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Health and wellbeing

Keep it Local Health Commissioning Guide

A practical 10-step guide for health commissioners to unlock the power of local VCSE providers.

Overview

In early 2024, we published Keep it Local for Better Health: How Integrated Care Systems can unlock the power of community. This expanded the Keep it Local approach for transforming local services solely from councils and into health systems.

This guidance explores the practical steps health systems can take to embed a key Keep it Local principle – commission services simply and collaboratively so they are “local by default”.

It builds on our previous version for local authorities, incorporating a wealth of insight based on more than a decade of working with forward-thinking councils, as well as Locality’s years of research developing the Keep it Local for Better Health approach. 

It has also been shaped by the real-world experience of West Yorkshire Integrated Care System (ICS), as they have become the first in the country to adopt Keep it Local.

Our experience shows the Keep it Local approach to commissioning can empower the local VCSE sector and enable them to achieve the full impact of their services.

The guide is a vital tool for commissioners seeking to strengthen the sector’s contribution to health and achieve the desired shift to a more prevention-focused and community-based “neighbourhood health service”.

If you’d like to understand more about the Keep it Local approach for your health system, contact us at policy@locality.org.uk

Related reports

How West Yorkshire became the first “Keep it Local” Integrated Care System
Keep it Local

How West Yorkshire became the first “Keep it Local” Integrated Care System

Published: 24 March 2026
20 minute read
1 document
Overview
Overview

What health systems across the country can learn from the trailblazing approach to delivering a more prevention-focused and neighbourhood-based health service.

Keep it Local for Better Health
Keep it Local

Keep it Local for Better Health

Published: 14 February 2024
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1 document
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How Locality’s long-standing Keep it Local principles for public services can help Integrated Care Systems unlock the power of community.

The VCSE sector in prevention and primary care

Published: 09 October 2024
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Locality has compiled this report on behalf of the NHS England People and Communities Directorate.

The formation of “VCSE Alliances” within Integrated Care Systems (ICSs) is an important step in embedding the voluntary, community and social enterprise sector within health systems.

On the back of this, this report seeks to continue NHS England’s focus on addressing barriers and developing a greater understanding of the benefits of embedding the sector by exploring its role in prevention and primary care in neighbourhoods.

It is an important topic – within ICSs, VCSE organisations play arguably their most important role at the neighbourhood level. Their close connection, trust, and understanding of local people and the wider determinants of their health is a vital asset to the work of the NHS to keep people healthy in their communities.

Through a focus on real-life examples across the country, this research focusses on understanding the trends and opportunities in VCSE involvement in prevention and primary care, the benefits produced, and the factors for success.

Space to thrive

Published: 30 March 2023
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1 document
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Creating health and wealth by stealth

Published: 31 January 2023
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New research from Locality recommends changes to the way the health system involves community anchor organisations in illness prevention services.

Our latest report – Creating health and wealth by stealth – explores the role of large, well established community organisations in promoting good health and preventing disease in their neighbourhoods.