What Neighbourhood Health can look like

When the NHS announced its ten-year Health Plan last summer, it revealed its intention to shift healthcare from hospitals to communities by establishing localised "Neighbourhood Health Services". According to the plan, these would “create integrated, multidisciplinary teams to provide proactive, preventative, and personalized care closer to home, focusing on early intervention, digital tools, and tackling health inequalities to keep people healthier longer and reduce hospital reliance.”

Like many people, I welcomed this on many levels. It acknowledged that good health is supported at the community level, and that prevention is preferable to repair.  I also understood the systemic challenges of moving from investment in centralised acute healthcare facilities and services to localised preventive health, where the infrastructure is variable or even non existent.

It's early days, but it’s likely that the success of Neighbourhood Health, like many top-down policy reforms, will be generated from the bottom up. In other words the policy shift gives  “permission” for local and community level actors to leverage resources and momentum to deliver services and programmes that keep residents healthy and living active and long lives.

So I’m on a mission to find these local and community actors and spotlight the exemplars in both practice and potential impact.  These are community- and neighbourhood- based organisations doing their thing and doing it well. We can learn a lot from them.

Last month I visited Hillbrow Health and Wellbeing in Eastbourne, a healthy living and activity centre formed through a partnership between Wave Active Ltd, and South Downs Health and Care GP Federation.

Wave Active is a Charity and Social Enterprise managing leisure sites across the Lewes District and Eastbourne Borough and is “passionate about providing services and opportunities that support individuals to gain, regain or maintain positive health, fitness and wellbeing”.  SDHC GP Federation is a CQC-registered organisation which runs NHS community healthcare services and is owned by the GP practices of Eastbourne, Hailsham, Seaford, Lewes, High Weald and Bexhill. Its vision is “to enable every person to live their best life”.

Together, through Hillbrow Health & Wellbeing, they provide a healthy living, activity focused centre linking resources between NHS Primary Healthcare Services and Community Leisure, ensuring GPs and Healthcare Teams can collaborate with leisure support staff to “provide proactive and dynamic care under one roof, enabling the best possible health and wellbeing in the community.”

I was given a full tour by the Wave CEO, Duncan Kerr, and its Chairman, Eric Kihlstrom, which included the swimming pool, sports hall (where a group of enthusiastic locals were playing pickleball), outdoor sports pitches, a full gym, a rehab facility and a dedicated Pilates centre.

All facilities and activities are accessible to local residents on a membership or pay-as-you-go basis.

I also visited the centre’s auditorium, where a staff member was preparing the A/V tech for an upcoming health education event. This was part of a regular programme of health education events, which cover a wide range of topics. Some recent events focused on

·      Active Age health MOT

·      Lung health management

·      Care for the carers

Health education is also delivered through the centre’s website via Podcasts and online articles. Some recent topics included

·      Hormonal health – understanding menopause

·      Navigating mental health challenges

·      Innovations in hip and knee replacements

My visit to Hillbrow coincided with the imminent opening of another Wave facility nearby, aimed at supporting older residents living with long-term health conditions. An outcome of Wave Active’s outreach initiatives in care homes, Lillian’s Room is funded through a legacy gift of an enthusiastic participant.

“Lilian lived in a nearby care home and regularly took part in our Wave Active Health outreach sessions. She embraced these visits with enthusiasm and joy, and it was clear that staying active meant a great deal to her. To honour her warmth and positivity, we have used her legacy to create a dedicated facility that will support active ageing, rehabilitation, and those living with illness or long-term health conditions.”

I followed up my visit to Hillbrow with some questions for Duncan and Eric to provide context and to expand on their aspirations for providing health and wellbeing services in their local community.

1. How would you describe Eastbourne as a city, place, neighbourhood and community in terms of health and health inequality?

