Neighbourhood healthcare cannot be delivered without relationships and data

Neighbourhood health cannot be achieved without local relationships and data, a general practice leader has said.

GP and Rochdale peer ambassador for modern general practice Dr Zalan Alam said that prescriptive models are ‘blunt instruments to create change’ and underlined that neighbourhood health needs to be designed around patient groups.

Speaking at the Pulse PCN London 2026 conference last week, Dr Alam discussed insights from the National Neighbourhood Health Implementation Programme (NNHIP) in Rochdale, one of the first 43 sites selected to roll out neighbourhood health services and tackle health inequalities.

Dr Alam said the teams in Rochdale, Greater Manchester, had used data to identify their main areas to focus on and that strong relationships had been vital to implementing neighbourhood services.

During his speech, Dr Alam said that, about ten years ago, the team recognised the need to address health inequalities, highlighting deprivation in the area.

By using an outcome-based framework that focused on intermediate care and interface working with general practice, his team was able to deliver ‘significant reductions in admissions of frail and elderly patients into hospital’.

Dr Alam also told the conference that as his team started to work at a neighbourhood level, issues were being addressed through ‘simple co-location and conversations in the corridor’.

'Small issues were being rapidly addressed, and what we were seeing was a rapid reduction in length of stay,' he said.

He added: ‘For us personally, we identified making a more integrated system where the provision of the service is more uniform proactively, plus addressing frailty were our main areas of focus, and that was driven by data.’

‘If you don't have the relationships and you don't have the data, you are not going to be able to achieve anything.'

The creation of a neighbourhood health service and shifting care out of hospitals is a key pillar of the government’s 10-Year Health Plan, which includes developing new integrated neighbourhood teams and opening 250 neighbourhood health centres across the country.

Dr Alam also said it was important to identify the patient groups that neighbourhoods should support and that resources needed to follow what patients need.

He added that because about 80% of neighbourhoods would behave the same, but 20% have local differences that need to be adapted for this means the model cannot be too prescriptive.

‘If you're going to talk about neighbourhoods, well, the design of that neighbourhood should follow whatever the neighbourhood says,’ he said.

‘So prescriptive models always have that problem. They're blunt instruments to create change.

‘And what I would say is that if you don't know what your patient group is, you're never going to address the issue.

‘And if your resources do not follow the alignment of what your patients need, then what was the point?,' Dr Alam said.

He added that as new multi and single neighbourhood contracts are developed he is hoping there will be flexibility to adapt to local needs.

‘Like everything else, there needs to be flexibility in the system, and I think that will apply to the single-neighbourhood model and the multi-neighbourhood model contracts as well, because you will have some areas where something is bigger than a neighbourhood, but it's not big enough to be a multi-neighbourhood but that's all the people in that area.

‘So, you're going to have to adapt for those things and I think, I'm hoping as policy design goes into this in more detail, they will allow a greater level of flexibility,’ he said.

When asked his view on whether primary care networks (PCN) will need to be aligned with neighbourhoods, Dr Alam said that, for neighbourhoods to work, PCNs need to be fully aligned as well as integrated with other services in the area.

‘But I think equally, for a PCN to work in the neighbourhood, it also needs to integrate with the other services in that area,’ Dr Alam added.

‘So, you can't do one without the other, if you're fully aligned but you're not integrated into your community and have brought in the other services, like the voluntary sector and other things, I don't think it makes a difference. You're just essentially addressing one part of the problem.’

He added: ‘You can't do it without actually treating it as a whole system.’

The new DES contract, published in March, said that PCNs will need to better align their patient lists with neighbourhood boundaries, though this was not intended to disrupt ‘well‑functioning PCNs with geographically contiguous boundaries’.

Pulse PCN is coming next to Birmingham on Wednesday 10 June.