4 reasons why the NHS needs community power

July 1, 2021  

Rising demand, poor outcomes, public expectations and the need to bring humanity to healthcare are why giving more power to communities is the change the NHS needs argues Luca Tiratelli.

The NHS is our most treasured national institution. For over 70 years now, it has been there for us as a country – universal, free at the point of use and available to all.

Ensuring it remains this way for the next 70 years and beyond is an imperative. However, considering the threats the service now threats, this will mean embracing change.

Community-based approaches represent that change.

They are based on the principle that people themselves have the best understanding of their own lives. They involve transferring power and resource down from bureaucratic centres and to people themselves. 

Whether it’s things like the Community Champions scheme, Local Area Coordination or simply community initiatives run out of GP surgeries – community power can make a difference.

Now is the time to start thinking about community power in healthcare. Here’s why:

The Crisis of Rising Demand

The number of people needing acute services is rising, both in absolute terms and relative to the size of the population. NHS budgets and staffing resources are not growing commensurately and will struggle to do so as the population ages.

This means we need a health service that is much more preventative – so that it can stop acute pressures from building and contributing to the crisis.

Community-based approaches are inherently preventative, as they deal with the life situations, environment and everyday issues that create poor health in the first place, in the places where people live their everyday lives.

A&E Admissions per 1,000 people per year

Poor Outcomes

Adopting more preventative approaches and reducing demand will then free up frontline staff to devote more time, energy and resource to the cases that remain.

As the GP Jaweeda Idoo noted at New Local’s recent conference, community power allowed her to get back to the “medical bits” of their job.

This can help improve the NHS’s performance. This is important, because at present, Britain lags behind other similar nations on a variety of metrics, for example cancer survival rates.

It might also help staff morale. At present huge numbers of those who work in the NHS feel like that the current state of affairs prevents them “doing their job properly”, or feel that the culture created by the demands of current ways of working is difficult is less than ideal. These things need to change.

Public Expectation

While the NHS is hugely loved as an institution, the broader picture is that today, many people do not enjoy their interactions with public services of any kind.

Too often, people’s experiences are characterised by unfathomable bureaucracy, paternalistic practice, and impenetrable jargon. They are dealt with either as a passive recipient, or as a customer.

Community-based approaches open the possibility of engaging with people as people, and of an equitable relationship emerging between the public and the public sector. This will lead to better outcomes and more positive experiences for all.

State of healh services by country, scored 1-10

Bringing Humanity to Healthcare

The final, and perhaps most important, reason why the NHS (and the wider public sector) needs to adopt community-based approaches is because they are fundamentally more humane.

Experiencing health problems is traumatic. Going to A&E, no matter how good the service and effective the treatment, is traumatic. Preventing people from experiencing these things is a moral good.

Similarly, building communities, and creating spaces where people’s health is nurtured and encouraged means creating a better society.

As such, community-based, preventative approaches, represent a fundamentally more humane vision of a health service.

New Local is running a Call for Evidence on how our health service can be improved, and become more community powered. Join it here until 9 July 2021.

Photo by Ian Taylor on Unsplash

Join our mailing list