Eastbourne is a coastal town with a mixed health picture, shaped by both its ageing population and the contrast between more affluent areas and neighbourhoods facing significant deprivation. These differences show up clearly in local health outcomes: some parts of Eastbourne experience higher rates of premature mortality, long‑term conditions, smoking, obesity, and alcohol‑related harm compared with national averages.

At a neighbourhood level, there are noticeable gaps in employment, education, and housing stability, all of which feed into wider health inequalities. Despite this, Eastbourne has a strong sense of community and an active voluntary sector, although support and resources aren’t evenly spread.

Overall, it’s a place where health varies a considerably depending on where one lives, and tackling these inequalities remains a major priority for local health services.

2. What do you see as the greatest needs amongst residents?

     I.         Housing Affordability & Supply

·      Eastbourne has a strong and growing need for new homes, with evidence suggesting around 735 new homes per year are required to meet local demand, including around 520 affordable homes annually.

·      Housing costs are high relative to local incomes, making it difficult for many residents, especially younger people and key workers—to buy homes and remain in the area.

·      There are concerns about the availability and affordability of private rented housing alongside specialist housing for older or vulnerable groups.

   II.         Cost of Living & Economic Constraints

·      Like many communities, Eastbourne has been affected by cost of living pressures, inflation, and wider economic uncertainty, putting strain on households and the Council’s finances.

·      Productivity and job quality remain local challenges, with productivity historically lower than the regional average and a relatively high proportion of jobs in lower-paid sectors, such as accommodation and food services.

 III.         Ageing Population & Care Needs

·      Eastbourne has an older demographic profile, with a significant and increasing proportion of residents aged 65 and over. This demographic trend drives demand for specialist housing, care and support services.

·      The proportion of people with disability or long-term health needs is higher than the national average, further underscoring the need for accessible services and accommodation.

IV.         Health & Wellbeing Inequalities

• Local health profiles show disparities in life expectancy and health outcomes across parts of the borough, pointing to wide health inequalities that impact demand for health and social care planning.

  V.         Deprivation & Social Cohesion

• While Eastbourne overall is not among England’s most deprived areas, localised pockets of deprivation exist (notably in areas such as Devonshire, Langney and Hampden Park), affecting opportunities and quality of life for some residents.

• There are also challenges around social inclusion, economic participation, and community cohesion tied to demographic and economic change.

VI.         Infrastructure & Connectivity

• Transportation, flood risk constraints, and limited development sites due to environmental and coastal factors are cited as barriers to growth and connectivity improvements.

• Digital connectivity and transport access remain priorities for planning and investment.

VII.         Opportunities for Young People

• Research into coastal communities more broadly highlights trends seen in Eastbourne too—where limited full-time employment opportunities and rising living costs make it harder for young people to stay and build careers locally.

In summary

Eastbourne’s local needs are shaped by housing affordability and supply challenges, an ageing population, economic pressures, health inequalities and pockets of deprivation. These are compounded by broader cost-of-living pressures and infrastructure limits, even as the town leverages its coastal location and cultural assets to support regeneration and economic strategy planning

Strategic Priorities for Local Health

Local health strategies emphasise:

• Reducing health inequalities through targeted prevention and support.

• Supporting healthy ageing with integrated health and care services.

• Addressing risk factors such as smoking, obesity, alcohol misuse, and physical inactivity.

• Strengthening community resilience and improving mental wellbeing.

Eastbourne’s health needs are strongly shaped by inequalities, chronic disease risk factors, an ageing population and socioeconomic influences on wellbeing. While overall health outcomes are similar to national averages, the gap between the healthiest and least healthy communities locally remains substantial, requiring coordinated public health, NHS and community action

3. What do you see as opportunities to serve the local area?

     I.         Become a National Example of Healthy Ageing

Eastbourne has one of the highest proportions of over-65s in the South East. That’s a challenge — but also a major opportunity.

Opportunities:

• Develop integrated active ageing hubs.

• Expand falls prevention, strength & balance programmes.

