Care Leaders Call for Equal Partnership in NHS Neighbourhood Health Plans
Directors of adult social services have welcomed the Government’s commitment to neighbourhood health as a cornerstone of the NHS 10-year plan, but stressed that local authorities must be treated as equal partners in its delivery.
The Association of Directors of Adult Social Services (ADASS) has published a comprehensive policy statement emphasising that social care brings decades of experience in delivering person-centred support close to home—principles that lie at the heart of the neighbourhood health model.
The statement, released last month, argues that adult social care’s long-standing commitment to choice, control and community-based support, enshrined in the Care Act, positions local government as a natural leader in shaping these new services.
A Familiar Approach for Social Care
The neighbourhood health model aims to deliver care as close to people as possible, offering individuals choice and control over their support. For social care professionals, this represents familiar territory rather than new ground.
Directors point out that people consistently achieve better outcomes and use resources more efficiently when they direct their own support, rather than relying solely on traditional, professionally-led service models. This principle underpins self-directed support and the use of direct payments—tools that social care has championed for years.
The policy statement emphasises that truly effective neighbourhood health services require more than simply relocating medical services into communities. Success depends on addressing the decline in community assets and infrastructure, and investing in long-term sustainability.
Opportunities for Transformation
ADASS views the neighbourhood health agenda as an opportunity for fundamental change in how health and care services operate. By strengthening connections between statutory services and communities, and tackling social determinants of health such as housing, education and employment, the approach could create a more responsive and equitable system.
The statement highlights several key opportunities, including the potential to advance integrated commissioning, develop neighbourhood teams that bring together health and social care professionals, and empower communities to lead service design based on local insight and strengths.
At its most ambitious, the vision includes delegating budgets to place-based partnerships that bring together community health, mental health, primary care, social care and public health services, with a renewed focus on personal health budgets as a proven but underused tool.
Essential Ingredients for Success
For neighbourhood health to work effectively, ADASS outlines eight critical design principles. These include ensuring that plans are driven by local needs rather than central diktat, with variations across areas reflecting different community contexts and priorities.
Local authorities must be enabled to take leadership roles, with adequate resourcing and clear accountability across health and care partners. Adult social care’s expertise, knowledge and community connections—built over many years—must be fully recognised and utilised.
The statement calls for a genuinely shared vision across the NHS, adult social care and local government, with partners working towards common outcomes rather than pursuing fragmented initiatives that report separately.
Workforce and Resources
Developing a multidisciplinary workforce represents another crucial element. ADASS argues that equity with NHS staff cannot be achieved unless pay, terms and conditions for social care workers become more closely aligned—a change that must be fully funded.
The statement supports co-locating frontline health and social care teams in the same community premises, with appropriate funding and support for delegated health activities agreed locally with the NHS.
Financial alignment also features prominently in the recommendations. ADASS calls for NHS funding and guidance to shift focus from acute to community care, with budgets realigned to reflect neighbourhood health priorities and clear expectations set for managing system pressures such as hospital discharge.
Listening to Communities and Carers
The policy statement emphasises the importance of embedding lived experience, community voices and unpaid carers into service design and priority-setting. Crucially, it warns that care closer to home must not create unsustainable pressures on family carers, whose voices must be heard and responded to.
Investing in voluntary, community, faith and social enterprise sector initiatives represents an essential element of the preventive approach, ensuring everyone in a neighbourhood has equitable access to services.
ADASS concludes that making neighbourhood health work will depend on the maturity of local relationships, bold leadership, willingness to delegate decision-making, and genuine commitment to working together at an agreed local level—with social care as a full and equal partner every step of the way.
