The Friendly Neighbourhood Hospital: Rethinking Diabetes Care Beyond the Consultation: A Conceptual Perspective

Contemporary diabetes care is largely organised around one-to-one clinical consultations and the regulation of biomedical outcomes. While such approaches remain essential, they may be insufficient for addressing the social and behavioural aspects of chronic disease management. Based on this conceptual perspective, we propose the Friendly Neighbourhood Hospital as an approach to supporting peer contact and self-management, complementing clinical care. Drawing on affordance theory, social architecture, and urban social geography, we argue that hospital environments can shape participation, learning, and behavioural change through mechanisms including peer interaction, tacit knowledge, situated learning, and institutional trust. We illustrate this approach using five settings: communal cooking, movement and social interaction, public and cultural events, flexible access, and digital participation. These examples are illustrative and not evaluated interventions, and their anticipated effects, ranging from immediate participation and belonging to longer-term behavioural change, remain hypotheses for future testing. From this perspective, we do not advocate for replacing individual consultations but rather for repositioning them within a broader social and spatial context.