A few weeks ago, Place Matters and UK Community Foundations (UKCF) convened colleagues from community foundations, the NHS, public services, social investment, philanthropy and the voluntary sector to explore a deceptively simple question: what does it take to make neighbourhood health work in practice?

I say “deceptively simple” because nobody in the room needed convincing that people should have greater control over their health, that prevention is better than cure, that people should spend as little time as possible in hospital, etc - basically the reasons behind the Government’s neighbourhood health agenda. But we had to wrestle with why it is so hard to deliver consistently at scale. The answer, from the energy and honesty in the room, was clear. Neighbourhood health cannot be delivered to communities from the outside. It must be created with communities, through the relationships, infrastructure and long-term investment that allow people and organisations in a place to act together. For Place Matters, this is familiar territory.

I was inspired by what is already happening

We heard from community foundations that featured in the Preventative Power report published last year - addressing young people’s mental health in Surrey, community recovery fund in Bedfordshire & Luton, and targeting health inequalities in Essex, Wiltshire & Swindon. Point North and Northern Cancer Alliance told us about community-led cancer support across the North East, delivered through three different community foundations. Cumbria Community Foundation told us about Well@Home, which has spent five years quietly keeping people well after they leave hospital, refining itself year on year even as the evidence of what it achieved wasn’t quite matched by the funding.

Social Finance and Macmillan Cancer Support walked us through what their partnership with government, socially-minded organisations and social investors has built, from a £12 million Care and Wellbeing Fund through to a £36 million End-of-Life Care Fund, both of which reduced hospital use in people's last year of life. What struck me wasn't just the scale of impact but the lessons learned: partner with communities on equal footing, design around the gap in the local system, give teams permission and headroom to test, and make outcomes measurable and meaningful. It is a great example of blended funding achieving results for people and for health systems.

One of the stories that will stay with me was from the National Neighbourhood Health Implementation Programme (NNHIP) Wave 1 in Barking & Dagenham. We heard about a man with asthma supported by a physiotherapist who happened to know the right community organisations, and by a local authority that helped him find a hostel place to start rebuilding his life. No single organisation did that. It was the connections between them (the hospice, the grassroots groups, the council, the health service) that made the difference. That’s the whole argument for neighbourhood health in one sentence, and it’s also a difficult thing to fund, because “the connections between organisations” doesn’t fit neatly into anyone’s budget line.

I got some new insights

Agreeing what to measure is harder than delivering the service. Two different breakout groups, working on completely different case studies, arrived at almost the same sentence independently.

Language is not insignificant - it conveys profound meaning. If instead of “discharge” we talk about “people returning home” it feels as if we want a good outcome for them rather than to unburden ourselves, which is not very friendly! Another example was replacing “social determinants of health” with “building blocks of health”, which community members would find easier to engage with.

American Anthropologist, Margaret Mead said "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has." It is true. We can actually deliver on the ambitions of neighbourhood health.

What we’d like to see more of?

The workshop closed with a clear appetite to move from describing the promise of neighbourhood health to creating the conditions that allow it to work in more places. Three things stood out.

Investment in the infrastructure of partnership. If we want collaboration, we need to fund the capacity that makes collaboration possible: convening, governance, shared learning, data-sharing, community engagement and trusted local intermediaries.

Funding models that reflect how change happens. Prevention and community-led work often create value before they create cashable savings. That means grants, public funding, philanthropy and social investment need to work together over longer timeframes.

Spreading learning while respecting the uniqueness of place. There is a real opportunity to share tools, principles and practice between places. But the goal should not be to copy-and-paste a single model. The goal should be to understand the conditions that help locally rooted partnerships thrive.