Are you designing Neighbourhood Health Centres like this?
This is part 2 of 2 . Find Part 1 here.
We are building neighbourhood health centres at the moment the ‘neighbourhood’ itself is under the greatest pressure it has faced in decades.
Closing libraries.
Shutting community centres.
Shrinking green spaces.
Cutting youth services.
Reducing bus routes.
Watching high streets empty.
I’m not sure you can build a neighbourhood health centre in a neighbourhood the system appears to be simultaneously dismantling - and expect a clinical building to hold things together.
But a bridge? A bridge is a different proposition entirely.
A bridge doesn’t just stand in a place. It connects two things that were previously separate. And it changes the relationship between them permanently.
That is what a neighbourhood health centre could be.
But it’s almost never what it is designed to be.
I’ll be open here - I am not against the Neighbourhood Health Centre (NHC) programme - I am genuinely excited by it. But there is a version of the NHC that becomes one of the most significant missed opportunities in a generation, and I do think we are drifting towards that version.
Yes, a well-designed new building could do wonderful things. It can support a high street, create space for local people and community activity, and even over time create civic pride. That possibility is real and it really does matter.
But we cannot afford to reduce this to a simple equation: Health centre + a few community rooms = a happy, healthy neighbourhood.
We should not be so hubristic as to assume it will work like that - without the thinking, the community grounded-ness, and a genuine spatial health strategy to back it up.
What’s needed now is something harder and more interesting than a building. A nuanced, connected spatial health infrastructure response – or better yet, an ongoing working practice - that asks not just what goes inside the health centre - but what that health centre does to the street, the local economy, the green space, the high street, and the community assets surrounding it.
And then: How all that translates into a strategic infrastructure plan for the NHC – one that bridges and networks to what is already there.
BUT…
None of this should be viewed through the lens of construction social value.
That is a completely different question.
This is a health and social infrastructure one.
The difference matters.
The potential of the NHC
Done properly, with the right thinking by the right people at the right time, this could produce a legacy nobody thought possible (and likely save money in the process).
Done purely as a building programme (clinical rooms + community spaces) with the usual community consultation bolted on, these buildings run the risk of becoming islands instead of the bridges they should be.
The question that should be in every single NHC business case - right now, at the start, before the brief is written is this:
How do we use this building to actively support the local places, people, and organisations that make this neighbourhood worth living in - and what would it look like if we got that right?
If nobody in the room can answer that question, the bridge hasn’t been designed yet.
And a health centre that’s not a bridge is just a building.
We can do so much better than that.
These Autumn 2026 pieces are written alongside the Festival of Wrong Conversations - Loxie and Unbuilt’s free, fully digital counter-festival challenging everything we think we know about health infrastructure. Browse the full programme here.
