On Wednesday 23rd September, Akeso hosted a Roundtable bringing together voices from across the North of England, representing the health system, VCSE, commercial partners and beyond to discuss neighbourhood models. Our attendees delivered a rich and insightful discussion on what it takes to implement genuine neighbourhood working, involving partners far beyond just healthcare (including education, charities, local authorities, private sector and central government) to drive the health and wellbeing of communities across the country.
The messaging was clear: making this policy ambition a reality must start from the insight, relationships and assets already present in neighbourhoods. VCSE groups, anchor organisations and local partnerships are central to this shift because they hold trust, understand household and community context, and can reach people earlier than statutory services often can. To make this happen, system structures need to enable, rather than constrain, neighbourhood working. The task now is not only to design better local models, but to shift power, incentives and stewardship so local relationships can shape, test and sustain practical change.
Key Insight
- Community voice must shape the model from the start. Neighbourhood solutions should be relationship-based, and designed with and around real communities, not administrative boundaries. Co-production needs to shape priorities, delivery and accountability, not simply validate decisions already made. This doesn’t need to happen from scratch. People already embedded in communities hold a wealth of insight that should be harnessed.
- VCSE actors, anchor organisations and local partnerships are core infrastructure. These organisations hold trust, local intelligence and practical routes into communities, particularly for people further from statutory services. Attendees noted a worrying contradiction, where the system often relies on these assets while continuing to underfund and undervalue them.
- Neighbourhood working should support whole people and households, not isolated conditions. Family, school-based and place-based approaches can identify needs earlier and stitch support around people’s lives. This requires basic frameworks, but enough local nuance to reflect different community realities.
- Initiatives need time and space to develop. Evidence matters, but systems also need space to test, learn and adapt rather than wait for perfect proof. Short-term funding risks weakening the community infrastructure that people depend on.
- Current structures create an uphill battle and need to be disrupted. Fragmented governance, unclear definitions, contractual constraints, organisational boundaries and misaligned financial incentives all make collaboration harder, even where local partners have strong intent. Often, they still discourage investment in services beyond hospital walls. This is why we need to be bold and disruptive to drive change, even if it feels uncomfortable.
- Leadership requires national clarity and local stewardship. Participants wanted clearer national signals on policy, accountability and enabling conditions, while also stressing that local leaders and communities should not wait for permission to build relationships and act.
You are not powerless as leaders, don’t wait for direction from on high, have the conversations that matter at the tables where you sit.
If you would like to find out more about our Neighbourhood Roundtable or be invited to future roundtables and events hosted by Akeso please contact andrew.paterson@akeso.co.uk
