Adult social care’s contribution to the Neighbourhood Health Service in England

For neighbourhood health to succeed, local government and adult social care must be equal partners in its planning and delivery. Professor Oonagh Smyth CBE and Sir David Pearson, share insights from the position statement on adult social care’s contribution to the Neighbourhood Health Service from the Workforce Strategy for Adult Social Care in England’s Oversight Executive Group; highlighting the actions required to enable adult social care and its workforce to play a full role in the Neighbourhood Health Service and where they are working successfully in neighbourhoods.

With 43 pioneer sites now active and the Neighbourhood Health Framework providing clarity about the overall purpose and priorities, attention needs to turn rapidly from ambition to delivery. For our local populations the inclusion of adult social care is a significant opportunity —but so are the risks if its contribution is overlooked.

Neighbourhood Health seeks continuous, accessible and integrated support, delivered by neighbourhood teams embedded in communities. This vision aligns closely with the strengths of adult social care with prevention expertise, person-centred practice and assets embedded in the community.

The Framework’s Ministerial foreword is clear, neighbourhood health will only succeed as a joint endeavour between the NHS, local authorities and wider partners. It’s why we, along with partners across adult social care, health and education through our own joint endeavour – a Workforce Strategy for Adult Social Care in England— came together to publish a joint position statement on adult social care’s contribution to the Neighbourhood Health Service. A call to action, it highlights how local partners can maximise social care’s contribution and the national enablers to accelerate local integration.

Progress across pioneers shows promise but remains uneven. Neighbourhood health is in danger of not using all the assets at our disposal to provide person centred proactive health, care and support. For neighbourhood health to succeed, local government and adult social care must be equal partners in planning and delivery as recognised in ADASS’ Neighbourhood Health policy statement.

Our joint statement outlines ten actions required to enable adult social care to play its full neighbourhood health role. One action calls for commissioning and support arrangements for delegated health activities (DHA) to be agreed locally across health and social care, with appropriate NHS funding and training. DHA reflect increased expectations of care work and when done well, they improve continuity, reduce duplication and ease system pressure. But they need to be supported with the right development opportunities, supervision, competency and governance. Implementation stalls due to unresolved insurance, funding and indemnity issues which entrench inefficient boundaries and funding flows.

We know what works. Skills for Care co-developed guiding principles and support resources, run learning roadshows and host practical case studies where DHA has been successfully implemented. Some neighbourhoods are embedding DHA learning into multidisciplinary teams, supported by blended roles like a DHA facilitator and BCF investment. South Yorkshire’s system-wide integration programme demonstrates how co-production from the start, shared learning through communities of practice and alignment with the Care Workforce Pathway have provided the catalyst for scalable and practical DHA solutions.

Neighbourhood health is built on shared purpose, strong leadership, trust and relationships across organisational and disciplinary boundaries. It’s why we recommend that local leaders should work and train together across the NHS and local government, at the level of neighbourhood, local authority and ICB. We also recommend that training for neighbourhood health teams should take place across professions and organisations and include employees from independent providers.

In West Somerset, systemic team coaching across health, social care and the VCSE sector has strengthened collaboration, reduced duplication and improved access. Similar approaches, alongside communities of practice and multi-agency operational groups, are emerging as vital facilitators of neighbourhood working. Trusted Assessor models also stand out, enabling safe and timely discharge and preventing avoidable system blockages.

We recommend that local people and skills strategies should be developed to cover recruitment, retention and training and development in health and care together, including the local independent sector. Given the fragmentation of the social care market, the unique strengths-based approach of adult social care needs to be valued and actively sought in service design and workforce planning to help develop one workforce. Inclusive working in Humber and North Yorkshire through the ‘Breakthrough’ programme has demonstrated how the extensive use of ASC-WDS has enabled a single, systemwide data platform and strengthened local planning.

Adult social care is the cornerstone to mature neighbourhood working. Our joint position statement provides a call to action on how adult social care can play its full role in the neighbourhood health service – a role we all have a part to play in and a joint endeavour.

Professor Oonagh Smyth CBE is the Chief Executive Officer at Skills for Care and Co-chair of the Workforce Strategy Oversight Executive Group alongside Sir David Pearson.