Neighbourhood working
The government’s Fit for the Future: 10 Year Plan for Health in England (2025) marks a decisive shift in how health and care will be organised. At the heart of the plan is the creation of a dedicated "Neighbourhood Health Service”, designed to be more responsive, proactive, and closer to people's homes.
Neighbourhood working isn’t a new way of working, but delivering it at scale is. For the last 6 months we’ve been researching and spending time with teams on the ground already delivering neighbourhood working, to understand what’s working, what isn’t and what is needed to deliver a Neighbourhood Health Service.
Our reports offer insights into neighbourhood working exemplars (both locally and abroad), analysis of the digital and data challenges facing teams, and a digital operating for how teams can communicate, coordinate and act.
Three distinct emerging structural archetypes:
Drawing on NHS England’s Neighbourhood Health Guidelines (2025/26), neighbourhood health brings together general practice, community and mental health, acute, social care and the voluntary sector to deliver joined-up, proactive care for populations of around 30,000–50,000 people, usually aligned to Primary Care Network footprints.
The aim is to dissolve organisational boundaries and create one team with shared accountability for the health and well-being of its community. This model recognises that poor health is often driven as much by housing, loneliness or unemployment as by clinical issues. By connecting medical, social and voluntary support around each person, neighbourhood health offers the most human and locally responsive version of the NHS yet conceived.
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International exemplars
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International exemplars
Ribera Salud (Valencia, Spain)
The "Alzira model," pioneered by the Ribera Salud group in Valencia, is a radical example of a fully integrated public-private partnership that aligns financial incentives around population health.
Under the Alzira model, a single private provider is given a long-term contract and a fixed annual capitation payment for every person living in a defined geographical area. In return, the provider is responsible for delivering the full range of primary, secondary, and specialist care for that entire population. The provider only makes a surplus if it can keep its population healthy and out of expensive hospital settings. This creates a powerful, built-in incentive for prevention, efficiency, and integration. The model is underpinned by a unified digital system that provides a shared patient record across all services
Cityblock (New York, USA)
Cityblock Health is a US-based care organisation reimagining how healthcare is delivered to people with complex medical, behavioural, and social needs. Founded in New York in 2017, Cityblock combines local “community hubs” with a powerful digital platform that connects clinicians, care coordinators, and social workers around each person’s needs. Its model focuses on proactive, personalised care - supporting people in their homes and communities rather than hospitals.
Cityblock operates on a value-based, capitated payment model, meaning it is rewarded for improving outcomes and reducing avoidable hospital use. The result is a holistic, data-driven approach that delivers better health, greater equity, and a more human experience of care.