Community-Powered Health and Care

June 25, 2024  

The health and care system faces mounting pressure on services and fundamental challenges to delivery models. It’s grappling with an ageing population, health inequalities and growing complexity in health and care needs.  

But against this complex backdrop, innovative individuals, services and organisations are finding new ways to work with people and communities to rethink how we address these challenges.  

This practice review shares some of these inspiring community-powered approaches, alongside the learning we can draw from them and practical actions to implement this learning. 

Purpose of this report 

Our first practice review spotlights innovative community powered practice in the health and care system. Community-powered practice refers to the wide range of ways health and care organisations are working with communities to ensure they have a role in the design and delivery of services, and in decision-making and action around health and wellbeing in the place that they live.  

This report aims to: 

  • Demonstrate the range of community-powered approaches already being used across the health and care system (at neighbourhood, place and system levels) and the impact of this – presented in a framework to support wider implementation.  
  • Provide inspiration and practical insights for those across the health and care system who are looking to build community-powered practice into their own work. 
  • Identify a series of actions which underpin these approaches and the steps that can be taken to implement them as mainstream practice across the health and care system.  

In Practice: Diabetes Management in Sheffield

Background: Heeley Plus Primary Care Network (PCN) delivers GP services to a population of 42,000 across Sheffield. They wanted to give people more power to manage their Type 2 Diabetes.

This work began with a co-production steering group drawn from primary care teams, local community anchor organisations, and people with lived experience of T2D, including staff members.

The group focused on:

  • Using the latest evidence for self-management, peer-support and group work, and a low-carb, real-food diet.
  • Empowering people and communities in line with asset-based community development, so that the locus of control shifted from services of ‘doing to’ to things ‘being done by’.

Approach: The main goal of Heeley Plus PCN’s initial co-production work was to create a “life-enhancing system” for managing T2D instead of a traditional clinic. Over six months, they used action learning to refine their approach through patient feedback.

Now, Heeley Plus PCN offers:

  • 30-minute holistic medical reviews with GPs or diabetes nurses
  • One-on-one support with social prescribing link workers, health coaches, or care coordinators
  • The patient-led ‘Kick Start’ group for peer support and self-management
  • The clinician-led ‘Diet for Remission’ group focusing on behavior change
  • Informal support through peer support cafes and patient groups

Impact: The clinic’s impact includes improved patient outcomes, particularly within Asian communities, by overcoming language and cultural barriers. They are now collecting information on patient outcomes and experience.

Read more case studies in the full report.

The rise of community powered health and care  

There is growing consensus around the need for health and care reform to enable a shift towards a system with a greater focus on prevention, early intervention and tackling health inequalities. It is against this backdrop that innovative parts of the health and care system are exploring new ways to work with communities and other partners, to help achieve this shift. Alongside this innovative practice, there have been important structural reforms with the introduction of Integrated Care Systems and a growing policy interest in the potential of health and care organisations working differently with people and communities.   

In Practice: Supporting new parents in West Yorkshire

Background: Launched in 2010, Auntie Pam’s is a peer-support service in Kirklees for women and families during pregnancy and early parenthood.

Approach: Delivered by volunteers, Auntie Pam’s takes a holistic approach to health and wellbeing, addressing challenges like housing, education, and relationships. Now part of Kirklees Council, it offers drop-in centers in Dewsbury and Huddersfield, plus community outreach. Services include housing and benefits information, smoking cessation, healthy eating guidance, and parental support, with a library and baby clothes swap shop. Volunteers receive training on pregnancy, baby care, and mental health.

Impact: Since 2010, Auntie Pam’s has had over 7,800 visits, 1,500 referrals, and trained over 300 local women as volunteers, with a pandemic-adapted phone support line.

Embedding community-powered practice

The review sets out a framework with three paths to embedding community-powered practice into the health and care system. Each path is accompanied by case studies to provide inspiration and insight into what this can look like in practice.

