Communities and health - a Kings Fund explainer

Communities and health
Kings Fund updated 5 May 2021 

• A starting point for those wishing to understand more about the role of communities in improving health.

LGA Research: Cohesion and Integration

LGA Research: Cohesion and Integration
LGA Research

• This series of LG Inform reports (one for each LA) has been compiled to highlight some indicators identified as important to community cohesion and integration, including English language proficiency, economic inactivity, residential segregation, and migration levels and to help build the evidence base needed to support local decisions. Importantly, the reports enable authorities to review and compare their profile with other authorities.

What does good social prescribing and community based support look like?

Social prescribing and community-based support: Summary guide
NHS England 31 January 2019

• The Social Prescribing Summary Guide is intended for people and organisations leading local implementation of social prescribing. It enables:
• increased understanding of what good social prescribing looks like and why social prescribing improves outcomes and experiences for people, their families and carers, as well as achieving more value from the system
• commissioning of local social prescribing connector schemes, enabling all general practices, local authorities and other agencies to refer people with wider social needs to community-based support
• collaborative working amongst all local partners at a ‘place-based’ local level, to recognise the value of community groups and assets and to enable people to build or rebuild friendships, community connections and a sense of belonging, as well as accessing existing services.

Community-centred practice: applying All Our Health

Community-centred practice: applying All Our Health
PHE 14 November 2018

• Information for front-line staff to adopt community-centred ways of working that help improves the health and wellbeing of the most marginalised communities. 
• The guidance for team leaders or managers includes PHE’s family of community-centred approaches which are used to map, plan, commission or deliver local services. Examples of community-centred and asset based practice can be found on PHE’s online library

Mobilising Communities: Insights on Community Action for Health and Wellbeing

Mobilising Communities: Insights on Community Action for Health and Wellbeing
NESTA 31 March 2017

• This report gathers a wide range of insights taken from three community sites on how to implement a people powered approach to health and wellbeing.
• Three main insights were found to be the most important to making a difference on the ground:
• Helping people help themselves
• Creating opportunities for people to help one another
• Creating value between the professional and social spheres - helping health and care
• The sites involved in the programme were
• The Bromley by Bow Centre and Health Partnership
• Spice and Lancashire County Council
• Horsham and Mid Sussex Clinical Commissioning Group

Community Pharmacy Clinical Services Review

Community Pharmacy Clinical Services
King’s Fund for the Chief Pharmaceutical Officer, December 2016

• This report is based on a review of the evidence, examination of current commissioning models and opportunities for community pharmacy.
• The report identifies the barriers that prevent best use of community pharmacies and workforce, makes recommendations for what clinical services community pharmacies should provide and how the service should be commissioned in future.

Spreading change and supporting self management through the EAST framework

Two publications from NESTA using the EAST framework which says that to encourage a particular behaviour you must make it Easy, Attractive, Social and Timely. Both feature a number of low-tech, pragmatic and manageable activities which can increase the spread of person- and community-centred health and wellbeing programmes

Spreading change: A guide to enabling the spread of person- and community-centred approaches for health and wellbeing
NESTA 6 September 2016

• This guide outlines how behavioural science can help spread the take-up of person- and community-centred approaches to health and wellbeing.

Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches
NESTA September 2016

• This guide offers a framework for understanding and changing behaviour, and real-world examples of how these changes happen in practice. It is written for people who support those living with long-term conditions, or who help people avoid these conditions using person- and community-centred approaches.

Realising the value of people and communities

At the heart of health: Realising the value of people and communities
NESTA February 2016

• This report brings together a wide range of person- and community-centred approaches for health and wellbeing. These range from collaborative consultations that focus on what is most important to people, to community dance classes in the local hall, and can happen in formal health and care settings, people’s own homes and in the wider community.
• The report provides an overview of the existing evidence base with a particular focus on the potential benefits of adopting these approaches.
• The evidence demonstrates the benefits across three dimensions of value:
• Mental and physical health and wellbeing
• NHS sustainability
• Wider social outcomes
• Annexes produced by the Institute of Health & Society, Newcastle University
• A scoping review of the evidence base 
• Evidence summaries for  - peer support, self-management education and  health coaching

Family of community-centred approaches for health and wellbeing

Health and wellbeing: a guide to community-centred approaches
NHS England, PHE 11 February 2015

• The case for change, the concepts, and the varieties of approach that have been tried and tested to support community-centred approaches for health and wellbeing.
• There is a diverse range of practical, evidence-based approaches that can be used by local leaders, commissioners and service providers to work with communities. These are grouped into: strengthening communities; volunteer and peer roles; collaborations and partnerships; access to community resources 
• A family of community-centred approaches has been developed to represent some of the practical, evidence-based options that can be used to improve community health and wellbeing. The approaches map the range of options to achieve a shift to more person and community centred ways of working in public health and healthcare. 
• A Briefing sets out the case for change and implications for commissioning and practice.

Commissioning of social prescribing

Evidence to inform the commissioning of social prescribing
CRD, University of York, February 2015

• “Social prescribing is a way of linking patients in primary care with sources of support within the community.”
• This review found little supporting evidence to inform the commissioning of a social prescribing programme. What evidence there is tends to briefly describe the evaluation of small scale pilot projects but fails to provide sufficient detail to judge either success or value for money. 
• Evidence on the cost effectiveness of social prescribing schemes is lacking
• The report includes examples of social prescribing pilots and outlines the evaluation used.

Evidence that community engagement can improve health behaviours

Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis
Public Health Research v1(4) November 2013

• Results from 131 studies included in a meta-analysis indicate that:
• there is solid evidence that community engagement interventions have a positive impact on health behaviours, health consequences, self-efficacy and perceived social support outcomes, across various conditions. 
• there is insufficient evidence – particularly for long-term outcomes and indirect beneficiaries – to determine whether one particular model of community engagement is likely to be more effective than any other. 
• there are also insufficient data to test the effects on health inequalities, although there is some evidence to suggest that interventions that improve social inequalities (as measured by social support) also improve health behaviours.
• there is weak but inconsistent evidence that community engagement interventions are cost-effective

Essential commissioning guidance launched on working with local communities

Working with Communities, Developing Communities 
RCGP Centre for Commissioning , 2 April 2013

• This guide puts forward both a financial case and health case as to why investing resources in Community Development is beneficial for local populations, primary care practitioners and CCGs.
• "Local populations must be seen as assets, not burdens, in order to make CCGs strong and successful."
• The report focuses on the need for CCGs to work together and build partnerships within their communities between health, education, housing and other services including policing.