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Community Health and Wellbeing Workers

Join our Community of Practice

Community Health and Wellbeing Workers (CHWW) are people recruited from their communities, who are embedded in NHS primary care teams and the community sector, to proactively assist in providing health and wellbeing services to those communities.

This model started in Brazil over 30 years ago where it is now the delivery model for primary care with 70% of the population now having a CHWW. .  Since the 1990s the results in population health improvement that Brazil has seen have been remarkable;

  • 34% reduction of cardiovascular mortality
  • 31% stroke mortality
  • improved horizontal equity
  • increased breastfeeding, vaccination and cancer screening rates, nationally.

When we were implementing this model from Brazil, we identified four key principles that make the model unique and effective:

  1. Comprehensive – The entire household and everyone in it.
  2. Hyperlocal – Based around a defined geography of 120-150 households.
  3. Universal – Not means tested but for everyone in that geography.
  4. Integrated – Fully integrated with the GP Practice and Local Authority.

CHWWs visit the households in their patch every month, regardless of need and at these visits they deal with any pressing issues within the households across their physical, mental and social health. They work with the wider system including primary care networks and local authorities to support residents’ health and crucially help address the wider determinants of health.

Individuals are recruited as CHWWs based on character; people who are natural problem solvers; have the right attitude; and recognise the need to be persistent, respectful and maintain confidentiality. The specially recruited teams get to know families and assess their health, social and wellbeing needs, promote healthy living, signpost to appropriate services and help residents navigate the health and care system.

The model has been implemented in Westminster and showed:

  • The households were 47% more likely to have immunisations that they were eligible for and 82% more likely to have cancer screenings and NHS health checks.
  • These households saw a 7.3% drop in unscheduled GP consultations.
  • Residents were appreciative of the ease of access, support and comprehensive approach provided
  • Engagement had been maintained with 60% of residents.
  • Multiple instances of issues being unearthed around suicidal ideation, child carers, domestic violence and intractable housing.

There has been a number of academic publications to date on the Community Health and Wellbeing Workers model in the UK.  You can read them here.

This model has already been rolled out across Cornwall as well at 23 other sites, with more in the pipeline.

We have created a Community of Practice for sites to come together, learn from each other and share resources.  If your locality is interested in adopting this model, joining the Community of Practice or you want more information on the effectiveness of this model, please email us at napc@napc.co.uk