Developing a ‘neighbourhood health service’: ensuring equity of access for rural populations

Recent discourse highlights important conceptual and practical challenges in defining and developing a 'neighbourhood health service'. 1A key part of the Government's 10-year health plan for England centres around integration and localisation of NHS services to neighbourhoods via so-called neighbourhood health centres, to support its vision for a shift from 'hospital to community '. 2 Integrating and localising services to neighbourhoods is a laudable goal, to increase accessibility, strengthen community involvement in design and delivery, and enable greater tailoring and responsiveness to community needs via care that is 'delivered closer to home'. 3 But what exactly is a neighbourhood in this context?Is this just renaming and/or regrouping of existing geographically bounded health systems, like primary care networks, without meaningful changes to underlying system structure, strategic oversight, and service delivery?