  1. Engaging with communities to understand what matters to them – There is growing awareness of the importance of deeply engaging with communities to understand what matters most to them around health and wellbeing. Health and care organisations can’t solve our big health and wellbeing challenges alone. Gaining insights from communities and using this as a launchpad for collaboration and community-led action, is therefore critical.  
  2. Centring service design and delivery around communities – There is growing interest in community-powered approaches to service design and delivery, and the potential to ensure services better meet people’s needs, improve access to services and link people to networks and support beyond formal health and care services. 
  3. Investing upstream in communities – Health and care organisations are increasingly recognising the importance of supporting action upstream of formal services, within communities, in order to help improve people’s health and wellbeing. This is particularly important given the need to take action on health inequalities, and the need to support people living with one or more long-term health conditions, including supporting people to live well as they get older.  

In Practice: Neighbourhood Networks in Leeds

Background: In Leeds, 37 Neighbourhood Networks, each run by a voluntary organisation, support healthy aging across the city.

Approach: Funded by Leeds City Council, each network is managed by a mix of paid staff and volunteers and involves older people in governance. They offer services and activities like lunch clubs, day trips, information and advice, volunteering opportunities, transport provision, and physical activity support. Membership is free, and people can join via referrals or through community connections, with opportunities for members to become volunteers and vice versa.

Impact: Research by the Centre for Regional Economic and Social Research highlighted the networks’ effectiveness from 2019 to 2022. The networks supported people with long-term conditions through prevention, delaying onset, and reducing pressure on carers and services. They increased social contact, reduced isolation, and promoted independence.

Read more case studies in the full report.

Four actions to grow community powered health and care  

Drawing on the presented case studies, the Practice Review sets out four practical actions to help mainstream community powered approaches across the health and care system.  

Action One: Look for opportunities to get out into communities – There are a range of ways that health and care organisations can get out into communities, rather than just expecting people to come into formal healthcare settings. This is possible for both the direct delivery of some health and care services as well as for community engagement activities. From a service delivery perspective, this could make it easier for people to access services. For engagement activities this could create opportunities to reach a wider range of people and open up space for different kinds of conversation about health and wellbeing.  

Action Two: Commit to ongoing community engagement as a strategic priority – Community engagement can inform a wide range of strategic and operational activity across health and care systems – supporting work including identifying overarching place-based priorities, improving services and organisational processes, and action upstream of services to improve health and wellbeing. Embedding engagement as an ongoing strategic priority requires a range of different engagement tools and approaches, a commitment to being action-orientated, a willingness to learn and adapt, and a focus on how to build community insight into key organisational and system structures and processes.    

Action Three: Take a strengths-based approach to working with people and communities – Taking a strengths-based approach to working with both individuals and communities is fundamentally about recognising that health and wellbeing can be supported by a wealth of resources, groups and networks out in communities as well as formal health and care services. It is also about recognising that health and care organisations can play roles in supporting and enabling community activity as well as delivering services. Strengths-based approaches can be applied to community engagement, the design and delivery of formal services, and to efforts to support community health and wellbeing upstream of formal services.  

Action Four: Contribute to building capacity in the VCSE sector and in communities – Complementing a focus on community strengths and assets, it is also important for health and care partners to consider how they can contribute to building capacity in the VCSE sector and communities. There are a range of practical ways to do this including direct funding for VCSEs or community initiatives, training and support, and working in supportive and genuinely collaborative partnerships.  

In Practice: Neighbourhood Lung Checks in Manchester

Background: The Lung Health Check pilot, initiated by Wythenshawe Hospital’s lung cancer team with Macmillan Cancer Support and University of Manchester researchers, aims to detect lung cancer and other lung conditions like COPD at earlier, more treatable stages. The initiative focused on screening in deprived areas of Manchester with high lung cancer prevalence, bringing healthcare services directly into communities.

Approach: Individuals aged 55 to 74 who were smokers or ex-smokers were invited for lung health checks at mobile units in accessible locations, such as supermarket car parks. The checks included an initial consultation and breathing test with a lung specialist nurse, followed by a CT scan if necessary.

Impact: The programme significantly improved early lung cancer detection, with 79% diagnosed at stage one, compared to the p;pnational average of 19.5%. Participant feedback was overwhelmingly positive, with 99% rating the service as “excellent” or “good,” leading to a national rollout of the approach.

Read more case studies in our full report.

We hope you find inspiration and practical support from this practice review. If you’re interested in working with us to embed some of these approaches, please get in touch with our practice team.

June 25, 2024
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