The NHS must adapt to a shift in patient demand and preferences, Curia’s Sprint Group Four of the NHS Innovation Accelerator workshop programme heard from experts who argue that GPs, care-facilities and specialist treatment centres must be integrated within communities, fostering a system of citizen engagement and shared outcomes.
Participants at the Curia hosted event heard that if the NHS were to shift from top-down, faceless care, to community-based personalised treatment, it could cut waiting times, relieve pressure on services and embed prevention at the heart of community healthcare.
“For too long, general practice has operated under immense pressure, shouldering rising demand while navigating legacy structures not built for the complexity of today’s needs.
Sprint Four Co-Facilitators John Williams and Paul Henderson.
“Meanwhile, the communities we serve are not just grappling with ill health – they are facing interconnected challenges tied to housing, employment, isolation, and inequality. It is within this context that the concept of neighbourhood placemaking and integrated community teams becomes not a policy aspiration, but an operational imperative”
The experts, including John Williams, Former Director, Birmingham Health Partners, Paul Henderson, Director of Consulting, IQVIA, and Paul Sheriff, Chief Officer for Partnerships and Integration, NHS Birmingham and Solihull ICB, outlined seven key themes that the NHS could act upon to change its trajectory.
Culture shift: Care and prevention through shared partnerships
Throughout the Birmingham Sprint, participants consistently underscored the need for a cultural shift across the health system.
One powerful analogy came from a comparison with the police service, which in recent years has adopted a more preventative, community-oriented approach: Prioritising early intervention and building trust through community engagement and increased transparency. Many argued that the health service must now do the same.
This transition requires a fundamental rebalancing of power: Moving away from a top-down, provider-led and one size fits all model towards one rooted in mutual accountability, shared outcomes, and deeper engagement with citizens as active partners with individual needs.
Local government leaders were quick to point out that this kind of approach is not new to them. Many councils have long embraced co-production with communities, working towards place-based solutions that reflect the realities of local need.
NHS colleagues, by contrast, candidly acknowledged that health services have often arrived late to this way of working. The challenge ahead, they agreed, lies in narrowing that gap. Health services, local authorities, and community groups must begin to build trust through sustained, collaborative practice that values the unique cultures, insights and assets that local communities possess.
Turning local issues into local solutions
Local issues often coincide, but the systems designed to tackle them struggle to overlap. If a household suffers from mould, they are more likely to suffer from respiratory issues, but the connection between the two may not be uncovered as the local authroity responsible for housing simply doesn’t know that they have asked their local GP for an appointment.
By expanding data sharing partnerships and using community intelligence, overlapping needs can be uncovered and open opportunities for combined investment and service delivery.
Building trust and relationships
Relationships matter more than structures. Trust requires time to be built, but can deteriorate over one poor decision. Local communities that have been promised investment and reform by one government or at one period of time, just to lose it when the political or fiscal tides turn, can severely throw off the positive progress made by local leaders and organisations.
Local design team and community leadership models were cited by the workshop participants as effective relationship builders, but their success depends upon structural stability and autonomy from the national, often short-term political swings.
Digital tools must be implemented with inclusion in mind
Technology is increasingly central to effective local governance models. But the group warned against assuming digital solutions are a panacea.
While many innovations are already improving access and efficiency, there was a shared concern about digital exclusion and system fragmentation.
Participants called for a more nuanced, needs-based digital strategy that avoids a one-size-fits-all approach. One participant described a pragmatic model in which digital tools are deployed to serve the 60 per cent of the population who benefit from them, with tailored support for those excluded.
The key message: “Don’t let perfection prevent progress but never lose sight of those at the margins.”
Making national contracts work for local practices
Healthcare providers across the country are actively disincentived from implementing neighbourhood programmes due to inflexible national contracts.
The proposed solution? A new contractual framework that incorporates experimentation with pooled budgets, delegated authority at the regional and local scales, and an emphasis on mutually-beneficial shared outcomes.
Embracing the voluntary and community sectors
Charities and community groups are the backbone of local care and prevention services, but they are too often “treated like they’ll do everything for free”.
Resources must be meaningfully allocated to support the work of voluntary community partners, recognising the trust they hold within their communities and the flexibility of their services.
Final Thought
If the NHS is to meet the scale of the challenge it now faces, it must stop working around communities and start working with them. This means reimagining healthcare not as a series of isolated services but as part of a wider ecosystem rooted in trust, shared insight, and locally tailored solutions.
From aligning digital innovation with inclusion, to reconfiguring national contracts that empower local delivery, the building blocks of this transformation are already in view. What remains is the collective will to act, to embrace cultural change, invest in meaningful partnerships, and hand real power to the people and places that know their needs best.
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