Neighbourhood working in a nutshell

What is neighbourhood working?

Neighbourhood working describes a way of working where neighbourhoods - often self-defined and often hyper-local - and statutory services, work together to improve the health and wellbeing of their population.

Neighbourhood working involves statutory and non-statutory stakeholders bringing their assets, capability, capacity and experience to a common goal. The exact membership of any neighbourhood working example may vary according to the scope and maturity of the work.

A spectrum exists of community-led interventions and service-led interventions and there are strong examples of each. Neighbourhood working exists in the middle of this spectrum, harnessing the benefits of both ends of this spectrum to improve health and wellbeing. Neighbourhood working can be a key component of, and provide valuable support to, integrated neighbourhood teams.

How is a neighbourhood being defined?

• Statutory-led examples tend to use administrative boundaries, such as primary care network geographies or local authority boundaries, but community-led examples use flexible boundaries.
• Rural, community-led examples are particularly flexible - using mobile outreach to get to sometimes very small and dispersed populations that are poorly served by public transport.
• A few examples exist of defining a neighbourhood as a “community of interest” – such as the homeless population in a city, or expectant mothers.
• Some use deprivation data to target their work, but others are established through a community representative responding to the observed needs of the area they live in.
• The social network of a neighbourhood is complicated. It encompasses many communities that live in the same geographical area but may not share the same views on issues like health, the local environment or use of local resources.
• Many case studies have multiple participants in the model but varying levels of participation, the level of participation can influence the activities and goals of neighbourhood working.

How is impact being measured?

• Most places can see the difference they're making - they may have done an evaluation but the decision to engage in neighbourhood working doesn’t always rest solely on formal evidence but might rely on observations from community members or anecdotal evidence from residents.
• Depending on the leadership of the case study, the outcomes participants are interested in can be very different. For example, a PCN-led model may have a goal of reducing footfall in a GP surgery, whereas a community group may focus on building social capital.
• Impact measurement varies across the case studies, with some examples of very strong quantitative and qualitative data and others where there is limited evidence gathered.
• Some have been able to establish a reduction in demand on primary care or acute services  through formal evaluative terms. However, evaluations that go beyond recording of activity and reach into outcomes are not available in all case studies, partly due to lack of resources.
• More statutory led examples tend to have more robust metrics that are established at the outset of projects.
• If impact on the wider system isn't built in as a measure at the start, it can be hard to retrofit a methodology.

What are the barriers and enablers of neighbourhood working?

Key barriers

1. Funding challenges: Long-term, flexible funding is difficult to secure, and managing multiple streams is resource-intensive.
2. Neighbourhood definition: Statutory boundaries often do not align with how residents define their neighbourhoods.
3. Leader dependence: Relying on a small number of leaders creates a risk if they leave or shift priorities.
4. Short vs long-term focus: Immediate needs often compete with long term investments in neighbourhood health.
5. Data sharing: Different systems and privacy requirements make sharing data between partners challenging.
6. Diverse views: Reaching consensus in diverse communities can be difficult, with the risk of catering to the loudest voices.
7. Partner engagement: Not all partners fully commit to neighbourhood working, limiting its impact.
8. Volunteer reliance: High volunteer turnover and uneven distribution of volunteers can disrupt continuity and spread of neighbourhood working.
9. Performance targets: Centralised, short term performance measures do not align with long term neighbourhood goals.
10. Limited infrastructure: Neighbourhoods with poor infrastructure face additional challenges in collaboration and engagement.

Key enablers

1. Trust  building: Establishing trust between communities, VCSE organisations, and statutory partners is key, especially for residents with previous negative experiences and distrust of statutory services.
2. Agreed approaches: Using flexible, context specific methods allows neighbourhoods to tailor interventions to local needs.
3. Co-design: Involving communities in designing solutions ensures relevance, buy in, and adaptability over time.
4. Shared goals: A clear, shared purpose from the start helps maintain focus, track progress, and secure funding.
5. Resource devolution: Giving neighbourhoods control over funding and decisions builds trust and creates ownership.
6. Flexible and long-term funding: Sustainable initiatives require funding that is adaptable and sustainable over time.
7. Collaborative governance: Inclusive governance ensures representation from all stakeholders, promoting sustainability.
8. Management support: Dedicated staff improve coordination and appropriately handle administrative tasks, increasing efficiency.
9. Community infrastructure: Access to physical spaces and social networks facilitates collaboration and engagement.
10. Impact tracking: Appropriate evaluation frameworks ensure the ability to measure and adjust efforts effectively.