How do we deliver truly integrated, outcomes-focused care as part of Neighbourhood Health?

On 1 December, IMPOWER and Hill Dickinson brought together senior leaders from across the Yorkshire health and care system for a roundtable, chaired by Dame Barbara Hakin. The session explored one of the most pressing questions facing health and care today: how do we deliver truly integrated, outcomes-focused care at the neighbourhood level? 

The conversation was clear: place matters, neighbourhoods deliver. While strategic planning often sits at the place level – aligned with local authority boundaries – the real work of improving lives happens closer to home. It’s in GP surgeries, pharmacies, and living rooms where health and care intersect most meaningfully. For populations of 30,000 – 50,000, neighbourhoods are the beating heart of transformation. 

Why Neighbourhoods? 

Participants agreed that neighbourhoods offer the scale and intimacy needed to make a difference. They allow services to be coordinated around people, not institutions. But this requires flexibility – working at both micro (neighbourhood) and macro (place) levels depending on the challenge. Crucially, health partners must catch up with local authorities and the voluntary sector, who have long understood the power of collaboration at this level. So, what shifts are needed? 

Integration beyond healthcare 

True integration means more than aligning services. It demands shared resources, pooled budgets, and co-located teams. It also means recognising that housing, benefits, and social connection are not “wider determinants” – they are the determinants. Social care too plays a critical role in neighbourhood models, particularly in areas like reablement and discharge planning. 

Culture change: from permission to empowerment 

One of the strongest themes was cultural. Leaders called for a shift from siloed, risk-averse behaviours to a culture of trust and psychological safety where forgiveness trumps permission. Empowering frontline teams with “freedoms within frameworks” is essential for morale, retention and innovation. Leaders must use their empathy advantage to create space for bold decisions and collaborative action. 

The pandemic showed what’s possible when urgency breaks down barriers. Today, financial pressures could serve as a similar catalyst. No single organisation can deliver improved outcomes alone. Collaboration is not optional, it’s existential. 

Making resources work harder 

Frustration around resource transparency was palpable. How much money and workforce is currently deployed at neighbourhood level? Without clarity, it’s hard to plan or reallocate effectively. The group urged pragmatism: start by rebalancing what we have, rather than waiting for new funding that may never arrive. 

Focus on outcomes, not just activity 

The tension between short-term performance targets and long-term prevention is real. But leaders agreed: we must start small, with a handful of meaningful outcome measures – avoidable admissions, long-term condition management, end-of-life care – and build from there. Stability in priorities and plans over three to five years is critical. 

Five priorities for action 

The roundtable concluded with five clear calls to action: 

1. Commit to a shared ambition for neighbourhood health across health and social care. 
2. Focus on a small number of outcomes that matter to communities. 
3. Empower local teams to act and innovate – launch a small number of targeted pilots now. 
4. Strengthen existing place-based forums for action – where do we update on progress, unlock blockers, share what is working. 
5. Lead boldly and support each other to take risks. 

The time to act is now. As one participant put it: “Don’t wait for new guidance or funding – just get on with it.” There are already examples of neighbourhood collaboration delivering results. The tools exist. The appetite is there. What’s needed now is courage, clarity and commitment. 

At IMPOWER, we believe better outcomes cost less. We’ve spent decades helping health and care systems operationalise integrated models that work. If you’re ready to turn ambition into action, let’s start the conversation.