As primary care networks assess their needs for development support, and their STPs and ICSs make plans to procure it, how many will feature ‘community engagement’ at the top of their list?
Perhaps not many. NHS staff and organisations are well conditioned to focus on their own organisational development; and with many PCNs still barely formed, it’s not surprising to hear most chatter being about clinical directors, additional staff, funding challenges, and relations with local systems.
But sidelining community relationships as something ‘for later’ risks missing a key source of the additional value and improved outcomes that PCNs can help secure.
In a webinar for the NHS Confederation from 12-1pm on Wednesday 11th September we and our partners NAPC (the National Association for Primary Care) and NALW (the National Association for Link Workers, who have previously blogged here) will explore the dimensions of value that coproduction with community partners can achieve.
People in primary and community care may already be seeing the benefits of ‘social prescribing’ arrangements.
These rapidly developing schemes help people find the community and voluntary sector groups and organisations that can support them: directly, to improve their health and wellbeing; and indirectly, by tackling the other factors in their lives that impair health, such as low activity, isolation, finances and housing problems.
Stories of radical changes in people’s outlook and outcomes through social prescribing are becoming common; but even these are only one part of the potential value of bringing the community into the network.
With some of National Voices’ member charities, we have begun looking at the meaning of a ‘development journey’ for PCNs, and the usefulness of a ‘maturity matrix’.
We want to help the networks ask some searching questions about what ‘mature’ community engagement would mean, what benefits to aim for, and how to get there from here.
Our voluntary sector members have used phrases like ‘the network is part of the community (not vice versa)’, and ‘the community co-creates the network’ to visualise the end state.
In such mature scenarios, networks could aim for the same goals as Healthier Fleetwood Primary Care Home, where community groups have mobilised to step in and support the overloaded health and care systems, or Frome, where community development has moved the emphasis far upstream into proactive prevention using trained community workers, plus the activation of people who meet people such as hairdressers and bus drivers.
They could learn from proactive commissioners such as Wigan and Salford, who carved out modest but significant funds for social innovation and impact, led by the most effective local groups and partners.
Networks can empower themselves to take action on entrenched inequalities by working in tandem with the groups who know what works for marginalised people, such as local community organisations or national voluntary organisations (like our colleagues in the Health and Wellbeing Alliance) who have developed gold standard approaches.
Significantly, networks can put themselves in the driving seat of population health management by grounding the general data they receive within their systems, with insight and intelligence that communities themselves contribute, about unmet need, unrecognised challenges, and getting the responses right first time for people who may be using services poorly or not at all.
In the end it will be these factors – plus action to codesign new care models to be community focused and person centred – that make primary care networks more than just another tweak to the creaking frontline.
This will be a long journey, and it may start with some basics: just creating time for some staff to go out and talk to whoever they can find; and/or opening up practices and medical centres for community use.
But every journey must start with a single step. These approaches need building into the fabric of PCNs now.
ICSs and STPs can play a role by making sure their support plans encompass the community dimension.
It would be a woeful missed opportunity if in three or four years’ time we see networks that are mature in their clinical governance and relations with statutory services, but still on the starting line in building community ownership.
This blog post was originally published by NHS Confederation on 5 September 2019.
Don Redding is Director of Influence and Partnerships for National Voices, the coalition of charities working for person-centred care.
The webinar, ‘Innovative partnership for population health management and community centred social prescribing’, is at 12-1 pm, Wednesday 11 September and also features Dr Nav Chana, National PCH Clinical Director, NAPC and Christiana Melam, CEO, National Association of Link Workers. Register here.
The NAPC has partnered with National Voices and the National Association of Link Workers to offer community engagement support across the health system from individual PCNs to CCGs, STPs and ICSs. Working with you, our team – which includes our primary care home (PCH) faculty of experts and our partners – can design a bespoke package depending on the maturity of the primary care network and your needs. For more information click here.