As neighbourhood health moves up the policy agenda, attention is turning to local leadership and joined-up services. But are we overlooking the community infrastructure that underpins prevention, early intervention and wellbeing? Here, Alison Brown, our Head of Business Services’, explores why neighbourhood health needs strong neighbourhoods.

 

The NHS is placing increasing emphasis on neighbourhood health. The ambition is simple: support people earlier, closer to home and through services that work together around the needs of communities rather than organisational boundaries. As Sandra Atik, Assistant Director of Procurement at the East of England NHS Collaborative Procurement Hub recently argued, neighbourhood health works best when systems create space for local leadership, relationships and local knowledge to shape delivery.

It is a compelling vision. But there is a crucial ingredient that is often overlooked. Neighbourhood health cannot succeed without neighbourhood infrastructure.

When people hear the word “infrastructure”, they often think about buildings, roads or technology. In reality, neighbourhood infrastructure is much broader. It is the network of community assets, local organisations, volunteers, meeting spaces and relationships that help people stay connected, active and supported.

These are the things that make communities resilient long before a health professional becomes involved.

In rural Cambridgeshire, that infrastructure can be found in village halls, community hubs, lunch clubs, transport schemes, local charities, parish councils, social groups and volunteer networks. It is the trusted volunteer who notices that a neighbour has not been seen for a few days. It is the community transport driver who helps someone attend a medical appointment. It is the village hall that hosts exercise classes, support groups and social activities that reduce isolation and improve wellbeing.

Many of the factors that influence health have little to do with healthcare itself.

Loneliness, social isolation, financial insecurity, poor housing, lack of transport and limited opportunities to stay active all have a significant impact on physical and mental wellbeing. Addressing these challenges requires more than clinical services. It requires strong communities and the local infrastructure that helps people access support before problems reach crisis point.

This is why community organisations must be viewed as partners in neighbourhood health, not simply as delivery organisations on the edge of the system.

The current discussion often focuses on the relationship between national bodies, Integrated Care Systems and neighbourhood teams. As Sandra Atik notes, neighbourhood health depends on getting the balance right between national direction, system leadership and local delivery. Yet there is a risk that we concentrate on structures and governance while overlooking the community assets that make local delivery possible in the first place.

A neighbourhood team can only work effectively if there are strong neighbourhoods to work with.

That means investing not only in health services but also in the community infrastructure that supports prevention and early intervention. It means recognising the contribution of volunteers alongside professionals. It means supporting local organisations that have spent years building trust with residents. And it means involving communities in shaping priorities rather than expecting them simply to receive services designed elsewhere.

This matters particularly in rural areas. Rural communities often have fewer services within easy reach and can face additional barriers such as transport difficulties, digital exclusion and ageing populations. However, they also possess significant strengths: strong community identity, active volunteers and deeply embedded local organisations. Effective neighbourhood health models must build on those strengths rather than applying a one-size-fits-all approach.

For organisations like Cambridgeshire ACRE, this is not a new idea. Much of our work is rooted in strengthening the community assets that help people live well and independently. Whether supporting village halls, helping communities develop local solutions, tackling isolation, strengthening volunteer networks or enabling community-led initiatives, we see first-hand how strong communities contribute to better outcomes for residents.

The future of neighbourhood health will rightly involve new partnerships between the NHS, local government and community organisations. But if we are serious about moving from treatment to prevention, we need to think beyond healthcare delivery.

The real question is not simply who is driving neighbourhood health. It is whether we are investing in the community infrastructure that allows neighbourhood health to happen at all. Because healthier communities are not built solely in clinics and hospitals. They are built in the places where people meet, connect, support one another and feel they belong. And those places matter more than ever.