A district score tells a commissioner where to care. It does not tell an outreach worker where to park the van. Reachable Neighbourhoods bridges that gap, ranking 17 named neighbourhoods by the factors that determine whether outreach will actually find the Missing Middle.
The journey from intelligence to action fails most often at the last mile. A commissioner accepts that a district is high-risk, but the team tasked with screening has no basis for choosing one neighbourhood over another. This tool exists to make that operational decision defensible, ranking neighbourhoods of around 7,500 residents by deprivation, solo living, access and — distinctively — three-month prescribing velocity.
Most signals describe a static state. Three-month prescribing velocity describes change: a neighbourhood where dispensing of frailty-associated medications is accelerating is a neighbourhood where need is emerging now, not historically. This is the trajectory principle applied at neighbourhood scale, and it is what lets the shortlist point teams at need that district-level snapshots have not yet caught up with.
Velocity is volatile. Short windows amplify noise; a three-month prescribing spike can reflect a single practice's coding behaviour rather than a real population shift. The signal is a prompt, not proof.
Named neighbourhoods invite over-confidence. Putting a real place-name on a card makes the analysis feel more certain than the underlying small-area data warrants.
Coverage is partial. Seventeen neighbourhoods is a shortlist, not a census of need; absence from the list is not evidence of safety.