A pragmatic framework for people activation – supporting integrated neighbourhood teams (February 2026)

Summary

Integrated neighbourhood teams (INTs) are being asked to do something hard but essential: improve outcomes and experience for local people while containing or reducing avoidable demand. Most current models focus on integrating professional services and redesigning pathways. This matters, but on its own it is unlikely to deliver the scale of change needed. The evidence from the last two decades is consistent.

What people do in their daily lives, and how able they feel to manage their own health and wellbeing, has far more impact on outcomes and costs than anything the formal system can do to them or for them. The degree to which people feel able to manage – their activation – is therefore not a “nice to have” side outcome. It is a core driver of health, demand and value.

This paper sets out a practical way for INTs to adopt activation as a core outcome, measured simply and improved systematically. We focus on both personal activation (people’s confidence and capability to manage) and community activation (how teams, services and neighbourhoods make it easier or harder for people to act).

The paper is written for:

• INT clinical and operational leaders
• ICB and place leaders responsible for INT design and oversight
• National teams shaping expectations and outcome frameworks for INTs.

Drawing on international evidence and our own experience in policy, clinical leadership and local implementation, it aims to offer a pragmatic route forward rather than another abstract framework.