Anchors, estates, and neighbourhood health centres
Neighbourhood health represents a seismic opportunity for transforming how local estates and assets are put to use for community benefit for years to come - but with proposals required by 28th May 2026 the window of opportunity for being part of this conversation is now.
Beneath all the think-pieces and policy papers about the shift to neighbourhood health in England, there is a story of bricks and mortar.
Neighbourhood health centres, or NHCs, are intended to be the physical spaces where much of what is included within the neighbourhood health model is actually delivered. As the recent guidance for ICBs states, NHCs will be “the place to go for most health needs in every community”.
In practice, NHCs are expected to bring together GP practices with “a mix of community, local authority, adult social care and civil society services, allowing staff to deliver more co-ordinated and effective care for better patient outcomes and experiences”.
The Government has set out plans to have 250 of these NHCs in place by 2035, with 120 coming by 2030. These are expected to be delivered through a mix of the following options:
Upgrading, repurposing or extending existing NHS estates - described by the guidance as the “quickest and most affordable route” where there is existing high-quality estate fit for this purpose
Repurposing community or civic spaces - for example adapting existing high street premises, libraries, leisure centres or other civic assets to host some, if not all, of the services expected within neighbourhood health offers
Cohort-specific hubs - existing hubs serving particular groups, such as women's health hubs, Best Start Family Hubs, community-based mental health centres, or respiratory hubs, integrated into the wider neighbourhood offer (whether co-located with an NHC or not).
Purpose-built neighbourhood health centres - i.e. new builds delivered through a mix of public capital and public private partnerships
The opportunity this represents for a major rethink and repurposing of how local estates and facilities are used is significant.
As a member of a local community group who has been trying for years to repurpose a room that sits mostly empty in a local health centre (containing multiple GP practices), I know first hand how frustrating it can be seeing estates not put to their best use, because of the layers of bureaucracy preventing better ways of working from taking root.
The hope for many (at least for us locally) is that the neighbourhood health agenda might finally act as the catalyst for moving stalled conversations about spaces forwards.
What does this mean for anchor organisations?
Local anchor organisations have a range of roles to play in helping realise the full potential of this major repurposing of local estates.
Mapping estates and their uses
As a start, ICBs and their partners in the health system should work with other local anchor organisations to conduct a thorough mapping of existing estates, so that the best candidates for neighbourhood health centres can be identified and put forward.
This process should be as open and inclusive as possible, so that smaller “community anchors” and the spaces they can bring to the table are considered alongside the estates of larger anchors. Ideally these conversations should go beyond traditional health and community engagement forums - so that the full diversity of local community assets are included in the picture when NHC proposals are being scoped and developed.
As well as mapping estates, community partners should be engaged in conversations about how these spaces are used, and the wider activities that are on offer. Indeed, partnership maturity and community engagement are explicit criteria against which NHC schemes will be assessed by NHS England, and where there is overlap with Pride in Place neighbourhoods there are opportunities to involve neighbourhood boards in these conversations.
Reviewing service offers
In addition to thinking about physical spaces, there is an opportunity for local anchors to conduct a full review of the services and activities they provide, asking the question: “which of our existing offers might we deliver as part of neighbourhood health centres?”
And these don’t just need to be traditional health and wellbeing support offers. The guidance asks ICBs to consider co-locating or aligning a wide range of services with NHCs, including social welfare advice (covering housing, debt, employment, domestic violence and immigration), carers' support, integrated health and employment support, services for babies, children and families, and "community-led activity". It also flags broader opportunities around community sport, physical activity and leisure provision.
NHCs as anchors in their own right
In addition to thinking about how anchor leads within existing anchor organisations can support this agenda, there is an opportunity for those working within and leading the new NHCs to recognise their role as anchor leaders in their own right. The guidance to ICBs is explicit in describing NHCs as future anchor institutions that will “contribute to wider social and economic development” and “support regeneration and strengthen community resilience, while addressing the wider determinants of health”. Where possible NHCs should link into existing local anchor networks and strategies so that they build on existing work in this space, rather than starting from scratch.
Disposals, as well as proposals
The NHC programme will also drive disposals - buildings that the NHS no longer needs, or that are being decommissioned to fund upgrades elsewhere. For local communities what happens to those buildings matters enormously. And this community benefit lens should be applied just as intentionally to disposals, as it is to the development of new NHCs, and where appropriate Community Asset Transfers should be considered.
The clock is ticking
Whilst the opportunities are significant, the window for shaping all of this is narrow.
Regions and ICBs are required to submit their proposed NHC pipelines to NHS England by 28th May 2026 - setting out, scheme by scheme, where investment will be prioritised, which existing facilities are in scope, and which disposals will be enabled along the way.
This means that decisions about which buildings make the cut, which partners are at the table, and how communities are engaged in the design of these spaces are being made over the coming weeks.
So if you have a vision for how the bricks and mortar in your local area can be better put to use for your local community, now is the time to make sure that vision is heard.
At HALN we're keen to support partners thinking through what this means in their place. We're planning a series of learning activities - including webinars, case studies and blogs - to support partners working in this space. If you've got an idea, an example to share, or simply want to be part of the conversation, get in touch at hello@haln.org.uk.