England's largest ICB by geography, serving 3.1 million people across some of the most deprived communities in the country. Two NNHIP Wave 1 sites are already active — and the region's health inequalities make the case for broader programme coverage.
Formed in July 2022 from the merger of eight former CCGs. The largest ICB in England by geography, spanning from the Scottish border to the Tees Valley, with a population facing persistent health inequalities and significantly lower healthy life expectancy than the national average.
The North East has the lowest healthy life expectancy of any English region. Multiple local authorities — including Middlesbrough, Hartlepool, Sunderland, and South Tyneside — rank among the most deprived 10% nationally. The gap between the most and least deprived communities within the ICB footprint is stark: male life expectancy varies by over 10 years between the most affluent and most deprived neighbourhoods.
Chronic disease prevalence is significantly elevated: cardiovascular disease, COPD, diabetes, and mental health conditions all exceed national averages. The region also has higher rates of smoking, obesity, and alcohol-related harm — the wider determinants that neighbourhood health programmes are designed to address.
Why this matters for NNHIP: The North East's health profile represents exactly the kind of population that neighbourhood health is designed to serve — high deprivation, high chronic disease burden, and a system under significant financial pressure that cannot rely on acute capacity alone.
Stockton and Sunderland were both selected in the September 2025 Wave 1 cohort. Both sit in areas of significant deprivation and have existing integrated care foundations to build from.
One of the most deprived boroughs in England with stark intra-area inequality. Central Stockton wards rank in the bottom 5% nationally for multiple deprivation. Strong existing partnership between the borough council and NHS providers, with a history of place-based health initiatives.
NNHIP Wave 1Long-established All Together Better (ATB) integrated care partnership — one of the most mature vanguard models in the country. Population of 277,000 with significant health inequalities. The existing infrastructure provides a strong foundation for NNHIP delivery.
NNHIP Wave 1| Area | NNHIP Status | Population | Key Challenge |
|---|---|---|---|
| Stockton-on-Tees | Wave 1 | 197,000 | Bottom 5% deprivation in central wards. Cardiovascular mortality significantly above average |
| Sunderland | Wave 1 | 277,000 | ATB integrated model established. Scaling from vanguard to neighbourhood level |
| Middlesbrough | No Programme | 141,000 | Most deprived LA in England (IMD 2019). Male life expectancy 12 years below least deprived areas |
| Hartlepool | No Programme | 94,000 | Among most deprived 10% nationally. High chronic disease burden, workforce challenges |
| South Tyneside | No Programme | 151,000 | Significant health inequalities, aging population, high emergency demand |
| Gateshead | No Programme | 202,000 | Strong VCSE infrastructure. Potential for community-led neighbourhood approach |
The gap: With only 2 of its most deprived areas in Wave 1, the NENC region has significant underrepresentation in the NNHIP programme relative to its health inequalities burden. Middlesbrough — the most deprived local authority in England — has no current neighbourhood health programme coverage.
A region where the health data makes the case for neighbourhood-level intervention without needing interpretation. The numbers are unambiguous.
Key decision-makers, influencers, and delivery partners across the NENC system.
The NENC system has scale, complexity, and acute health inequalities — but only two NNHIP sites. The opportunity lies in building programme architecture that connects Wave 1 learning to the broader regional need.
Stockton and Sunderland need audit-ready evidence chains that demonstrate impact to the ICB board and NHSE. Our TIP methodology (Tasks, Initiatives, Proof) provides the structured framework that programme coaching alone doesn't deliver.
Immediate valueMiddlesbrough, Hartlepool, and South Tyneside have deprivation profiles that justify programme inclusion. We can build the evidence base, governance design, and stakeholder alignment needed for compelling Wave 2 applications.
Strategic positioningPurpose, Place, Habitat, Environment, Organisation — applied to the NENC geography. Understanding how neighbourhood health sits within the physical estate, policy context, and governance structures that shape delivery across 12 local authorities.
Place-based designUnlike many regions, the North East has a history of integrated working that predates NNHIP. Sunderland's All Together Better partnership, County Durham's integrated community services, and the wider ICS development programme all provide foundations that neighbourhood health can build on rather than create from scratch.
The challenge is not the absence of partnership — it's the absence of structured programme architecture that turns partnership intent into measurable, auditable neighbourhood-level outcomes. That's the specific gap where RiDraw's cross-sector methodology applies.
The strategic case: NENC's ICB Chair (Prof Sir Liam Donaldson, former CMO) brings national credibility. The region's deprivation profile makes it a priority for neighbourhood health expansion. And the existing integration foundations mean the work starts from partnership, not from scratch. The missing piece is the evidence and programme discipline that connects these assets to demonstrable outcomes.
RiDraw works with NHS and public service systems on transformation challenges where multiple organisations must align around shared outcomes without shared governance.
Every neighbourhood health programme needs an evidence chain that satisfies ICB boards, NHSE, and the national taskforce. Our TIP framework structures work into clear tasks with defined initiatives and auditable proof.
Evidence disciplineNeighbourhood teams bring together hospital doctors, GPs, community nurses, social care, pharmacy, VCSE, and councils — without a single point of authority. We map influence, identify blockers, and design governance that works.
Governance & relationshipsPurpose, Place, Habitat, Environment, Organisation — understanding how neighbourhood health sits within the physical and institutional landscape. Directly relevant to NNHIP estates enabler group and wider determinants.
Place-based designA 30-minute conversation to share what we're learning across NNHIP sites and explore how it applies to the North East and North Cumbria.
Start a ConversationRiDraw Exchange turns programme intelligence into structured, shareable evidence. Create exchanges that prove what NENC is delivering.
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