I’m a fan of Neighbourhood Health, not only as a concept, newly coined by Government as a cornerstone of the NHS’s future direction, but as an actual way of working. After all, I’d argue that I’ve been delivering a neighbourhood health approach as an innate part of working in the voluntary, community and social enterprise (VCSE) sector for the past 25 years.
Everywhere I turn, terms such as Neighbourhood Health, place-based working, community partnerships and integrated care are being discussed. From where I’m sitting, however, I find myself encouraged, puzzled and increasingly concerned.
I’m encouraged because the principles underpinning Neighbourhood Health are absolutely sound. People do not experience their lives through organisational boundaries. Health is shaped by relationships, connection, housing, finances, activity, purpose and community. Supporting people where they live, through trusted local networks, is undoubtedly the right direction of travel.
I’m puzzled, and occasionally frustrated, because for many charities this is not a new approach at all. It’s simply how we’ve always worked. VCSE organisations have long been embedded in communities, building trust, understanding local need and joining up support around individuals. We have spent decades working across organisational boundaries because people needed us to, not because a framework, strategy or policy told us to.
And I’m increasingly concerned because there is a growing, often unspoken, cost to delivering Neighbourhood Health from a charitable perspective.
To be a good partner, charities are expected to attend meetings, contribute local intelligence, co-design solutions, participate in workshops, build relationships and support system priorities. All of this requires time, expertise and money. Yet there is rarely any guarantee that this investment of charitable resources will translate into funding, contracts or sustainable support for the organisations making those contributions.
The assumption often seems to be that charities will continue to turn up because it’s the right thing to do.
And we will. Our communities deserve nothing less.
But perhaps it’s time to ask a more challenging question. If the NHS increasingly recognises that neighbourhood-based, community-led approaches deliver better outcomes, why is so much of the cost of developing those approaches still being absorbed by the voluntary sector?
Perhaps the real test of Neighbourhood Health is not whether charities can support the NHS, but whether the NHS is prepared to invest in and sustain the organisations that have been delivering neighbourhood health long before it had a name.
If Neighbourhood Health truly represents the future of health and care, investment must follow rhetoric. Partnership cannot simply mean asking charities to contribute their expertise for free. It must mean recognising, valuing and resourcing the community infrastructure that makes neighbourhood working possible in the first place.
After all, if we’re serious about building healthier neighbourhoods, supporting the organisations that already live and breathe this approach every day seems like a good place to start.
Written and contributed by Liz Murray, Head of Active Ageing, Valley Leisure Ltd
Written By: HIVCA
