How national ambition for neighbourhood health is being shaped - and what it means for the VCSE sector

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The 10‑Year Health Plan for England: Fit for the Future is the Government’s long‑term strategy for reforming health and care. It sets out both the ambition for change and the system‑level thinking about how that change may be delivered, with neighbourhood health positioned as a key way of improving outcomes, reducing inequalities and working more closely with communities.

This page explains the plan in plain English, with a particular focus on what it means for neighbourhood health in south east London and for the voluntary, community and social enterprise (VCSE) sector.

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The 10‑year ambition

The plan sets the overall direction of travel for health and care over the next decade. It makes the case for a shift away from fragmented, hospital‑centred and reactive services towards approaches that:

• prioritise prevention and early intervention
• organise support closer to home, at neighbourhood level
• address health inequalities and the wider determinants of health
• recognise that the NHS cannot improve health outcomes on its own

Neighbourhood health is presented as the level where these ambitions become real - because it is close enough to people’s lives, communities and everyday support to enable joined‑up, preventative care.

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Fit for the Future: delivery and system change

Within the same publication, Fit for the Future focuses on the delivery implications of the 10‑year ambition. It explores how the health and care system may need to reorganise itself to deliver neighbourhood health and population health approaches at scale.

This includes consideration of:

• population health delivery models
• neighbourhood and place‑based working
• partnership and collaboration across organisations and sectors
• commissioning, contracting and accountability arrangements

Where the 10‑year plan explains what needs to change and why, Fit for the Future examines the choices about how change happens in practice - choices that will shape what neighbourhood health looks like on the ground.

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Why this matters for neighbourhood health

Taken together, the plan establishes neighbourhood health as a core part of the future health and care system, rather than a short‑term programme or pilot. It reinforces the need to:

• work with whole populations, not just high‑need cohorts
• bring together health, care, local government and community support
• intervene earlier to prevent escalation and crisis
• build long‑term, place‑based capacity rather than relying on isolated services

How these principles are interpreted locally - and which partners are meaningfully involved - will determine whether neighbourhood health delivers on its promise for communities.

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What this means for VCSE organisations

For the VCSE sector, the 10‑Year Health Plan: Fit for the Future:

• strengthens the policy case for community‑led, preventative approaches
• increases expectations that VCSE organisations will play a role in neighbourhood health
• highlights the importance of trusted relationships, lived experience and local knowledge
• creates opportunities to influence design, commissioning and delivery
• also brings risks if VCSE roles are assumed rather than recognised and resourced

The way Fit for the Future is implemented locally will be particularly significant for smaller and specialist organisations, community infrastructure and workforce sustainability.

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How this connects to our work

The SEL VCSE Strategic Alliance works with the South East London Integrated Care Board (ICB) and system partners to help translate the ambitions of the 10‑Year Health Plan: Fit for the Future into meaningful neighbourhood‑level change.

We do this by:

• working with the ICB to shape how neighbourhood health is developed and implemented locally
• advocating for VCSE involvement in neighbourhood, place and system decision‑making
• bringing VCSE insight, lived experience and community intelligence into system discussions
• acting as a critical friend, questioning approaches that risk overlooking community capacity or assuming unpaid VCSE contribution

Our aim is to ensure that neighbourhood health in south east London is built on strong community ecosystems, equitable partnerships and sustainable VCSE involvement - not just new system structures.

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Read the original publication

You can read the full 10‑Year Health Plan for England: Fit for the Future on GOV.UK.

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