role.
Neighbourhood health centres are the physical manifestation of the ambition for neighbourhood working. Yet too often, they are discussed in abstract terms. It’s time to answer the big questions: what should they look like, how should they run, who should run them, and where do they fit in the primary care landscape?
The Big Idea: Why Neighbourhood Health Centres?
The 10-year plan is clear: services need to shift closer to home, reducing pressure on hospitals and improving access to holistic care. NHCs are designed to bridge the gap between GP surgeries and hospital services, offering a single point of access for a range of health and wellbeing needs. But we should steer away of putting form before function. We have been working successfully with colleagues across a defined geography to support neighbourhood working without the need for a neighbourhood centre.
The physical design of a neighbourhood health centre needs to reflect its purpose: accessibility, flexibility, and fit for the needs of the community.
- Location matters: Ideally situated in high-footfall areas, close to public transport, schools, and local amenities, NHCs should feel like part of the community, not an isolated medical outpost.
- Space for collaboration: Open-plan areas for team working, alongside private consultation rooms, are essential. Think beyond the current GP model, there should be space for group consultations, community meetings, wellbeing classes, and voluntary sector drop-ins.
- Digital-first, but inclusive: Technology should underpin services, offering online booking, remote consultations, and shared electronic health records, while ensuring digital exclusion is addressed with on-site support but don’t expect technology to dramatically reduce the estate needed.
- Welcoming design: Natural light, clear signage, and family-friendly spaces can make the centre feel less clinical and more community-oriented.
At their core, these centres should deliver integrated, multidisciplinary care, bringing together GPs, community nurses, pharmacists, mental health practitioners, social prescribers, and voluntary sector partners under one roof. The aim? To make prevention, early intervention, and chronic disease management the default, rather than emergency care.
But regardless of the space provided integration is key and this is a space where integration meets reality. NHCs should be part of the established system they are operating in rather than standalone the centre must act as a hub, connecting GP practices, community services, and voluntary organisations.
Brave leadership
We have set out the case for brave leadership recognising both in theory and in practise in areas of the country that we have been supporting to develop neighbourhood working, that for a completely new model of working the leadership should not be afraid to embrace change and the services that will contribute to the health and care needs of the population that it serves. A multidisciplinary leadership team, will ensure every voice, clinical, social, and community, is heard with a determination to embrace the following:
- Flexible workforce: Roles such as advanced nurse practitioners, physician assistants, previously known as associates, social prescribers, and care coordinators are essential for sustainability.
- Population health focus: Human led, data-assisted approaches to identify at-risk groups, target interventions, and measure impact on health inequalities.
- Open-access ethos: Extended hours, walk-in capacity, and same-day care options can help meet community needs.
Who is best placed to ‘run’ the new way of working? This question sparks debate. Should it be NHS-led, local authority-led, or a hybrid? The most promising models so far are partnership-based, with PCNs taking a lead role but embedding voluntary, community, and social enterprise (VCSE) organisations as equal partners.
The accountable body is a topic of great debate, but we know that accountability for resources and outcomes needs to be developed across a number of parts of health and care systems and probably at some scale to manage the risks involved. Whatever the model, partnerships with local authorities, housing associations, and VCSE, primary, community and secondary organisations needs to be centred around communities whose first port of call for most of their care will be within a primary care network. Most importantly, co-production with communities must be baked in, not as a tick-box exercise, but as an ongoing governance role. Without shared ownership, the risk is clear: centres become top-down constructs, not trusted community assets. Transparency, community engagement, and strong clinical governance are non-negotiable. This requires a culture shift—from episodic appointments to longitudinal, relationship-based care, supported by risk stratification and social prescribing.
So where does all this sit with current primary care provision? NHCs are not a replacement for GP surgeries, they are an extension. GP practices remain the cornerstone of primary care, but NHCs provide the scale and infrastructure to deliver all that primary care encompasses, including pharmacy, optometry, dental, and mental health provision, as well as multidisciplinary services, enhanced diagnostics, and proactive care.
In short: GP practices for continuity, neighbourhood centres for capacity and integration.
Neighbourhood working is a bold step toward person-centred, community-based care. If designed well, physically and operationally, they could be the game-changer the 10-year plan envisioned. The challenge now is to make the rhetoric a reality, ensuring centres aren’t just buildings, but vibrant hubs that support the health and wellbeing of the local communities.
Dr Minesh Patel is a GP and member of the NAPC senior leadership team
