“Neighbourhood Health has a very simple purpose, to enable people to live gloriously ordinary lives, to support them to flourish, to contribute, and live the lives that they want to lead.” Dr Minal Bakhai MBE
Healthcare doesn’t begin in a hospital or at a GP surgery – it starts in our neighbourhoods and in our communities. True wellbeing can only be achieved when we feel safe, valued and have a sense of belonging.
Our activating healthy and engaged communities webinar focused on how we can best provide our communities with the tools they need to feel empowered about health. Chaired by our CEO and founder, Dr William Bird MBE, this webinar outlined the theory and tangible examples of successful local work, to guide a national move towards Neighbourhood Health.
Shifting healthcare to our communities has already begun with initiatives such as social prescribing and part of the 2025 10 Year Health Plan for England: fit for the future being focused on a new Neighbourhood Health strategy.
The webinar brought several people who are setting strategy together to discuss how to embed this across the nation. If successful, activity and engagement can reduce chronic inflammation and chronic stress and ensure our clinical interventions are far more effective. Having this nationwide, would be a real game-changer for all our health and wellbeing.
Meet the panel
Dr Minal Bakhai MBE is the Director for Primary Care and Community Transformation and Improvement for the NHS in England and is leading the National Neighbourhood Health Implementation Programme. She is also a practicing GP for 14 years in an area of extreme socio-economic deprivation.
Professor Sir Sam Everington has been a GP in East London since 1989. Sam is an Honorary Vice President of the British Medical Association. In 2015 a Knighthood for services to primary care.
Dr. Gillian Orrow is a GP and community health innovator whose work has redefined how primary healthcare engages with local communities. She is the Founding Director of Growing Health Together, a pioneering initiative that places community collaboration front and centre of neighbourhood health.
Donna Rowe is the development manager for Central Cornwall Integrated Care Area. She has been a leader in introducing community health and wellbeing workers to Cornwall, a successful programme that has had a positive impact on the county’s health.
“Healthcare does not work like manufacturing or retail. It is irreducibly local.”
Kicking off the webinar, Minal stressed that none of what Neighbourhood Health is putting forward is new. In fact, it’s been a policy ambition for at least five decades and there are already brilliant examples of it. However, these places have succeeded despite of, rather than because, of the system.
“Previous change efforts were judged narrowly through the lens of the NHS with regards to success, with a focus on hospital activity rather than whole person outcomes”
Minal explained that everywhere has different populations, different pressures, different assets and different relationships. Therefore, healthcare that works in one place may not just fail somewhere else, it may actively damage the trust that makes care possible in the first place.
“We’re taking what I call a tight-loose, tight approach: tight on a shared mission, accountability and outcomes and actively learning, but loose on how places deliver with the freedom to adapt to local context.”
A practice that has shifted virtually all type 2 diabetes care out of hospital
Next up, Sam detailed his work over 15 years in Tower Hamlets where he was chair of the local CCG. The area had primary care networks and social prescribing in every practice.
Sam’s practice has shifted virtually all type 2 diabetes care out of the hospital and set up a care group owned by all the GPs in Tower Hamlets that manages out-of-hours and the urgent care centre in the Royal London Hospital.
He has been asked why, if they can do it in one of the most deprived and diverse and challenging communities in the country, why hasn’t it been delivered elsewhere? He thinks Neighbourhood Health is the response to this.
“I like to say I’m not a brilliant GP, but I am brilliant because of my team”
Sam also shared some key secrets about what makes this work including building relationships over a curry evening and training together as many mistakes come down to poor team culture. He finished by outlining the huge cost of repeat outpatient attendance and how this could be vastly reduced by using best practice. This would, in turn, free up valuable funds for our neighbourhoods.
How neighbourhoods can come together to boost health and wellbeing
Gillian spoke about how she co-founded an initiative called Growing Health Together with colleagues, patients and local partners. They realised that whether they were a GP, a head teacher, a local vicar or community development worker, they were dealing with the same problems. These being that neighbourhoods are not really supporting people’s health and wellbeing, and people are not being able to live their best life. They decided to collaborate to try and co-create improved conditions for health and wellbeing.
At Gillian’s surgery, they have practice health champions who run coffee mornings, walking groups, craft groups and undertake DIY in people’s homes. If people can’t get to their GP practice appointment or the hospital, they will drive people to their appointments.
“Put a bit of investment into people being able to access what they need to live healthily, rather than just treat the consequences of unhealthy environments over and over”
One notable example is a patch of National Trust woodland. GPs recommend patients to be more active to improve their diabetes, their hypertension or their heart disease but most of this area is often too waterlogged to be used. Therefore, local volunteers managed to secure funding to have an all-weather path through the woodland, so people, whether they’re pushing buggies or using wheelchairs, etc, they can get out into, and reap the benefits of, access to nature.
Cornwall’s game changing Community Health and Wellbeing Worker programme
“The starting point was recognising the importance of our communities, the importance of supporting people in the most deprived areas.”
The genesis of the Cornwall’s Community Health and Wellbeing Worker Programme was hearing about work happening in Westminster that had originated in Brazil.
Community health and wellbeing workers work with everybody in a household who wants to engage with them. The support they give to residents is fully integrated with general practice and they work alongside social prescribers.
“We felt that this was a transformational way of working, a way of investing funding in our local communities. away from the bureaucracy of healthcare and local statutory services.”
Social prescribers are referred to by GPs primarily, whereas community health workers go door-knocking to build connection with the residents in that area. Community health workers support children, older people, people who are unemployed, people with mental health problems. They pick up on the need, building trust and long-term relationships with residents.
“The commissioning process, the commissioning decision-making needs to change. It needs to be transformational, turned on its head and away from working in silos around commissioning for just mental health, or just commissioning for long-term conditions, but commissioning for the population.”
If you would like to read more about community health workers in Cornwall, please read our previous interview with Donna.
Your questions, answered
For the final part of the webinar, there was an opportunity for attendees to ask questions to the panel.
These revolved around the role of public health and local authorities, how the volume of housing doesn’t bake in poor health outcomes, how to get ICBs and volunteer groups around the table with primary care, how to convince healthcare practitioners that this is the way and more.
You can watch the full Q&A below, along with the final question posed to the panel: What’s driving you and what’s your vision?
What’s next for activating healthy and engaged communities?
This discussion proves that there is an appetite for changing the way in which we provide healthcare to create more healthy and engaged communities.
Intelligent Health is undertaking a suite of webinars to highlight bright spots of activity and bring together the people leading the change to share what’s working, as we seek joint action from state, community and business. If these three groups work together effectively, it creates the conditions for people to thrive.
At Intelligent Health, our aim cis to be central to this change and to ensure everyone has the opportunity to reach their full potential for health and happiness.
The next webinar in this series will take place in the spring. If you would like to join, please email communications@intelligenthealth.co.uk
In the meantime, for more progressive health discussion, check out our health hub.