• Partner health, leisure and voluntary sectors around “prevention first”.

• Position Eastbourne as a “healthy coastal retirement town”.

   II.         Lead on Prevention & Active Health

Chronic disease, inactivity and health inequalities remain major local issues.

Opportunities:

• Embed physical activity into GP pathways.

• Scale community-based behavioural change programmes.

• Commission exercise as medicine initiatives.

• Target deprived wards with hyper-local outreach.

There is real potential for Eastbourne to become a prevention-focused system, reducing pressure on acute services.

 III.         Tackle Health Inequalities at Neighbourhood Level

Certain wards experience significantly poorer health outcomes.

Opportunities:

• Community-based “health ambassadors”.

• Co-location of services (health + advice + activity).

• Food insecurity partnerships.

• Culturally tailored mental health outreach.

IV.         Strengthen Community & Voluntary Sector Integration

Eastbourne has a strong charity and community presence.

Opportunities:

• Shared data dashboards between council, NHS and third sector.

• Joint commissioning models.

• Outcome-based funding for prevention programmes.

• Social prescribing expansion.

  V.         Develop as a Regional Centre for Rehabilitation & Recovery

With an ageing population and hospital provision already present:

Opportunities:

• Expand community rehab services

• Post-operative recovery programmes linked to activity centres

• Long-COVID, cardiac and MSK pathways delivered locally

• Reduce hospital readmissions through community follow-up

4. How do you build from this powerful blend of sports, exercise, rehab, clinical infrastructure to have real impact on the health and wellbeing of this local community?

Opportunities:

     I.         Build Seamless Clinical → Community Pathways

The biggest lost opportunity nationally is what happens after hospital discharge.

Imagine this model:

Hospital discharge → automatic referral → community-based supervised activity → behaviour change support → peer network → long-term membership model.

That requires:

• Shared referral criteria

• Shared outcomes dashboard

• Agreed clinical governance

• Named pathway leads

   II.         Create Tiered Levels of Support

·      Level 1 – Universal Prevention

Open access, low-cost physical activity.

·      Level 2 – Targeted Support

Structured programmes for inactive or at-risk groups.

·      Level 3 – Clinical Rehabilitation

Supervised, condition-specific programmes with governance.

·      Level 4 – Maintenance & Social Connection

Peer-led groups, community walking, social sport.

 III.         Data is Key

Impact only becomes visible when:

• measure physical activity levels

• track hospital readmissions

• monitor falls rates

• measure mental wellbeing

• track long-term adherence

Shared dashboards between leisure, primary care and demonstrate

• Reduced GP visits.

• Reduced readmissions.

• Reduced falls.

• Improved quality-of-life scores.

  
  

IV.         Use Eastbourne’s Scale as an Advantage

Eastbourne is large enough to matter, but small enough to align system leaders.

Convene:

• Hospital clinicians.

• Public health leads.

• Leisure operators.

• Voluntary sector.

• Primary care networks.

Shared aims, e.g:

·      Increase healthy life expectancy in the lowest two wards by 3 years over 10 years.

·      Reduce 65+ emergency hospital admissions by 10%.

  V.         Position It as Economic Strategy, Not Just Health

Better health means:

• Fewer work absences

• Lower care costs

• Higher volunteering rates

• Reduced social isolation

• More active older population

Prevention becomes economic resilience.

VI.         Build a Flagship Programme

Well-branded, evidence-backed, outcome-measured programmes that shift perception from “leisure” to “health partner”, e.g:

• “Active Recovery Eastbourne”

• “Stay Strong 75+”

• “Coastal Cardiac Pathway”

• “Move Back to Health”

5. Do you see this model as scalable to other local communities?

Definitely!

Many thanks to Duncan and Eric for their time and enthusiasm. Hillbrow is an exemplar of what is possible in promoting and supporting neighbourhood health.

Clare Delmar

Listen to Locals

17 February 2026