Our extended GENIAL 2.0 framework also makes it clear that in order to promote the health and wellbeing of our nation, the NHS cannot shoulder the burden alone. We present a range of compelling evidence that the health and wellbeing of individuals are not just determined by individual factors and that community and environmental determinant of health that must also be targeted to reduce the burden imposed by chronic conditions. This requires a shared understanding of the problems and solutions and joined up working between the