For years now, the NHS Confederation and our partners have attested to the transformative power of integration across public services at ‘place' – the geographic level best recognised by communities and seen by health and local government leaders as where integration is best delivered.

The Government rightly recognises the benefits of local, community-driven planning and delivery of health and care services, which is why the health and social care secretary Wes Streeting has put creating a Neighbourhood Health Service at the heart of his agenda. 

With the sector now rallying around this new concept, asking important questions about what it really means, how it works and what should change, there is a risk that by focusing on ‘neighbourhoods', we forget the crucial and different role for ‘places'.

Though they do sound it, these aren't just abstract concepts. Place partnerships and neighbourhood teams are built around populations and geographies, reflecting and responding to how people live their lives. Our recent report - The state of integration at place - highlights some of the ways in which place partnerships are improving people's health by reducing avoidable admissions or programmes to make housing adaptations that prevent people from falling in their homes. 

Where this has been successful is where the focus is on a meaningful local geography that the public recognises; local leaders understanding their geographies through community connections and population health data; and collaborative working to address specific, shared challenges. 

Through the regular conversations I have with local leaders, it is clear to me that ‘neighbourhoods' are about a stronger and more responsive relationship with communities. They aim to build hyper-local, collaborative ways of working which means services, whether led by the public sector or communities, improve people's health and wellbeing. This might be a programme to improve vaccine uptake in a specific religious community, a targeted programme to drive diabetes health checks in a deprived urban neighbourhood, or a new community space for young mums that brings together medical post-natal services with wellbeing support and socialising opportunities. 

‘Places' operate at a larger scale and can be both about delivery at scale and about planning and commissioning services across their place. Where I live in York, partners have worked together to successfully reduce the number of frail patients in hospital care and decrease ambulance call-outs by over 100 per month. This work can only have a meaningful impact if it is delivered beneath the ‘system' scale – sometimes covering populations over a million – and above ‘neighbourhood'. This is why ‘place' is so crucial.

National policy leaders are focused on place, but we know there is contention over what it really means, and where it's best applied. This isn't about place versus neighbourhood and which is better. It needs to be about both and setting clear parameters about their collective contribution to the country's healthcare ambitions.

This isn't just about the NHS either. Planning and delivery at place can and should be about improving how the NHS works, but also about addressing the wider determinants of health. It is about supporting NHS providers with the immediate challenges they face in urgent and emergency care, the winter crisis we are all experiencing, and ambulance handovers, and about long-term change: shifting care closer to communities, preventing ill health, and capitalising on the two-way relationship between good health and the economy. 

This means that place should include and consider how NHS providers of all stripes work together to improve people's health, but should also involve voluntary and community organisations, charities, businesses, local government and others to address the wider determinants of health, including local economic development. In many areas, the NHS should indeed be led by those organisations who have unique experience and knowledge for us to learn from. This is not how the NHS has worked in the past, but how we must work in the future.

We are about to enter a period of significant policy development in health and social care. A clear narrative about the role for partnerships, planning and delivery at system, place and neighbourhood levels is essential. In and amongst the focus on defining a Neighbourhood Health Service, we must not lose focus on the places that matter to people.