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Local first: NICE guidance is clear mandate for community approaches to health and wellbeing

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Unique ID: SOCA1506 Caption: Female service user painting with female carer.A group of men and women. An elderly lady with a young care assistant member of staff. Doing handicrafts. Art. The day centre specialises in day services for Asian Elders. Restrictions: NHS Photo Library - for use in NHS, local authority Social Care services and Department of Health material only Copyright: ©Crown Copyright

I wholeheartedly welcome the new guideline on community engagement published today by NICE to support the NHS, local authorities and other service providers to better engage local communities in decisions that affect their health and their lives.

The new guideline includes recommendations on:

  • overarching principles of good practice – what makes engagement more effective?
  • developing collaborations and partnership approaches to encourage and support alliances between community members and statutory, community and voluntary organisations to meet local needs and priorities
  • involving people in peer and lay roles – how to identify and recruit people to represent local needs and priorities
  • making community engagement an integral part of health and wellbeing initiatives
  • making it as easy as possible for people to get involved

The new guideline has been informed by PHE’s own guide, launched just over a year ago to support local areas to develop community-centred approaches to health and wellbeing. In that time, our guidance publication has been visited almost 14,000 times, and community engagement is becoming increasingly important for those working to improve public health and reduce inequalities in their local areas.

Community and placed-based approaches to health and wellbeing underpin all of our work at PHE, from tackling obesity to ensuring every child has the best start in life. We see this concept as one of the big ‘game-changers’– a unique opportunity for positive change and much faster progress on our public health priorities.

The Marmot Review said: ‘The extent of people’s participation in their communities and the added control over their lives that this brings has the potential to contribute to their psychosocial wellbeing and, as a result, to other health outcomes.’

A place-based, or community-centred, approach aims to develop local solutions that draw on all the assets and resources of an area, integrating services and building resilience in communities so that people can take control of their health and wellbeing, and have more influence on the factors that underpin good health.

In the past year we have seen community-centred approaches becoming more embedded in public health services and in health and social care. The new NICE guideline will help to build on this progress, providing a clear mandate for collaboration with communities to plan, design, develop, deliver and evaluate public health, using our guide as a framework for developing options in practice.

In this blog I would like to share some of the recent highlights from our work on community engagement.

Keeping the conversation going

In June, I blogged about  how community-led LGB&T Pride events are a practical demonstration of the four core approaches to community centred health and wellbeing. More than 80% of lesbian, gay, bisexual and transgender people have experienced some form of hate incident, which we know can be an important factor in generating ill-health. Pride marches can be an important way of developing community cohesion, celebrating identity and encouraging social connectedness.

The four core approaches to community-centred health and wellbeing:

  • Strengthening communities – building community capacity to take action on health
  • Volunteer/peer roles – providing advice, information and support, and organising activities
  • Collaborations and partnerships – working with communities to design and deliver services
  • Access to community resources – connecting people to information and social activities

At the PHE conference in September, healthy places and communities was a key theme, with talks on engaging communities and commissioning collaboratively. We heard inspiring stories from our speakers, including Christine Mead from Westminster City Council, whose Community Champions programme is providing a £5 return for every £1 spent. The programme, run in partnership with local organisations, residents and volunteers, helps to give residents and communities the tools and resources to identify local issues and to come up with their own solutions.

A new approach to care

In December 2015, we contributed to an NHS England directory of the national support on offer for the new NHS vanguards – a selection of organisations and partnerships acting as pilots for new models of care across England. The directory aims to help them develop new partnerships with patients, the public and communities, and PHE has included information on how the vanguards can use our guidance on community-centred approaches to develop their services.

More organisations are being invited to be part of a more comprehensive directory of national and local support which will be published in April 2016.

Looking ahead

We are committed to continuing our work on community centred approaches throughout 2016 and beyond. For example, we look forward to working with partners in newly devolved powers such as Greater Manchester to promote greater public participation in local decision-making and to ensure that local economic growth strategies include social objectives to promote health and wellbeing and reduce health inequalities.

We also welcome continued work with our national partners, including the Department of Health, the Local Government Association, NHS England and the Association of Directors of Adult Social Services, to develop a new Memorandum of Understanding to further integrate community engagement and empowerment across the health, social care and public health sectors.  This work forms part of the Think Local Act Personal programme on building community capacity.

I hope that the incorporation of our family of community-centred approaches into the new NICE guidance will smooth the way for even greater progress on health and inequalities in the year ahead.

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