Across the NHS, local authorities and wider public services, commissioning is still largely organised around contracts, activity and organisational accountability.

That model made sense in a more stable environment.

It does not hold in systems where outcomes are shaped collectively — across providers, neighbourhood teams, voluntary organisations, housing, education and beyond.

The reality is this:

We are trying to…

For a while, commissioning became a bit of a dirty word in the NHS. We talked about system convening instead — as if the purchaser/provider split had quietly disappeared — despite ICBs holding statutory commissioning responsibilities. Commissioning never went away. We just stopped calling it that.  For a while… It was never just about buying and monitoring…

There's lots circulating on neighbourhood health at the moment - often about integrated teams, the role of ICBs, provider models (IHOs, neighbourhood providers), funding, contracts, behaviours and collaboration.

‼️ This is all important. But it's incomplete.

?There is a massive opportunity for HWBs to form new relationships with General Practice and PCNs - after all…

There’s a clear direction of travel across health and care. The NHS England “Fit for the Future” work makes it explicit: New population-based delivery models are coming — and they’ll be expected.

It means a shift towards:

▪️ Working across organisational boundaries

▪️ Thinking in terms of populations, not services

▪️ Aligning multiple partners around shared outcomes

All of that…

The NHS Medium Term Planning Framework (MTPF) marks a milestone moment in system reform - a shift from the short-term transactional planning, to multi-year, place-based planning and co-ordination at a neighbourhood level. It asks neighbourhoods to become the organising unit for joined up care - where primary care, social care, local government, VCSE organisations…

Cross-sector collaborations and alliances are increasingly becoming the norm in the public sector. In my sphere of work, over recent years, we have seen the introduction of Integrated Care Partnerships, Primary Care Networks, Provider Collaboratives and Safeguarding Partnerships. More recently, policy from the 10 year plan has opened up the path to Neighbourhood Health Services…

“What's the problem we’re trying to solve?” comes up all the time in meetings in public service partnerships.

Superficially, it seems like an easy question to define. In public services we don't have a shortage of issues... Access to see a GP, hospital waiting times, housing lists, health and social inequalities, and workforce pressures. Yet in…

Sustaining the Neighbourhood Health Centres of the FutureMy last blog on team management in neighbourhood health centres sparked energetic debate in LinkedIn and beyond - and rightly so. Direct messages from people have been appreciative of the inclusion of some theoretical perspectives and evidence from the management literature -…

Do we really need to rip up and redraw organisational charts? 

The ChallengeNeighbourhood health centres are now a flagship policy direction for the NHS in England. NHS England has issued 2025/26 guidance for integrated care boards (ICBs) to progress neighbourhood health ahead of the new 10-Year Health Plan; the government…

The NHS’s 10-Year Plan paints a compelling vision: health services rooted in neighbourhoods, driven by prevention, and delivered in partnership. It’s a shift from crisis response to proactive, person-centred care.

But vision without collaborative execution risks becoming another “grand strategy” that dies in the committee room. The real work—the knotty, political, relationship-driven work—happens in how partners collaborate…

Complex, multidimensional problems that resist simple fixes are known as wicked problems. The interdependence, ambiguity, and existence of numerous parties with competing interests are frequently the characteristics of these issues. As opposed to tame problems, which have a straightforward solution & can be resolved with conventional linear problem-solving techniques, wicked problems are rarely easily solved.…