Debs Harkins, Director of Public health at Calderdale Council reflects on Calderdale’s decade long journey to build neighbourhood health through strong relationships, community anchors and integrated local teams. She describes how a democratic, place based and prevention focused approach is improving outcomes, reducing inequalities and embedding health and wellbeing in the everyday lives of communities.
Neighbourhood health has become one of those phrases that rolls easily off the tongue but is much harder to make real. For me, it’s about organising ourselves around the everyday lives of people and communities – recognising that health is shaped far more by where you live, who you know and how supported you feel than by any single service. Done well, neighbourhood health creates the conditions for prevention, early help and care to come together in ways that genuinely reduce inequalities and improve outcomes.
In Calderdale, neighbourhood health isn’t something we’ve suddenly “implemented”. It’s been a journey of nearly a decade, built through relationships, local democracy, and a willingness to work from the ground up. We certainly wouldn’t claim to have cracked it – but our experience so far may be useful to others navigating similar challenges.
Our neighbourhood health story so far
We started in 2018 with Calderdale Cares, working across five localities (now called neighbourhoods) building from Primary Care Network footprints, to develop a more place based, joined-up approach to health, care and wellbeing. Right from the beginning three well established and trusted local voluntary and community sector anchors were at the heart of neighbourhood health partnerships, and this has developed further in recent years with new community anchors being supported to develop in areas that previously didn’t have them.
As national policy evolved, our local approach continued to mature. Following the Fuller Stocktake in 2022, we formally adopted integrated neighbourhood teams, building on what was already happening rather than starting again. Family Hubs have developed on the same geography and more recently, partners have agreed that Family Hubs are our integrated neighbourhood teams for children and families.
Local elected members have joined each neighbourhood health partnership, and we have a senior Public Health colleague linked to each neighbourhood. The Elected Members and public health officers have been coming together a couple of times a year to share experiences and learning.
We’ve developed intelligence packs for each neighbourhood and are taking a deliberately bottom up approach to our neighbourhood health plan, starting from the priorities and strengths already identified by each neighbourhood.
What we’re working towards is ambitious but simple:
• improved outcomes for people and communities experiencing the greatest inequalities
• reduced avoidable hospital use, particularly for people who are at risk of frailty, people at the end of life care and those with long term conditions
• improved access to timely, coordinated primary and community services
• stronger prevention, early help and community resilienceAll of this is explicitly tied to Calderdale’s
outcomes based wellbeing strategy – from enabling children to be ready for school, through to supporting older people to live connected lives in vibrant communities. For us, neighbourhood health is a way of delivering on the Councils’ core purpose, not an extra layer of work.
The role of the council – and the Health and Wellbeing Board
One of the most important things we’ve learned is the unique role Councils can play in neighbourhood health. Our Health and Wellbeing Board has been central to this. In October 2025 we held a development session, co led with Voluntary and Community Sector Anchors, to reflect on what was right for Calderdale and how we could hard wire neighbourhood health into the way we lead the system.
That conversation wasn’t about compliance with national expectations. It was about seizing the opportunity locally, building on what we’ve already achieved, and giving the Health and Wellbeing Board a meaningful role beyond oversight and sign off of the Neighbourhood Health plan. In the new municipal year, we plan to review our membership to better reflect neighbourhoods and strengthen the Board’s focus on outcomes, relationships and shared accountability.
This is where Local Government adds real value: connecting the NHS with communities, anchoring work in democratic accountability, and holding a firm focus on the fundamental determinants of health and wellbeing.
What neighbourhood working looks like on the ground
Across Calderdale, our integrated neighbourhood health teams are working with voluntary and community sector anchors, residents and partners to address inequalities in ways that make sense locally. That includes improving uptake of screening and immunisation, supporting timely antenatal care, increasing access to speech and language therapy, delivering stop smoking support, boosting physical activity and identifying and treating hypertension earlier.
In Central Halifax, the integrated neighbourhood team grew out of Calderdale Cares and was originally known as the Central Halifax Wellbeing Hub. Co chaired by a GP and the Chief Executive of Halifax Opportunity Trust (the local community anchor), it uses public health data to inform shared priorities and practical action, grounded in the social determinants of health. The team has created space for partners to share intelligence, coordinate initiatives and respond together to local wellbeing data. Importantly, the work has shown that neighbourhood deprivation shapes wellbeing beyond individual characteristics – reinforcing the need for a multi agency approach rooted in place.
In the Upper Calder Valley, partners have delivered a holistic healthy ageing programme for older people at risk of frailty, now scaled across all neighbourhoods. They’ve also brought together over 120 people and organisations to develop shared principles for working better together – an investment in relationships that will pay dividends long after individual projects end.
Reflections from the journey
If I were to summarise what we’ve learned so far, it would be this:
- we can achieve far more together than separately, but only if we take the time to understand each other, listen and actively seek out new voices
- neighbourhood health works best when everyone takes responsibility for doing things differently, with communities genuinely at the heart
- curiosity, openness and honesty matter as much as structures
- starting with what already exists – trusted Community Anchors, local community hubs, General Practices, Family Hubs – builds legitimacy and momentum
- neighbourhood health exists to serve the people who live there, not organisational boundaries or institutional interests.
We’ve also seen the benefits of stronger Voluntary and Community Sector involvement, developing system leadership across organisations, and combining lived experience with data to understand what’s really happening in our communities.
The system context continues to change. In Calderdale, changes in the Integrated Care Board mean there will no longer be a dedicated Calderdale place team, and a new provider partnership will take on some functions – creating both opportunity and a gap. As we reflect on our journey and write a “letter to the future”, my hope is that it will say this: taking time to build relationships was worth it; partners are valued for different reasons; and neighbourhood health worked best when it was flexible, locally led and democratically grounded.
Elected members have been clear that they want to be involved – and when they are, they add immense value through their deep knowledge of place and the legitimacy they bring. For councils across the country, neighbourhood health is not just a health agenda. It’s a powerful way of fulfilling our role as stewards of place, convenors of partnerships, and champions of our communities.