It is unusual for me to read a policy document from NHS England that I feel generally pretty positive about. The launch at the end of January the NHSE Neighbourhood Health Guidelines might be an important and hopeful moment. However, in order for these guidelines to make a difference they must be used by local change agents in the statutory and voluntary sector as a platform to engage with, motivate and challenge NHS structures to respond and put in place actions that will fundamentally change current working practice.