Adult social care’s contribution to the Neighbourhood Health Service in England

Published on behalf of the Workforce Strategy for Adult Social Care in England's oversight executive

January 2026

Adult social care provides neighbourhood-based support to boost independence, health and wellbeing, helping people to live well in their homes and reducing need for high-intensity healthcare. It is essential to the shift from ‘hospital to community’.

This position statement describes the government’s vision for the Neighbourhood Health Service set out in the 10 Year Health Plan for England and outlines how adult social care can help to bring it to life. It then explores:

The implications for the adult social care workforce
How local partners can maximise social care’s contribution
National enablers that can accelerate local integration

Read the statement in full:

The Neighbourhood Health Service
The adult social care contribution
The social care workforce and neighbourhood health
How local partners can maximise social care's contribution
National enablers

The Neighbourhood Health Service

The Neighbourhood Health Service is a promise of continuous, accessible and integrated care located within communities.

It will encompass restored access to GPs and dentists, enhanced services from pharmacies, and urgent and specialist healthcare and therapy services delivered outside hospitals.

Health and care professionals will work together across disciplinary and organisational boundaries in neighbourhood teams that will offer holistic, joined-up care for people with complex needs, organised around groups with similar characteristics, and personalised to the requirements and choices of individuals and their families.

Interventions will be more predictive and preventative, using data to stratify risk, anticipate emerging needs and reduce inequalities. As much care as possible will be delivered in people’s homes, assisted by digital technologies, and in local settings including Neighbourhood Health Centres in every community.

Services will be designed to avoid or reduce the need for emergency hospital admissions, with rapid responses in the community and short-term intensive support.

The adult social care contribution

Adult social care is essential to realising the Neighbourhood Health Service vision.

Social care delivers practical and emotional support and care to sustain wellbeing, dignity, health and independence, focused on the whole person in the context of their family and community - their assets, relationships and personal choices.

It secures essential rights and protections and is shaped by the voices of people who draw on support and carers. Working alongside the NHS, public health, housing and other local services, social care plays a key role in preventing illness and dependency, promoting population health and wellbeing and enabling people who need to draw on support to live ‘gloriously ordinary lives’.

It is essential to reducing demand on the wider health system – by addressing risks that can result in hospital admissions and enabling people to regain and maintain participation and independence in their daily activities.

The government now wants the local NHS to embrace the same whole-person, community-focused ethos, which means learning from the best of adult social care.

Social care professionals have essential expertise in supporting adults of all ages whose independence and wellbeing may be at risk – especially people with learning disabilities, significant physical disabilities, frailty or dementia, serious addiction, or severe and enduring mental health conditions. Frontline care and support workers have deep insight and expertise built on their relationships with the people they work with. Social workers and other coordinators of care assess needs, build trust and work with people to personalise and join-up support (looking across practical needs, relationships, housing and employment). They also use data and intelligence led approaches to identify and respond to risk across the community. They will be at the heart of effective multi-disciplinary neighbourhood teams.
Social care prevents health needs. It stops people with learning disabilities from needing unusual levels of healthcare by helping them to lead ordinary, active lives. It helps avoid unplanned emergency care for frail older people and people with severe mental health conditions and through 21,500 social workers it plays a vital safeguarding and care planning role. It supports people to live well through community engagement, skills development and local-area co-ordination of community activity that can take advantage of neighbourhood buildings as assets. It keeps people safe and independent using aids, adaptations and technologies in the home. It also enables recovery, participation and independence through reablement services, where occupational therapists can play a critical role to reduce the need for long-term care packages and residential care. Working with the NHS, social care provides crisis interventions, rehabilitation and short-term care to prevent hospital admission, secure safe discharge and avoid readmission or institutional care.
Social care is a partner in healthcare. Care workers, support workers and personal assistants are increasingly relied on to deliver delegated healthcare activities (e.g. wound care, medication support, blood pressure monitoring) which are key to realising neighbourhood health. They can also help people to use smart devices and access remote specialist healthcare, to help shift care from hospital to home. Care homes deliver healthcare to their residents, employing tens of thousands of highly-skilled registered managers, nurses and other regulated professionals. Nurses in care homes are starting to take on prescribing roles and with the right support and information from GPs, community and acute health services, care homes can sustain residents’ health and avoid emergency care, including by working as part of ‘virtual wards’.

Integrated care and support maximises the value and effectiveness of public spending. Good community healthcare reduces the need for social care, good social care reduces the need for healthcare, and good housing and housing-related support reduces the need for both.

Working together they all build wellbeing, independence and good health, by focusing resources on early and ongoing support over acute or crisis intervention. In recent years this has been recognised through the Better Care Fund, which pools resources from the NHS and adult social care to deliver integrated, prevention-focused services. It is an important pre-cursor to the Neighbourhood Health Service.

But taxpayer-funded adult social care faces significant challenges at present: tightly-rationed funding, workforce pressures, fragmentation and inequality.[i] Unequal access results in unmet and under-met need and services that are insufficiently tailored to people’s diverse identities, backgrounds, preferences and requirements.

Importantly, adult social care stretches far beyond local authorities.

Integrated neighbourhood care needs to support people who pay for their own care and support; and include social care staff working for independent providers and individual employers. Choice and control need to be at the heart of neighbourhood health, people drawing on care and support, their carers and families should be enabled to direct and co-produce the support that they want; and to influence the design of services.

The social care workforce and neighbourhood health

Jobs in social care are changing to encompass: expertise in more complex needs; empowering, asset-based approaches; the use of new technologies; and delegated healthcare activities.

