Buckinghamshire’s approach to neighbourhood working builds on integrated system working that has been a key focus since April 2023. An agreed Health and Wellbeing Strategy places Neighbourhoods at the core of delivering improved outcomes.  

Buckinghamshire’s Neighbourhood Programme brings health, social care, and community partners together to deliver coordinated, person-centred care. Six Neighbourhoods have been established across Buckinghamshire, each serving 85,000-120,000 residents and aligned to Primary Care Network (PCN) boundaries. 

Partners include an integrated NHS trust, 13 PCNs, mental health services, the local authority, and voluntary sector organisations. Each Neighbourhood has a dedicated Integration Lead, funded through pooled resources, who coordinates collaboration with teams working at a hyper-local level. 

Using population health data and community insight, Neighbourhood steering groups identify local priorities. Consistent themes have emerged: prevention, early intervention, and proactive support for those with complex needs. Current priorities include frailty, diabetes, chronic kidney disease, and childhood obesity. 

Our approach responds to Buckinghamshire's population needs and health inequalities by moving beyond traditional organisational boundaries and putting residents at the centre. Our key programmes include: 

• Proactive care clinics 

• Establishing a Community Health and Wellbeing Worker model 

• Shifting Long Term Condition management into neighbourhoods starting with Chronic Kidney Disease and Diabetes 

• Moving outpatients into the community starting with Gynaecology and Dermatology