What is the neighbourhood health service?

The idea of a neighbourhood health service seems to be mentioned everywhere; from the Labour 2024 manifesto, to the 10-year plan for a modernised NHS in England that was brought forward in July 2025 and most recently featuring prominently in the National Cancer Plan for England. But what does it mean and why does it matter to Macmillan?  

It is being positioned as a way to rethink how and where care happens, with the goal of shifting care out of hospitals and into communities, delivering services as locally as possible to help people live longer, healthier, and more independent lives. Many would argue that this is not a new vision but an ambition that has so far failed to be realised on a national level despite the commitment of successive governments and broad support across the health and care system.  

In this blog, we share some of the work Macmillan have been doing on this topic. We have also published a long read that goes into more detail about the neighbourhood health service and why it is important. 

Delivering the neighbourhood health service now means a shift to proactive care, rooted in communities, accessible to everyone. This chimes with our approach at Macmillan - for many years we have been supporting service provision focused on person-centred care for people living with cancer that is delivered in the way and place that best suits the needs of the individual. In that time, Macmillan has listened, tested and innovated to develop models of care and system improvements to create better experiences and outcomes.  

We think that a neighbourhood health service offers a real opportunity to move from the fragmented care pathways that many people living with cancer experience today to joined up care and services. And more recently we have been working on helping change how services are funded so more people get the support they deserve through the Neighbourhood Transformation Fund (NTF), which aligns with NHS neighbourhood health principles and focuses on local community strengths and needs.  

We have been really interested in the momentum gathering around neighbourhood health in England and our National System Change Team have been trying to understand more about how it is developing and the enablers that can support its implementation.  

The team gathered insights from some of the people in the system who are grappling with the opportunity and change that neighbourhood health brings, as well as taking the learning we've gathered from many years of working to make care more joined-up, personalised and delivered in a way that suits people best.  

We focused on how neighbourhood health is developing in England given the current emphasis placed on this by the UK government, with a specific National Neighbourhood Health Implementation Programme (NNHIP), which offers an opportunity to explore what the conditions for success are in this context. But that is not to say that England is the only nation that is focusing on neighbourhood health as a concept, for example, in Northern Ireland the Health and Social Care Reset plan 2025 commits to establishing a neighbourhood centred system and discussions about how this will work are well underway. Similarly, in partnership with Macmillan the Scottish Government has been delivering the Improving the Cancer Journey (ICJ) model to enable people living with cancer to access support in their communities and as close to home as possible. 

We brought all the insight we’ve gathered together into a long read which explores the potential of a neighbourhood health service in more detail and highlights some of the key enablers that can support its development. The piece can be found here and through a link at the end of this blog.  

During our conversations with system leaders, it became clear that there is real support for a neighbourhood health service as the right direction of travel for the health and care system. These insights, alongside what we are learning from the development of our Neighbourhood Transformation Funds, have surfaced some key themes about what might be needed to support this new way of working. The enablers covered both practical foundations, such as funding and physical infrastructure, but also more relational aspects, such as having strong relationships and trust.  

These enablers to support turning the vision of neighbourhood health into reality include: 

• Flexible funding mechanisms that reduce risk and allow investment to move from hospitals into the community. 
• Clear, collaborative accountability arrangements that avoid competition for new neighbourhood contracts and instead bring primary care, community and secondary care services, and the VCSE sector together as equal partners. 
• A workforce trained and supported for multidisciplinary, community-based practice, alongside the physical spaces and digital infrastructure that allow these teams to coordinate, share information and deliver integrated care.  
• Leaders also repeatedly stressed that shared purpose, strong relationships, and trust are fundamental underpinnings to effective working. There needs to be a locally owned vision, protected time to collaborate and develop new ways of working. 

Overall, there seems to be a real willingness to try new things to achieve the long-held ambition of reimagining how care is delivered through the neighbourhood health service. And while the challenges and barriers to doing this were discussed, there was a sense of optimism about what could be achieved locally by capitalising on this new national impetus. 

At Macmillan, we're working alongside governments across the UK as they drive forward the neighbourhood health agenda to build healthier communities and deliver more care closer to where people live. While nobody has all the answers on exactly how neighbourhood health will work, we're exploring different kinds of funding and delivery while taking part in continued discussion about how we can build the best neighbourhood health service for people living with cancer and other long-term conditions across the UK.