Neighbourhood health is being designed around prevention, continuity, population need and care closer to home. Much of that work is already familiar territory for primary care nursing.

For Estefania Costa, Regional Primary Care Nursing Workforce Educator Lead for NHS England in the East of England, that creates both an opportunity and a concern. Her work spans the nursing workforce pipeline, from students’ first exposure to primary care through to career development, retention and workforce intelligence.

“Nurses already work at the intersection of clinical care, prevention, continuity, relationships and population need,” she says. “And that is exactly where neighbourhood health needs to operate.”

Yet, Estefania argues, the scale of that contribution is not always matched by nursing’s visibility in the conversations shaping future care. Nurses already play significant roles in long-term condition management, immunisation, screening, prevention and patient education, but can still be brought into workforce planning and service redesign too late.

General practice nursing has historically been viewed through the lens of service delivery, while its contribution to leadership, workforce intelligence and system design can be harder to see.

Understanding the workforce therefore means looking beyond current numbers and understanding the full pipeline. Where are people entering primary care? Can they see opportunities to develop and lead? Furthermore, where are the gaps beginning to emerge?

Without that intelligence, systems risk planning tomorrow’s services without a clear picture of the workforce expected to deliver them.

"When making decisions about neighbourhood care we need to understand the workforce that will deliver and shape it."

This also informs Estefania’s view of retention. Keeping somebody in post is only part of the picture; nurses also need to be able to see a future for themselves in primary care, with opportunities to develop, progress and influence the services the help deliver.

For those responsible for designing neighbourhood services, this matters beyond the nursing profession itself. If new models depend on nursing expertise, understanding how that workforce is recruited, developed and retained becomes part of making those services sustainable.

It is why Estefania describes nursing as part of the “strategic architecture” of neighbourhood care.

Her positioning is about representation within the wider multi-disciplinary team: ensuring nursing expertise is present while decisions are being shaped, rather than introducing it once a model has already been designed.

Neighbourhood health presents an opportunity to embed nursing leadership from the outset, drawing on its understanding of patients, communities and population need. Moving ahead without that representation risks creating services dependent on nursing expertise without sufficient involving the workforce expected to make them work.

At Best Practice Birmingham 2026, Estefania will explore that challenge alongside senior nursing leaders from education, clinical practice and system leadership, examining what the nursing workforce needs, to help neighbourhood care succeed.

“Neighbourhood health will be delivered more effectively when nursing is visible, supported and involved in decision-making from the start. Look around your decision-making tables and if nursing is not there, ask why - and then change it.”