The language of “Neighbourhood Health Hubs” is everywhere right now. Integrated teams. Shared services. Care closer to home. A seamless system wrapped around a population of 30,000–50,000 people. On paper, it sounds transformative. In practice, many working in primary care are asking a more uncomfortable question:
How can neighbourhood hubs work when the buildings, workforce, and infrastructure simply aren’t ready?

Because while the policy vision is ambitious, the reality on the ground is far more complicated — and patients are already feeling the consequences.

Let’s be honest: much of this is already happening in PCNs

Neighbourhood hubs are often described as something new, but the truth is:

• shared workforce
• extended access
• multi‑disciplinary teams
• centralised diagnostics
• cross‑practice clinics

…are already happening under PCNs.

Neighbourhood hubs are essentially PCNs with more expectations and a new badge.

The difference is not the concept — it’s the scale, the visibility, and the pressure to deliver more services from fewer sites.

This Week’s Announcement: 27 New Neighbourhood Health Centres Proposed

On 26 March 2026, the Government announced the first 27 Neighbourhood Health Centres, part of a long‑term plan to create 250 centres by 2036. These first sites will:

• open by 2027
• operate 12 hours a day, 6 days a week
• provide urgent care, GP access, pharmacy services
• expand to include social care, employment support, and voluntary‑sector services

But the most important detail is this: These hubs are not new buildings. They are refurbishments or expansions of existing NHS estate.

The Government confirmed that the first wave — and indeed the first 50 centres — will be created by repurposing existing GP practices and health centres, not building new ones.

This means the entire neighbourhood hub model is being built on the current primary care estate, much of which is ageing, cramped, GP‑partner‑owned, and already at capacity. The vision is new. The buildings are not.

The estates elephant in the room: GP‑owned buildings

A large proportion of primary care estate is owned, leased or maintained by GP partners. This creates a fundamental tension. The NHS does not own the buildings it expects to transform into neighbourhood hubs.

It cannot force partners to upgrade, mandate co‑location, require structural changes or compel expansion

And crucially: There is no national capital programme to upgrade GP‑owned buildings for neighbourhood hubs.

ICS capital budgets remain extremely limited and are largely consumed by hospital projects. Primary care estates funding is patchy, competitive, and often insufficient.

The Workforce Reality: Who Will Staff a 12‑Hour‑a‑Day Hub?

The announcement promises hubs open 12 hours a day, 6 days a week. But primary care is already struggling with:

• GP shortages
• nurse shortages
• recruitment gaps in ARRS roles
• retention problems
• burnout
• rising demand

Extending opening hours means more reception cover, clinical cover, security, cleaning, utilities and rota complexity.

Yet no additional workforce plan has been published alongside the hub announcement. This is why many in primary care fear the model risks becoming “More hours, same staff.”

And that is not sustainable.

The Financial Reality: Overheads Will Rise — Without Matching Funding

If a building is open 12 hours a day instead of 8, virtually all costs rise immediately. For GP‑owned premises, these costs fall on the partners unless the NHS provides a revenue uplift, a service‑level agreement, or a dedicated estates budget.

So far, none of these have been confirmed. The Government’s announcement focuses on refurbishing existing buildings, not funding the ongoing operational costs of running them for longer hours.

This is a major gap in the policy.

The Patient Experience: Care Further Away, Not Closer to Home

This is where the gap between policy and reality becomes painfully clear.

A real example illustrates the point: I needed a certain test that could only be done at another practice in the area, about 8 miles away. That was okay, as I could drive, but many do not and getting there would be costly or inconvenient. The test I needed was one that was previously taken at my surgery.

This is happening everywhere:

• diagnostics centralised at one site
• ARRS staff placed where there’s space
• extended access delivered from the “biggest” building
• community teams squeezed into whatever room is available

For many patients, neighbourhood hubs mean longer travel, less continuity, more confusion and less choice.

This is not “care closer to home.” It’s care further away, but under the same banner. And extended hours will probably not solve this. Many older or vulnerable patients will not want — or be able — to attend a 7:30pm appointment in the depths of winter.

Why the system thinks this is good — and why patients don’t feel it

The system’s logic:

• centralise equipment
• centralise specialist staff
• improve quality
• reduce duplication
• increase efficiency

The patient’s reality:

• more travel
• more complexity
• more waiting
• less personal care
• less clarity about where to go

Both perspectives are valid — but only one is lived. The real issue: hubs are being built on the wrong foundations. Neighbourhood hubs could work brilliantly — if:

• buildings were modern
• transport was reliable
• staffing was stable
• digital systems were integrated
• capital investment was real
• patient experience was prioritised

But right now, hubs are being layered onto old buildings, GP‑owned premises, limited capital, patchy transport, overstretched workforce, and inconsistent IT.

The foundations simply aren’t ready.

The uncomfortable truth

Neighbourhood hubs are not inherently bad. The idea is sound. The ambition is right.

But without new buildings, proper investment, realistic travel planning, genuine co‑location, clear communication and a primary care estate strategy that matches the rhetoric, then… the model risks becoming PCNs with a new name, not a meaningful improvement.

And patients — especially those who don’t drive, who are frail, or who rely on local continuity — will feel the impact first.

Integration must start with reality, not rhetoric Neighbourhood hubs could transform care. But only if the system acknowledges the truth: You cannot deliver “care closer to home” without investing in the places where care happens — and the people who deliver it.

Until then, patients will continue travelling further for services that used to be local, and primary care will continue carrying the weight of a vision built on the wrong foundations.

References

1. Department of Health and Social Care (2026).

Communities to benefit from health centres on their doorstep (26 March 2026).

Confirms first 27 centres, £50m investment, 12‑hour opening, and refurbishment of existing buildings.

2. Pulse Today (2026).

Government announces first 27 neighbourhood health centres (26 March 2026).

Details locations, services, and the focus on repurposing existing estate.

3. NHS England (2026).

Neighbourhood Health Centres: National Rollout Update (26 March 2026).

Confirms that the first wave will be delivered through upgrades to existing premises.

4. BMA & GPCE Statements (2024–2026).

Workforce shortages, GP retention concerns, and sustainability warnings.

5. NHS Digital / Primary Care Workforce Data (2025–2026).

Evidence of GP, nurse, and ARRS recruitment pressures.