Who owns health? Building trust and agency at a neighbourhood level

Can the NHS truly shift from delivering health to enabling it, even when it means ceding power? With tension between the NHS’s instinct to ‘own’ neighbourhood health and the reality that genuine health creation happens outside institutional boundaries, this session will examine the gap between political short termism and the long term, hyperlocal work needed to build trust, agency and collective capacity. Drawing on The NHS Alliance’s hyperlocal neighbourhood approaches, the session will follow the intellectual journey from service-led improvement to community-led change. It will explore case studies where communities have taken the lead — sometimes with the NHS as partner, sometimes despite it — and the friction this creates for system leaders who are used to command-and-control models. Rather than landing on neat solutions in what could be a 'messy' policy environment, the session will draw out the choices every system must make about control, trust, and what counts as ‘success’ at neighbourhood level.