Neighbourhood working is about more than bringing services closer to home. Its success will depend on strong relationships, tenable support and whether people and communities have real influence over the factors that influence their lives.
As I left home to attend the NICON conference a couple of weeks ago, I bumped into my neighbour. We exchanged a few words about life, the state of our yards and our plans for the day. The conversation lasted less than a minute but, as I drove away, I found myself returning to a question I had been asked recently: “What defines a neighbourhood?”
For me, neighbourhoods are rooted in such moments. They begin in chats at the school gate, a greeting in the corner shop or on a walk in the park. They begin in conversations over a garden fence. Health and wellbeing are shaped not only in hospitals, GP surgeries and clinics, but in the places where people live their lives. They are a shared responsibility.
More than services closer to home
That idea stayed with me throughout the two-day NICON event. Neighbourhood working moves services closer to home, yes, but it also demands that people, communities and services work together to arrive at key decisions. Reform must strengthen those relationships, supported by viable structures and long-term investment.
For neighbourhood working, lived experience is a vital component. Their insights can influence delivery. Indeed, the recent World Mental Health Day theme, Lived Experiences Heard: Real Voices, Real Change, captured that challenge well.
One conference speaker offered another useful way of thinking: hospital with community. Rather than simply shifting care from hospital to community, specialist and acute services must work alongside families, third-sector organisations and neighbourhood networks to support wellbeing, recovery and earlier intervention. This must not become a transfer of public-service responsibilities to communities. It should be a genuine partnership, with shared influence, clear responsibilities and sustainable resources.
A service-user consultant brought the discussion back to what support feels like for the person receiving it. Three questions cut through the complexity.
Do you know me? What happens next? Will you support me?
They should sit at the heart of any neighbourhood model. Success means support that feels connected and easier to navigate, something that responds to what people actually need.
Every day, frontline workers build trust, solve problems and connect services; they are a key driver of progress. Across Inspire services, we are privileged to see colleagues bring skill, compassion and commitment to their roles. If we want them to deliver change, we must trust them to help build it too.
But there is another challenge beneath the neighbourhood conversation. Communities are different and local organisations bring credibility that cannot be created by a top-down approach. At the same time, people should not experience a different standard of support simply because of where they live.
The answer is not to choose between local and regional approaches. Community-based organisations bring trust, local insight and the flexibility to respond creatively to need. Regional organisations contribute specialist expertise, strong governance and the capacity to share learning at scale. Working together, they can preserve local flexibility while ensuring the same commitment to excellence wherever people live. It is therefore essential that both local and regional services remain closely connected to their neighbourhoods.
Learning From Others
A recent conversation with Emma Latimer, Interim Director of Strategy and Partnerships at Sheffield Teaching Hospitals NHS Foundation Trust, prompted me to consider how models beyond Northern Ireland are shaping neighbourhood support. Sheffield City Council’s When Communities Lead report offers one practical example. It suggests that communities are well placed to identify what matters, find solutions and build relationships. It also challenges larger institutions to act as partners, convenors and enablers, connecting communities with learning, resources and opportunities.
That feels particularly relevant in Northern Ireland, where conversations about neighbourhood working and health reform increasingly depend on robust links between people and decision makers.
From Listening to Influence
Northern Ireland’s past conflicts still affect mental health and wellbeing in the region. People are drawing on a wealth of experiences and insights, often showing great generosity in sharing stories that are deeply personal and difficult. The recent inquiry by the Northern Ireland Assembly’s All-Party Group on Suicide Prevention was a powerful reminder that behind every statistic is an individual, a family and a life forever changed. We honour those experiences when listening leads to action.
Success will not be measured by the number of conversations or organisations at the table, but by whether community insight influences decisions and outcomes. The real test will be whether that voice carries into the places where priorities are agreed, resources are deployed, pathways are designed and progress is measured. The voluntary and community sector therefore needs a meaningful role in those decisions, not simply a seat at the table. The wider system must demonstrate the ways in which community insight continues to guide implementation.
That intersection matters because local flexibility without wider support can leave good ideas isolated. Without local influence, regional ambitions risk producing services that do not adequately reflect people’s lives. A strong neighbourhood system should hold both together.
Locally, the People to Partners report stresses partnership rather than passive participation. During a neighbourhood model workshop at NICON, service user Ross Anderson laid down a challenge to those leading the reform agenda: how will people know that their voices have influenced decisions?
The Test for the Neighbourhood Model
The real test for the neighbourhood model is not how many conversations take place but whether they herald positive change. People must have genuine influence over decisions, with local flexibility matched by consistent standards and support.
Ultimately, perhaps we should return to that trio of simple questions:
Do you know me? What happens next? Will you support me?
If neighbourhood working can answer all three, while giving communities a genuine stake in forming the answers, we will have moved beyond bringing services closer to home. We will have started doing things differently.