Unlocking the potential of communities to transform health

A new report from the NHS Confederation and Local Trust – The case for neighbourhood health and care – explores why health services in England need to engage with neighbourhoods and communities. Here Rachel Rowney, chief operating officer at Local Trust, looks at the impact of health-related projects on communities in the Big Local programme.

To purposefully misquote an aphorism, if you start with health you can change everything.

Twelve years into the Big Local programme, I feel confident in writing that every single one of the 150 Big Local areas has chosen to spend a portion, if not all, of their just over one million pounds on health-related projects.

The reason I feel so confident writing this is that health-related projects aren’t limited to the obvious examples, where Big Local areas have brilliantly partnered with their local primary care providers to offer community-based health checks or advice.

When I think about health in a Big Local context, I  think about the community pantry in Dover offering nutrition advice and cookery lessons, and the Shape Shifters programme in Northwood, where local people have had the chance to exercise but also to make friends and improve their overall wellbeing.

I also think about Ewanrigg Big Local’s We Will campaign in Cumbria around young people’s mental health and the Pom-Poms 4 Loneliness project in East Coseley Big Local, to name just a few.

The impact of social infrastructure on health and wellbeing

In the past decade, the link between mental health and physical health – and vice versa – has become well established. Local Trust’s policy team has been working to develop the evidence base that demonstrates the impact that social infrastructure has on both.

This includes examining the impact of providing communities with the spaces and assets that support good mental and physical health through connection, outdoor activities, creative outlets, skills development and so much more.

Big Local offers so many examples of this impact because, at the core of the programme model, is the radical proposition that communities know what their priorities are. I think it’s telling that not only have so many Big Local areas prioritised health – in myriad different ways – but that so many felt they had to take the lead in improving the health outcomes of their neighbourhood because the top-down, system-led services weren’t working.

The case for change

This is why the launch of Local Trust and the NHS Confederation’s report ‘The case for neighbourhood health and care’ is such an important part of  Big Local’s legacy.

This report showcases what the NHS and the Department for Health have to learn from communities like W12 Together, which has worked to find community-based solutions to improve access to health, and Par Bay Big Local, which has successfully set up initiatives to address social isolation and youth mental health.

As the report puts it, “the support to change lives effectively exists in our neighbourhoods”. A great example of this is the story of the Centre West Cumbria – formerly part of Ewanrigg Big Local – who have today published a powerful blog about how their work embodies what the case for change is all about.

Shifting healthcare to a preventative model

There is a growing consensus around the need to shift healthcare to a preventative model, reducing demand on acute services and creating healthier places to live, in order to reduce health inequalities such as the growing life expectancy gap between the wealthiest and least wealthy neighbourhoods in England.

Based on research in Big Local areas, and other community projects that have partnered with their local health providers, the case for change demonstrates both the necessity and effectiveness of doing this work with communities at the neighbourhood level.

The next step is ensuring the implementation of the report’s recommendations. While much of the work needs to be done at a system level, Local Trust and the NHS Confederation will be taking this forward in a programme of action research with communities, in neighbourhoods.

In parallel, we will be working with a network of partners to ensure that decision makers across the health system are aware of the potential already present in communities and what steps they need to take to unleash it.

Visit the NHS Confederation’s website and sign up for more information.