Many conditions, such as dementia, span both health and care, making an integrated approach to neighbourhood health particularly important. And, within neighbourhood teams, supporting the health and wellbeing of the workforce is essential in making sure that people with care and support needs and their families receive good quality care so they can live as independently as possible.

Reforms are also in train to improve how people who work in social care are valued, respected, rewarded and supported in their careers. There is a new sector-wide career framework, the care workforce pathway; rising expectations regarding skills and qualifications to reflect changing roles; and a forthcoming Fair Pay Agreement which will agree new terms and conditions for adult social care.

Social care leaders are implementing a sector-led workforce strategy that will help deliver the 10 Year Health Plan, sitting alongside the government’s planned health workforce plan. This all provides foundations on which proposals from the first phase of the Casey Commission can build. These developments will lead to better outcomes for people drawing on support but they need to be adequately funded.

For adult social care to play its full role in the neighbourhood health service, further action is needed with respect to the care workforce:

Local people and skills strategies should be developed to cover recruitment, retention and training and development in health and care together, including the local independent sector.
The care workforce pathway should be adopted by all social care providers to evaluate each role, shape job expectations and support development and training.
Nursing careers in social care should be promoted and supported, with initial training routinely including social care settings and local NHS responsibility for continuing professional development.
Training for neighbourhood health teams should take place across professions and organisations and include employees from independent providers.
Training and qualifications in social care and community healthcare should evolve to reflect the changing demographics (such as increasing dementia prevalence) and the key skills required for integrated, holistic care with government funding for key qualifications.
‘Skills passports’ for care workers should be introduced to track qualifications and accreditation across providers, building on harmonised workforce data records.
Commissioning and support arrangements for delegated health activities should be agreed locally across health and social care, with appropriate NHS funding and training
Social worker and occupational therapy training and development should embed joined-up neighbourhood working and the effective use of local data and intelligence.
Local leaders should work and train together across the NHS and local government, at the level of neighbourhood, local authority and ICB.
The proposed Fair Pay Agreement should be developed to reflect the changing roles and responsibilities of the care workforce, the importance of high-quality training, and improved, consistent pay and benefits should be fully funded.

How local partners can maximise adult social care’s contribution

Jointly commission integrated community health and home care services, building on existing models including joint mental health provision and intermediate care arrangements under the Better Care Fund, with budgets allocated across institutional boundaries to where they will make the biggest difference.
Co-locate and integrate teams from different organisations within neighbourhoods, including voluntary organisations and independent care providers.
Align boundaries and operational footprints between the NHS and local government as much as possible to improve integration and collaboration across local government, primary care and community healthcare at neighbourhood and local authority level.
Define care homes as key parts of neighbourhood multi-disciplinary teams and ‘virtual wards’, providing them with specialist healthcare support.
Connect support workers, care workers and personal assistants who work in people’s homes into neighbourhood multi-disciplinary teams and ‘virtual wards’, including those supporting self-funders and people with personal budgets.
Adopt shared health and care records and data analysis across the local NHS and adult social care system, including VCSE organisations involved with providing care and support.
Maximise use of Personal Health Budgets and Direct Payments including for people who wish to use them alongside each other.
Create local joint registers of unpaid carers and develop integrated support and services for carers.
Put housing at the heart of neighbourhood health service plans, working with housing teams and social landlords providing general purpose, adapted and specialist housing.
Strategically shape the local market for adult social care to align with the requirements of neighbourhood working and integrated provision, and reflect this in commissioning practice and the design of provider contracts (e.g. outcome-based contracts, minimum employment standards).

National enablers

The reforms introduced in the 10 Year Health Plan will enable the NHS and adult social care to work together to deliver the Neighbourhood Health Service. Additional policy measures could further accelerate the speed and depth of change:

The 10 year health workforce plan should cover healthcare professionals working in social care settings within its purview, such as occupational therapists and other allied health professionals – and possibly also regulated social care professions.
This should be complemented by a national workforce plan for the rest of adult social care, developed collaboratively by DHSC and the sector with NHS England, building on and informed by the sector’s Workforce Strategy.
The ‘modern service framework’ for frailty and dementia should be developed and implemented jointly across the NHS and adult social care (and a similar approach should be followed for learning disabilities).
Approaches to measurement and performance should be integrated or aligned, building on the experience of the Better Care Fund and CQC assessments, with areas held account for a limited number of strategic outcomes that reflect excellent experiences of care.
Democratic accountability and oversight should be built into the NHS at the level of ICBs, Health and Wellbeing Boards and neighbourhoods, as well as the proposed new local delivery structures led by GPs and foundation trusts.
The NHS digital strategy should include adult care, with a joint approach to the development of the NHS App, the single care record and adoption of care technologies. Localities should be required to have joint digital plans and shared care records should be fully open to adult social care.
High-quality housing with care developments should be significantly expanded nationwide, by revising planning and funding policies.
Update legislation and policy on joint commissioning and pooled budgets including examining VAT issues and the current review of ‘Section 75’ arrangements.
A cross-government carers strategy that joins-up support and protections for carers across NHS, adult social care, social security and employment.

Get in touch

Please contact the Workforce Strategy Implementation Unit on ascworkforcestrategy@skillsforcare.org.uk with any questions relating to the role of adult social care services in neighbourhood health.

References

[i] The state of health care and adult social care in England 2024 to 2025 Care Quality Commission; The state of the adult social care sector and workforce in England report Skills for Care 2025, Adult social care reform: the cost of inaction, House of Commons health and social care committee, 2025