Health starts in communities: Reflections from the Health Devolution Commission

The government's vision for neighbourhood health is one of the biggest opportunities in a generation to rethink how we improve people's health and wellbeing.

‍

At the recent Health Devolution Commission, leaders from national government, the NHS, local government, academia and the voluntary sector came together to discuss how that ambition becomes reality. The discussion focused on the government's Neighbourhood Health Framework, and, importantly, the conditions needed to make neighbourhood health work.

‍

NAVCA was invited to provide the voluntary and community sector perspective. Our message was simple: the ambition is right, but the delivery conditions are not yet in place.

‍

Relationships are infrastructure

‍

A key message we shared at the Commission was that neighbourhood health cannot simply become another NHS redesign programme. Communities do not experience life through NHS operating models. They experience places, relationships and the wider factors that shape their health every day. If neighbourhood health becomes primarily a programme of clinical redesign, we risk missing the very thing that makes neighbourhoods healthy in the first place.

‍

Local infrastructure organisations connect hundreds of community groups with local government, the NHS and wider partners. Those relationships take years to build. They create trust and collaboration, and generate community intelligence that formal data alone cannot provide. But they also require investment.

‍

If neighbourhood health is serious about shifting from treatment to prevention, we need to invest not only in services, but also in the organisations, partnerships and community assets that create health in the first place.

‍

Health doesn't start in hospitals

‍

Our key theme was that health starts long before someone walks through the door of a GP surgery or hospital. Every day, local voluntary and community organisations create the conditions that help people stay well.

‍

They help people build friendships. They reduce loneliness. They support employment. They improve confidence. They provide trusted spaces where people feel connected.

‍

These aren't optional extras, they are fundamental building blocks of healthier communities.

‍

That is why we have developed two new infographics that capture this story.

‍

Health starts in communities

‍

Our first infographic illustrates how local community organisations help create healthier neighbourhoods.

‍

By enabling connection, purpose and belonging, community organisations strengthen social networks and social capital. Those stronger relationships improve wellbeing and resilience, reduce loneliness and isolation, and ultimately reduce reliance on formal health and care services.

‍

It is a reminder that investing in grassroots organisations is not separate from health policy; it is health policy.

‍

‍

Health starts with strong foundations

‍

Our second infographic looks beyond health services altogether.

‍

It shows how the wider social determinants of health; education, employment, housing, transport, community networks and access to services; create the foundations on which good health is built.

‍

Local voluntary, community and social enterprise (VCSE) organisations are uniquely placed to work across these areas because they are rooted in communities.

‍

‍

Looking ahead

‍

The Health Devolution Commission discussion reinforced something we've heard consistently over the past 18 months; that there is growing agreement about where we want to get to. The next challenge is creating the conditions that allow neighbourhood health to succeed.

‍

That means involving communities from the very beginning, sharing power rather than simply consulting, valuing community intelligence alongside population health data, and recognising that healthier neighbourhoods are built through relationships as much as services. These themes were echoed throughout the Commission discussion, alongside calls for genuine partnership between the NHS, local government and the voluntary sector.

‍

Neighbourhood health will not be achieved by health services alone.

‍

Because, quite simply, health starts in communities.

‍

You can also click here to see our infographics of which start to explain the VCSE sector.