Turning neighbourhood health from policy into practice

There is now clear national momentum behind neighbourhood working as the foundation for prevention and improved population health. The Government's new neighbourhood health framework signals a shift towards services organised closer to communities, with stronger integration between the NHS, local government, mayors and strategic authorities, and the voluntary, community, faith and social enterprise sector.For local systems, the question is no longer whether neighbourhood working is the right direction. The challenge now is how to make it deliver in practice.Across Cheshire and Merseyside, we recognised early that responding effectively to this shift required a shared approach across places and partners. Through All Together Fairer, our Marmot-led collaborative programme, we have developed an evidence-based framework to support the creation of neighbourhood health plans across our subregion.The framework builds on our long-standing commitment to tackling the social determinants of health and draws on the wider All Together Fairer programme endorsed by all nine Health and Wellbeing Boards. This is crucial as these very same Health and Wellbeing Boards will also play an important role in local oversight of neighbourhood health plans, helping ensure delivery is shaped through strong partnership between a wide range of partners. All Together Fairer Neighbourhoods is not a new programme layered onto existing structures, it provides a practical foundation to help translate national ambition into locally led action, a challenge many systems will now recognise. Its development reflects coordinated leadership across our nine Directors of Public Health working alongside the Integrated Care Board and public health teams across the subregion, with particular leadership from Mike Bridges, Consultant in Public Health at Warrington Borough Council.Neighbourhoods are where services meet communities, where prevention can happen earlier and more effectively, and where local leadership can make the greatest difference in addressing the wider determinants of health.Like many areas, Cheshire and Merseyside faces persistent inequalities, rising demand and constrained resources. As neighbourhood approaches matured locally, it became clear that without shared guiding principles there was a risk of fragmentation. A common framework helps partners align around population need while still supporting local flexibility.The emerging model set out in the NHS's Fit for the Future: 10 Year Health Plan for England provides clear national direction. The task locally is to organise delivery in ways that turn integration in principle into a genuine one-team approach in practice.The Government's ambition to establish a neighbourhood health service, alongside investment in neighbourhood health centres, creates further opportunity. As this develops, it will be important to ensure new investment aligns with and strengthens existing community assets and neighbourhood infrastructure rather than unintentionally duplicating what already works locally. But neighbourhood health is not primarily about buildings, nor is it the same as neighbourhood healthcare. It is the integration of health, local and regional government and community action around prevention and the wider determinants of health that ultimately improves outcomes.Drawing on the All Together Fairer Neighbourhoods framework, several principles have proved particularly important in practice.First, neighbourhood plans must be shaped by local insight. Using neighbourhood-level data alongside lived experience helps ensure action is targeted where it will make the greatest difference.Second, prevention needs to be embedded across everyday delivery rather than treated as a separate workstream. It is most effective when it becomes part of how the whole system operates.Third, genuine community partnership is essential. Communities are not simply recipients of services; they are central partners in improving outcomes.Alongside these priorities, aligning neighbourhood plans with existing strategies and focusing on outcomes rather than activity helps strengthen what already exists locally rather than creating parallel structures.Through All Together Fairer Neighbourhoods, partners across Cheshire and Merseyside are working to translate national policy direction into practical neighbourhood delivery grounded in Marmot principles. The framework also highlights neighbourhood-level work already underway, demonstrating how prevention and equity can be embedded through locally led action.We are also pleased that this approach is endorsed by both the Cheshire and Warrington and Liverpool City Region Combined Authorities. In a joint statement, Councillor Louise Gittins, Chair of the Cheshire and Warrington Combined Authority, and Steve Rotheram, Mayor of the Liverpool City Region, said:"While national policy sets the direction, it is in neighbourhoods that real and lasting change happens. All Together Fairer Neighbourhoods reflects our shared commitment to support local leadership, strengthen prevention and work alongside communities to turn national ambition into practical action that reduces inequalities and improves health for our residents." The shift towards neighbourhood health represents one of the most significant opportunities in a generation to improve population health and reduce inequalities. If systems can organise around neighbourhoods, align partners around prevention and work alongside communities as equal partners, they have the foundations to make that ambition real.Matt Ashton, Director of Public Health for Liverpool and Co-Chair of Cheshire and Merseyside's All Together Fairer BoardIan Ashworth, Director of Population Health for NHS Cheshire and Merseyside and Co-Chair of Cheshire and Merseyside's All Together Fairer Board Helen Bromley, Director of Public Health for Cheshire West and Chester and Chair of the Cheshire and Merseyside All Together Fairer Neighbourhoods Task and Finish Group

Title

NEIGHBOURHOOD HEALTH

Turning neighbourhood health from policy into practice

By Matt Ashton, Ian Ashworth, Helen Bromley | 19 June 2026

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