The ambition behind neighbourhood working in the NHS is bold, and rightly so. Neighbourhood Teams sit at the heart of integrated care, close to the communities we serve, and uniquely positioned to shape healthier futures. Yet ambition alone does not deliver change. Success demands clarity of purpose and a disciplined approach to collective action.
That is the foundation of my neighbourhood development pyramid. At its simplest: neighbourhoods need to be clear on what they are trying to achieve, and confident in how they will deliver it.
Clarity of Purpose: Getting the “What” Right
Neighbourhoods thrive when there is a shared, cross-boundary strategy. This means stepping beyond organisational lines and traditional silos. It means thinking in systems, not institutions.
To build this strategic foundation, neighbourhoods need:
- A shared vision that rises above organisational boundaries
- Digital tools used consistently and collaboratively, not in isolation
- Structured strategy development approaches to ensure direction is not left to chance
This is deliberate work. A vision does not emerge simply because we say we want one. It takes disciplined exploration, structured thinking, and a willingness to understand perspectives different from our own.
Capability in Delivery: The “How” – Turning Strategy into Reality
Once the “what” is defined, the “how” becomes paramount. Delivery is not a by-product of good intentions. High-performing, cross-boundary teams do not appear organically. They are built.
Neighbourhoods need:
- Intentional team development – because high-performing teams are created, not stumbled upon
- Proven implementation methodology – so ideas convert into sustainable change
- A culture shaped consciously, not left to drift
Culture matters because doing things differently is the essence of transformation. If we do not attend to behaviours and norms, nothing changes. Culture is how work really gets done – and when we manage it consciously, improvement accelerates.
Tools That Make the Difference
To support neighbourhoods on this journey, we provide structured, practical tools that build capability and confidence:
- System-mapping to build shared visibility across organisations
- Facilitation and coaching to strengthen trust and collaboration
- SWOT analysis and alignment to connect strengths to opportunities and confront risks with purpose
- Data capability development to support insight-driven action
- Conflict management skills and frameworks – because constructive challenge is healthy, and tension is inevitable
- Process mapping and continuous improvement methodology (including our published DMAIS framework) to bring clarity, feedback and iteration to delivery
Leadership
And woven through it all sits leadership: – the interpersonal, strategic and adaptive capabilities that allow teams to navigate complexity, remain grounded in purpose, and bring others with them.
A Continuous Commitment to Better
No neighbourhood operates in a straight line. Progress is iterative. Challenges will emerge. Conflict will surface. That is not failure, that is reality. What matters is how we respond.
Neighbourhoods succeed not because they avoid difficulty, but because they face it together, equipped with the tools, mindset, and shared commitment to move forward.
