Community engagement: how to help people care about health

It becomes apparent sometimes that the health messages primary care trusts and their partners are putting out are just not being heard by the populations they serve. When the conventional approaches to broadcasting public health concerns are not enough and there is no evidence for any improvement in wellbeing or positive changes in behaviour, part of the solution might lie in better community engagement.

Along with his colleagues, Neil Grahame, deputy delivery manager at the Department of Health’s Health Inequalities National Support Team, is engaged in a series of consultancy visits to England’s 70 spearhead areas - which have the worst health, deprivation and life expectancy figures - to assess how localities can take their community engagement to the next level.

“To secure long term changes in people’s health, you’ve got to have things happening at the individual level, throughout the culture at a community level and overall at a population level,” says Mr Grahame.

The consultancy visits, which run over five days, focus on the DH targets for improvements in life expectancy by 2010.

Under consideration are not only those health challenges where it is more likely that an immediate impact could be achieved - such as alcohol harm reduction, cardiovascular disease and infant mortality - but also the vision, strategy and partnership working of the areas’ leadership on community health and wellbeing engagement.

Mr Grahame says: “The central part of our community and neighbourhood engagement model, on which we base our feedback and recommendations, contains the active elements of community engagement. However, you cannot just put a team of people in to do that in isolation. Successful engagement requires organisational adjustments and backup work to help things happen.”

The community and neighbourhood engagement model provides a valuable insight into what a fully engaged community might look like and the development stages that cities and boroughs might expect to go through.

Its 15 categories are divided into three sections: structures and profiling; engagement and capital building; and organising for delivery.

Structures and profiling examines the features that might be thought of as the backdrop for community engagement.

It includes the structures that have been developed for communities of place and looks at whether they operate to variable or shared divisions and boundaries.

Provision for identifying and empowering communities through analysis, profiling, neighbourhood forums and action plans are also considered.

Engagement and capital building looks at levels of consultation, partnership work and empowering communities and also considers how individuals and communities are supported in engagement and integration activity.

Local empowerment

“In some areas you may find that the local strategic partnership will have a toolkit that gets them using a lot of consultation but doesn’t then carry through into framework for partnership working,” says Mr Grahame.

“Where such a framework is developed it can be a mechanism for empowerment - with community based organisations being able to take part in service delivery as members of a town or parish council, community interest company or industrial and provident society.”

The third section looks at the resources committed to the delivery of neighbourhood engagement.

Do frontline staff have clearly defined roles, do services act as a gateway to other services, are multi-agency teams working from shared buildings and how is engagement measured?

“We know community and health and wellbeing engagement is a widely held interest and are keen to take the model and the learning from the spearheads to a bigger audience, developing joint approaches with other organisations where we can,” says Mr Grahame.