Inside Neighbourhood health: Turning policy ambition into place-based delivery

The publication of NHS England’s neighbourhood health centre (NHC) guidance and accompanying design specification in April 2026 marks a significant moment for the delivery of the 10 Year Health Plan For England 2025.

At its core, the guidance is not simply about delivering new buildings. It reflects a broader shift towards neighbourhood-based healthcare models that bring services closer to communities, support prevention and enable greater integration between organisations.

Sewell Advisory’s Jonathan Turner examines how integrated care boards (ICBs), providers and local authorities can face the challenge of moving quickly from policy ambition to practical delivery.

A framework for integrated care

The fact is most people want to access health and care services as close to home as possible, in the most convenient way, and most health and care staff want to support patients and service users in the most suitable care setting. However, for many years and despite numerous initiatives, this has not been possible.

Neighbourhood health will only be a success if it is a truly joined up effort between a wide range of partners to deliver integrated care. The neighbourhood health framework has been coproduced with leaders from primary care, mental health, community and acute providers and leaders in local government and ICBs and forms a clear blueprint for ensuring that the person is at the centre of how services are delivered.  The key aims are:

  • Improve people’s health and care outcomes, reduce health inequalities and help them stay well at home
  • Organise services around the person with more convenient, personalised and joined-up care
  • Reduce pressure on more acute services – including hospitals and care homes
  • Help the NHS to deliver against targets whilst cutting waste and duplication

To deliver these key aims services will need to be improved across the board, from people who need routine healthcare to proactive care for people with complex needs, providing better alternatives to hospital care delivered local and aligned to neighbourhood population health need.

A changing role for the NHS estate

The guidance sets out a framework for neighbourhood health centres that combine general practice, community services, diagnostics, mental health, local authority services and voluntary sector provision within accessible community settings.

In many respects, the direction of travel is familiar. The NHS has long recognised that:

  • Prevention and early intervention are more effective when services are delivered locally
  • Co-location supports stronger multidisciplinary working
  • Flexible, shared estate models improve utilisation and efficiency
  • Community-based services can improve access and patient experience

What is different is the level of detail now being provided around how systems may begin delivering these models at scale.

The guidance also reinforces that neighbourhood health is not solely an estates programme. Estate will be a critical enabler, but success will depend equally on clinical strategy, workforce planning, digital infrastructure and collaboration across organisational boundaries.

From isolated assets to neighbourhood infrastructure

One of the most notable aspects of the guidance is its emphasis on neighbourhood health centres as community anchors rather than standalone healthcare facilities.

The design specification references accessibility, civic integration and adaptable models that reflect local population need. For many systems, this is likely to involve:

  • Repurposing existing NHS estate
  • Exploring town centre and high-street opportunities
  • Co-locating services across health, local authority and voluntary sector partners
  • Aligning estate investment with wider regeneration priorities

Importantly, the guidance recognises that there is unlikely to be a single national model. Urban, rural and coastal systems will all require different approaches depending on their estate, geography and population need.

The planning challenge ahead

Although framed around neighbourhood health centres, the implications of the guidance extend far beyond individual projects.

To develop credible proposals, systems will first need a robust understanding of their existing estate, service configuration and population demand. Across many NHS organisations, estate data, utilisation insight and long-term planning remain fragmented.

As neighbourhood healthcare models develop, systems need to:

  • Establish a clear baseline understanding of estate condition, utilisation and cost
  • Map services against population need and access patterns
  • Identify duplication and opportunities for co-location
  • Prioritise investment at system level rather than organisational level

This will require much closer alignment between strategic estates planning and wider health planning than many organisations have historically developed.

Balancing ambition with deliverability

The ambition behind the neighbourhood health centre programme is significant, but delivery will take place against a challenging backdrop of constrained capital, ageing estate and operational pressure.

The systems most likely to succeed will be those that view neighbourhood health as a long-term transformation programme rather than simply a capital initiative.

In many areas, there will need to be a balance between new-build developments enabled by public private partnerships (PPP) and smarter use of existing estate, which will require targeted refurbishment and incremental service integration.

The guidance recognises this pragmatism through its emphasis on flexible and adaptable delivery models.

A defining moment for neighbourhood‑based healthcare

The neighbourhood health centre guidance signals a continued move away from organisation-centric estate planning towards more integrated, neighbourhood-based healthcare infrastructure.

Done well, neighbourhood health centres will help improve access, support prevention, reduce pressure on acute services and create more sustainable use of the public estate.

However, success will depend less on the buildings themselves and more on the quality of planning, collaboration and long-term strategic thinking that underpins them.

There are some clear timescales attached to the guidance including the 28th May 2026 when ICB’s must provide a detailed submission which will be reviewed by regional and national teams.  This submission is required to identify how neighbourhoods are defined, how the neighbourhood health centre model will be structures (including high level site level details and any associated disposals) as well as key funding information.  Organisations with the strongest estate intelligence and clearest understanding of population need are likely to be best placed to turn policy ambition into practical delivery and here at Sewell Advisory we are able to provide that support and advice to support with this process.

Sewell Advisory’s Deputy CEO Jonathan Turner brings nearly 30 years of experience in the property industry, with a proven track record working across both the public and private sectors. Jonathan has a particular interest in population health needs, clinical and strategic healthcare planning and service transformation.

This is the first in a series of articles which will look at neighbourhood health, including the detailed planning requirements and practical advice on how to deliver facilities that enable truly integrated care.