Engaging with People and Communities to Improve Outcomes: Primary Care Networks and Cardiovascular Disease
Topics for themed discussion were chosen based on system need, as implementation of the NHS Long Term Plan begins. These topics aligned with concerns raised by communities identified in previous workshops (September 2018 and March 2019). The areas chosen to focus on for this event were; Primary Care Networks (PCN), Cardiovascular and Respiratory disease (CVD).
Executive Summery
To be able to engage people from marginalised communities in health services and thus potentially improve their health outcomes, it is essential to engage both individuals and groups from specific communities in service design and delivery.
NHS England / NHS Improvement co-hosted an event with WE – Working with Everyone on 18th September 2019 to hear from people from ‘marginalised communities’. From discussions at the event, the following suggestions can be considered as key when engaging people and communities in service design and delivery.
Knowing your local population, the issues that affect them and the places where they are already engaging. Then proactively seeking them out, in a targeted way, and engaging them in a way that is meaningful to them. Identify any health needs specific to a community and any barriers specific to their members accessing services in a way that would normally be expected. This information could inform both service design and delivery. There was felt to be significant value in knowing local voluntary and community groups. They may already be engaging with specific communities and could possibly act as a “trusted intermediary” for targeted engagement activities. These groups are also likely to be in contact with and may be already providing services for specific communities. It may be possible to work in partnership with existing voluntary and community groups and/or commission them to provide specialist support services.
When working with marginalised communities it was felt that often individuals presented to health services with problems that had a non-medical cause, such as poor diet, trauma or inadequate or insecure housing. It was felt to be important to help people with the cause of their problems rather than just providing a medical solution to the problem.
When providing healthcare information, it is important to give clear, consistent messages that are targeted to the specific community and delivered in a way that makes sense for that community. Again, the use of trusted intermediaries was considered to be valuable.
When working with individuals to deliver their healthcare, whether general health or for specific health conditions, the first problem is to engage individuals. This means clear points of entry to the system that are easy to access and where people will feel welcome. The next problem is how to get people to come back and continue engaging with services. It was noted that many people from the communities represented would disengage totally after one poor experience. The complexity of the system was also highlighted, and many people mentioned additional support to navigate the system and a more person-centred approach to service delivery.
The idea of delivering both engagement activities and health services in places that people and communities are already using was considered to be a good way of reaching those in marginalised communities and thus improving their health outcomes.
While it was recognised that there are many common approaches that will work with all marginalised communities, it was considered vital to recognise that each specific community also has its own particular needs and preferences. So, approaches would vary significantly from area to area and from community to community.
