All Together Fairer Neighbourhoods – Strengthening prevention and reducing inequalities across Cheshire and Merseyside

As neighbourhood models continue to evolve nationally, it has never been more important that we embed prevention and health equity at the heart of local delivery.

Across Cheshire and Merseyside, our public health system has come together to provide exactly that clarity through the publication of All Together Fairer Neighbourhoods – An evidence‑based framework for Cheshire and Merseyside to support the creation of local neighbourhood health plans.

We developed this framework because neighbourhoods are where prevention truly happens. They are the scale at which partners can work side by side with communities, understand local circumstances, and take early, proactive action to improve health and wellbeing.

As national policy continues to shift towards more integrated, neighbourhood level models – as outlined in the NHS 10 Year Plan for health and recently-published national Neighbourhood health framework – local areas need a shared foundation that turns national direction into grounded, practical action.

It is clear that neighbourhood health is not, and should not, be the same as neighbourhood health care. It is the integration of these neighbourhood level models that will truly make a difference in our communities.

Why we created this framework

Across Cheshire and Merseyside, we have a strong, long standing commitment to reducing health inequalities based on the Marmot principles.

All Together Fairer Neighbourhoods builds directly on that commitment, drawing from the wider All Together Fairer programme, which has been endorsed by all Health and Wellbeing Boards across our area and provides a consistent mandate for action on the social determinants of health.

What became clear as neighbourhood approaches matured is that, despite excellent work, there was a risk of fragmentation without a shared set of guiding principles. Our nine Directors of Public Health therefore worked collaboratively with our ICB Director of Population Health, along with public health consultants across the area including myself, to develop a single, coherent framework that supports local flexibility while ensuring consistent standards across the system. 

What the framework provides

The framework sets out six guiding principles that underpin effective neighbourhood action, including: 

• Co production and community power: Shaped with communities, building on local assets and sharing power to drive meaningful change
• Prevention and tackling inequalities: Prioritise prevention and tackle health inequalities by addressing the wider determinants of health, proportionate to need.
• ‘One team’ system leadership: Work as one system across organisational boundaries, with shared ownership and accountability for outcomes.
• Outcomes focused delivery: Success should be defined by improved population health, reduced inequalities and better experience, not activity alone.
• Alignment across strategies: Align with existing strategies, evidence and system priorities to maximise impact and avoid duplication.
• Insight driven action based on local data: Local data and insight should drive priorities, decision-making and evaluation at neighbourhood level.

These principles are grounded in national and international evidence and reflect the real strengths already present across our local authorities, NHS partners and the voluntary, community, faith and social enterprise sector. 

Crucially, the framework does not prescribe a single model. Instead, it offers coherence and shared direction, supporting Health and Wellbeing Boards, Integrated Care Systems and local partners to design neighbourhood plans shaped by local assets, need and lived experience. It also showcases real examples of neighbourhood level work already underway across our subregion, demonstrating how prevention and equity can be embedded in practice. 

For us, one of the most significant achievements of this work is what it represents: the power of coordinated public health leadership across Cheshire and Merseyside. By aligning around shared principles, we strengthen our ability to tackle the root causes of ill health, build resilient communities and deliver better outcomes for our residents.  

Neighbourhoods remain central to the future of health and care. With this shared framework in place, we are better positioned than ever to translate our collective ambition into meaningful, preventative, community led action.

• Read the executive summary 
• Read the full framework
• Find out more about All Together Fairer. 

Mike Bridges
Consultant in Public Health at Warrington Borough Council
Lead Consultant for All Together Fairer Neighbourhoods