Domain 6 asks what the board's leadership is producing as an output in neighbourhoods: is the board creating conditions in which communities are more capable, better connected and more in control than they were before? It focuses on what the board is building at neighbourhood level: the place-based systems, infrastructure and governance that allow communities and services to work together over time. It is distinct from domain 5, which focuses on how the board hears from and works with communities as an input to its own decisions.
Is the board actively leading neighbourhood health planning and building the structural conditions through which communities can take greater control of the factors that affect their health and wellbeing?"
Neighbourhood health plans
From 2027 to 2028, neighbourhood health plans are required to be developed under the collective leadership of the HWB, grounded in the JSNA and connected to wider public service reform (neighbourhood health framework, DHSC and NHS England, March 2026). A board receiving ICB presentations on neighbourhood plans and endorsing them without having actively shaped them will, from that point, be in breach of its statutory obligations as well as at the floor of this maturity scale.
Score 1: Not evident
Neighbourhood health is understood by the board primarily as an NHS programme.
The ICB leads the development of neighbourhood health plans, and the board's role is to receive presentations on progress and endorse the resulting plan. The board plays no active part in setting the vision for what neighbourhood health should achieve for its population, agreeing the neighbourhood geographies, or connecting NHS neighbourhood health reform to wider local priorities around housing, employment, the VCFSE and community resilience.
The board has not had a substantive discussion about what neighbourhood health means for its place.
The national NHS goals for neighbourhood health (improved frailty outcomes, GP access, planned care, urgent care, patient satisfaction) are treated as the ceiling of what neighbourhood health should achieve, rather than as minimum requirements from which local population health and wellbeing ambitions should extend considerably further. There is no board-level framework connecting neighbourhood working to the wider conditions that shape population wellbeing.
Score 3 note: Growing
The board has begun to set its own view on what neighbourhood health should achieve for its population, going beyond the national NHS metrics.
It has engaged actively with the question of neighbourhood geographies and is pressing the ICB to explain how neighbourhood plans will address local health inequalities. However, the board's contribution remains primarily a challenge and oversight rather than co-leadership and co-design.
Score 5: Embedded
The defining test for this domain is whether communities in the board's area are measurably more capable, better connected and more in control of the factors that affect their health and wellbeing as a result of the board's leadership - that is the outcome the board is working toward, and everything else in this descriptor is evidence of whether it is on that path.
The board leads neighbourhood health planning from a population health and wellbeing and place-based starting point. It has set a clear, locally owned vision for what neighbourhood health should achieve, grounded in the board's JSNA-informed population health and wellbeing priorities and going substantially beyond the national NHS delivery metrics. Neighbourhood geographies reflect communities as people actually experience them, agreeing with the board's active involvement rather than defaulting to NHS administrative boundaries. The JSNA informs the neighbourhood health plan, and the neighbourhood health plan connects back to the board's wider wellbeing strategy: these are not separate documents.
The board actively connects neighbourhood health to the broader conditions that shape population wellbeing: housing, employment, skills, the prevention agenda and the infrastructure of the voluntary and community sector. It can point to measurable shifts in how communities and services are working together at neighbourhood level, and to the growth of community-led networks and resilience as structural outcomes of its leadership, not just as aspirations. The board understands and applies the distinction between commissioning services in neighbourhoods and building the conditions for community resilience and co-governance: the former is necessary but insufficient; the latter is what this domain is measuring.
Related resources for the Rationale, HWB Maturity Matrix, HiAP and the PHIP page