Neighbourhood Health Framework published by Government and DHSC

The Department of Health and Social Care has published its Neighbourhood Health Framework, detailing how the Government’s shift from hospital to community care will begin to work in practice.

The framework aims to clarify what ‘neighbourhood health’ is, set out the challenges it should address, and establish clear metrics for success.

It also defines the roles of integrated care boards (ICBs), local authorities, health and wellbeing boards, and other partners crucial to the development and implementation of a neighbourhood health service, within the new model.

The neighbourhood health plan aims to create an environment where local services, working within the NHS and wider health and care system, are able to deliver care within communities, meeting local need whilst being delivered and funded in a consistent way, the framework said.

The concept of a neighbourhood health service has been tested through a “plethora of inspiring pilot programmes” both within the NHS and in the wider healthcare system in recent years, minister for care, Stephen Kinnock MP, said in his introduction to the framework.

Kinnock also noted that the framework would be regularly updated as learnings come to light.

Speaking in the House of Commons on Tuesday 17 March, Kinnock outlined next steps that should be taken by the NHS and local government to deliver neighbourhood health.

“Neighbourhood health is at the heart of the 10 Year Health Plan,” Kinnock said.

He reiterated that this means shifts from hospital to community, treatment to prevention, analogue to digital, and that “neighbourhood health is pivotal to all three.”

“The shift to a Neighbourhood Health Service will ensure services are easier for people to access and professionals to deliver, with multi-disciplinary teams that work together to reach people earlier, support them to stay well and live independently, and prevent needs escalating,” he added.

Kinnock emphasised that “this joined-up approach will deliver more preventative, personalised, and digitally enabled care.”

He acknowledged that there are already strong examples of neighbourhood health working across the country, and that he hopes the Neighbourhood Health Framework will provide the consistency and clarity needed for healthcare leaders to scale-up services in their areas.

What is in the Neighbourhood Health Framework?

The framework is divided into sections covering how the success of neighbourhood health will be measured, how it will be delivered, who will provide the service and who the workforce will be, and how neighbourhood health will be financed.

The framework defines neighbourhood health, including community healthcare and outpatient services, as a model that puts people at the centre of how health is delivered.

The framework will approach this by improving patients’ health outcomes and reducing health inequality, organising services around patient need in a more joined-up way, and reducing pressure on services such as hospitals.

The healthcare system in England has skewed towards hospitals over the past decade, the framework identified, “with significantly greater spend and investment in hospitals rather than in primary and community care.”

The challenge is to change this, the framework emphasised.

The framework also noted that it fits within the Government’s wider agenda for the redesign of public sector services to integrate around people’s lives, improve long-term outcomes through a focus on prevention, and devolve power to local areas, “which understand the needs of their communities best.”

Three major changes – covering the governance structures to help neighbourhood health succeed, delivering guidance to create both a common description of neighbourhood health and a common set of outcomes and metrics, and information on financial incentives designed to support acceleration of change – are outlined in the framework.

The three changes were committed to with the publication of the Medium Term Planning Framework in October 2025.

Guidance for ICBs and goals for the NHS

The Neighbourhood Health Framework sets out a minimum set of interventions that all ICBs should follow over the next three years, underpinned by “common-sense actions that work well everywhere,” Kinnock said in his House of Commons statement.

The framework notes that ICBs and local authorities will need to agree on how neighbourhood health can deliver measurable benefits and how these might develop over time and address local priorities and health inequalities that have already been identified, working closely with health and wellbeing boards.

In terms of delivery, ICBs will be expected to improve services for patients who need routine healthcare, improve proactive care for people with complex needs, and deliver better alternatives to hospital care.

Routine healthcare reform includes a greater role for pharmacists and improved technology, including in terms of diagnostics, for GPs.

Data sharing between neighbourhood health services and secondary care will also be improved as part of this process, the framework said.

“ICBs need to reform services based on what’s right for their local population, and what the frontline tells them needs to change,” the framework said.

In total, the framework lays out 10 core steps that local governments and ICBs will be expected to facilitate in 2026–2027.

Work done in 2026–2027 will lay the groundwork for actions to be taken in 2027–2028, when local Neighbourhood Health Plans are expected to be created.

Neighbourhood Health Centres are central to the Government’s plans, and the ambition is for there to be a Neighbourhood Health Centre in every community, Kinnock said.

The Government is aiming for 120 Neighbourhood Health Centres by 2030, and 250 by 2035.

Five minimum goals for the NHS to work on by March 2029 are also identified within the framework:

• Improving health outcomes, with housebound patients, care home residents and those with diabetes identified amongst the patients being prioritised
• Improving access to general practice
• Improving experiences of planned care
• Better urgent and emergency care performance
• Improving patient and staff satisfaction.

All five goals are underpinned by objectives and metrics, based on a 2025 – 2026 baseline.

Kinnock emphasised that the current healthcare system is siloed, and that the people working within it will be central to the culture change that is required to ensure a multidisciplinary service that delivers “seamless, integrated, person-centred care.”

“The framework is designed to create the conditions for local leaders to succeed, giving them the flexibility to design services that best meet the needs of their local communities,” Kinnock said.

He added that a 10 Year Workforce Plan, to be published later in 2026, will help to inform local NHS workforce plans, whilst a National Neighbourhood Health Implementation Programme will build capability and identify success criteria for the scaling of new neighbourhood health models.

The concept of neighbourhood health will also be prioritised in other national reform agendas, including Best Start Family Hubs, Pride in Place initiatives, Local Get Britain Working plans, and WorkWell, Kinnock said.

Optometry in the Neighbourhood Health Framework

Whilst optometry is not directly referenced as part of the current neighbourhood health plans, the framework acknowledges that the eye health profession does have a role to play.

Optometry will be considered in the coming years as plans develop, the framework said.

The framework reads: “Over the next few years, we will look at how we can support other important services to effectively contribute to neighbourhoods, such as community pharmacy, dental services, optometry, learning disabilities and neurodiversity services and others.

“In the meantime, important reform agendas will continue to improve services in these areas.”

The framework also emphasised that ICBs are welcome to work with optometry and other identified services “further and earlier,” if they wish to do so.

Dr Peter Hampson, clinical and policy director at the AOP, said: “We are currently analysing the full implications of what is contained within the Neighbourhood Health Framework, how it may affect members and we will share a policy briefing in the next few days. 

“Our initial impression is while there is clearly plenty of ambition in the wider sense, in terms of utilising the skills and expertise that the optometry profession can bring to the wider NHS, this feels like a missed opportunity. Why wait until a subsequent phase of transformation, when our profession is ready to help deliver the aims of the 10-Year Health Plan today?”

The Neighbourhood Health Framework can be read in full here.

Read more

Policy briefing: Neighbourhood Health Framework

The AOP’s summary – and what it means for optometry