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?

I’ve had cause recently to use several NHS services — GP appointments, hospital visits, the lot. And one thing really struck me. Many of the doctors and nurses who looked after me were from overseas. I want to be absolutely clear: this isn’t a criticism. In fact, it’s the opposite.