Neighbourhood health is rapidly moving from policy ambition to delivery priority. As systems explore how to provide more care closer to home, the focus is shifting from what neighbourhood health should be to how it can be successfully delivered.
At Healthcare Estates 2026, Willmott Dixon convened healthcare, local government, and industry leaders to explore the opportunities and challenges ahead. The roundtable discussion highlighted four key themes: keeping clinical need at the heart of decision-making, strengthening collaboration, engaging primary care, and creating funding models that support long-term transformation.
Keeping clinical need at the heart of neighbourhood health
With significant attention on the ambition to deliver 250 Neighbourhood Health Centres by 2035 (with 120 open by 2030), participants stressed the importance of remaining focused on the programme's ultimate purpose: improving patient outcomes and delivering care in the right place.
While estate investment will play a crucial role in enabling new models of care, participants agreed that decisions should continue to be driven by clinical need, service transformation, and an understanding of local population health challenges. The starting point should be how services and patient pathways need to evolve, with the estate responding to those requirements rather than leading them.
Every community faces different challenges and opportunities, meaning neighbourhood health solutions should be shaped by local need. In some locations this may involve repurposing existing assets, while elsewhere new facilities will be required.
There was broad agreement that where a new build solution has been identified, greater consistency in design principles, delivery models, and procurement approaches will help improve efficiency, reduce timescales and create greater programme certainty. This is the thinking behind our CURA platform: a library of pre-designed components that gives the speed and cost certainty of standardisation, while allowing each centre to be configured around its local services and setting.
There was also a strong reminder that success should be measured not by the number of centres delivered, but by whether neighbourhood health improves access to care, supports earlier intervention, and creates better outcomes for local communities.
Collaboration will determine success
A clear theme throughout the discussion was that neighbourhood health cannot be delivered by any single organisation acting alone.
Participants highlighted the need for stronger collaboration across integrated care systems, providers, primary care, local authorities, community organisations, and delivery partners. Acute providers were identified as an important part of this conversation. If neighbourhood health is intended to support a shift in care away from hospital settings, hospitals must be involved in shaping that future from the outset.
Local authorities were also recognised as critical partners, with neighbourhood health creating opportunities to align healthcare delivery with wider priorities around housing, regeneration, wellbeing and community resilience. The new £125m Derelict Buildings Fund announced in Budget 2026, which will help councils transform derelict buildings into what their communities need, ‘from health centres to civic spaces’, gives them a further lever.
David Atkinson, Director of Development & Investment at Willmott Dixon Developments, reflected that neighbourhood health has the potential to become a powerful catalyst for place-based regeneration.
The challenge is bringing together partners with different objectives, timescales, and funding pressures behind a shared vision that delivers lasting benefits for communities.
Bringing primary care on the journey
Primary care featured prominently throughout the discussion, with participants recognising the essential role GPs will play in successful neighbourhood health models.
As trusted healthcare providers, GPs have valuable insight into local needs and patient experience. Participants agreed primary care must be involved early in shaping neighbourhood health plans rather than being consulted once proposals are developed.
However, the conversation also acknowledged some of the structural barriers to collaboration. GP practices operate under an independent contractor model and are often responsible for their own premises, meaning there can be understandable caution around changes to established operating and funding arrangements. Neighbourhood health programmes will need to demonstrate clear benefits for primary care and create incentives for collaboration.
Funding the transition
Funding generated some of the most candid discussion of the session.
While participants were aligned on the long-term benefits of neighbourhood health, there was recognition that achieving transformation requires not only investment, but greater clarity around how that investment is structured and delivered.
A key challenge discussed was where investment sits within the system and the implications of different funding and ownership models. Considerations around on-and off-balance-sheet arrangements can significantly influence decision-making, shaping how organisations assess affordability, risk, and long-term value. The 2025 Budget’s confirmation that neighbourhood health PPPs will be budgeted as if on balance sheet makes that question more pressing, not less.
Participants also noted that the benefits of neighbourhood health are often shared across multiple organisations, while investment decisions are frequently made within individual budgets. This can make it difficult to align investment with the wider system outcomes neighbourhood health is designed to achieve.
A clear commitment to neighbourhood health delivery through visible pipelines, predictable routes to market, and stable delivery models would give confidence to delivery partners and investors looking to commit over the long term.
Ultimately, participants agreed that capital alone will not deliver neighbourhood health. Workforce planning, service redesign, and operational transformation must sit alongside estate investment if new models of care are to succeed.
From discussion to delivery
The roundtable concluded with a sense of optimism. There is no shortage of ambition for neighbourhood health. The challenge now is translating that ambition into action.
That means bringing partners together earlier, creating funding mechanisms that support collaboration, and providing the confidence to attract long-term investment. Private sector delivery partners called clearly for earlier engagement, drawing on the NHS LIFT model where the private sector played a key role in helping public sector partners shape development opportunities, from assessing clinical need and identifying suitable existing assets through to sourcing sites for new facilities.
That call reflects our own experience. Willmott Dixon delivered 16 community health centres through NHS LIFT, and the lesson that has stayed with us is that the most successful centres were shaped before a design brief existed, when clinicians, commissioners, local authorities, and delivery partners worked through the service model together. The government has said the new PPP model will build on lessons from past models, including LIFT. Early engagement should be one of them.
It also means striking the right balance between consistency and flexibility, adopting standardised approaches where they can accelerate delivery and improve value, while ensuring solutions remain rooted in local health needs.
Neighbourhood health represents a significant opportunity to reshape healthcare delivery for future generations. Realising that opportunity will require collective leadership, shared accountability, and a commitment to working across traditional boundaries.
The ambition is clear. The next step is delivery.
Find out more about Willmott Dixon’s approach to Neighbourhood Health Centres at willmottdixon.co.uk/expertise/neighbourhood-health-centres-