Community development route to health improvement in Aylesbury
Programme includes a Healthy Living Centre community in the Aylesbury town area alongside engagement in other key areas of deprivation across Buckinghamshire.
Summary
The programme uses a community development approach to health improvement providing a Healthy Living Centre (HLC) within the Walton Court and Southcourt communities of Aylesbury town in the Buckinghamshire county council area, alongside engagement in other key areas of deprivation across Buckinghamshire.
The overall programme includes a generic Skilled for Health (SfH) programme called English for Health and Wellbeing (SfHW), a Skilled for Health Maternity programme with Black and Ethnic Minority (BaME) women of childbearing age. It also includes a range of health improvement activities, for example, ‘simply walk’, chair-based exercise, youth hub and boxing club, and dementia activities such as silver singers and senior lunch clubs. These are underpinned by a range of community development and engagement approaches, including volunteering.
Background
The development of this centre was informed by previous engagement work with this community by the former Primary Care Trusts (PCTs), which identified specific needs around promoting health, developing skills for work and community development and supporting families.
The original service model had 3 focus areas:
- health promotion and improvement
- supporting and enabling people into learning and work
- community development
The purpose of the projects was to provide targeted health promotion initiatives for those in disadvantaged and vulnerable groups, mainly focused on people on low incomes, black and minority ethnic groups (BaME), older people, children and young people, people with emotional wellbeing issues and people living in isolated circumstances, in order to promote health and wellbeing and reduce inequalities.
It took a holistic view of health and offers services to users which cover not just lifestyle services, also, employment advice, reducing social isolation and volunteering.
What was involved?
The aims of the Community Development and Health Improvement programme include:
- to co-produce a range of health improvement projects based upon preventive and early health interventions that aim to enable individuals and communities to take responsibility for their own health
- to work in collaboration with the local statutory and voluntary sectors to enable and enhance community ownership, capacity, resilience and cohesion by building the confidence and skills of local people
The programme operates from a physical centre and offers a range of different community and health improvement programmes, a nursery, community café and the hire of a community centre, managed on behalf of the local housing trust.
It has also expanded since the original service model and now delivers projects in other geographical locations, for example, the SfH programme in High Wycombe and Chesham.
The community café operates partly as a key mechanism to enable engagement with the local community. The environment is informal and due to its location is not related to any other services. There is, therefore, no stigma attached to entering or using the venue. The café has also proved an effective way to engage users who otherwise would not easily engage with statutory services such as local authorities, the police or the NHS.
There is an Ofsted registered fully subscribed nursery on site, which offers crèche and other childcare options for those in the area and using the centre for any of its activities.
In 2014 the HLC conducted 15 local conversations with diverse interest groups within the broader community, partnered by The People’s Health Trust. The portfolio of projects and programmes delivered from the HLC are built around these priorities and focus on health, skills and employment, social and family problems. The delivery methodology of all these programmes is community engagement, recognition of community resources and joint problem solving.
Outcomes
An evaluation of the HLC entitled ‘Nourishing the Community: an evaluation of the added value of the HLC’ described the added benefits to the community:
General community
It provides a positive social space, use of a community building, food and drink, access to nursery provision, computer suite that is a tangible asset to the local community.
For individuals
Benefits have been critical, for example, removal from domestic violence and achieving stability in family relationships, volunteering and employment opportunities.
For partners
It has provided affordable room hire, administration and opportunity to develop a multi-issue approach across a community.
For commissioners
It has provided qualitative insight and feedback on community issues for more vulnerable communities and extended reach into new communities.
There are separate outcomes for each project delivered from the HLC. Some of the outcomes for the overarching health improvement and community development programme include:
- reducing social isolation, increased social connectedness, increased knowledge and awareness of health issues, changes in health behaviours, and better access to services
- increased capacity through additional volunteers, funding or shared resources
- more appropriate use of services, increased capacity to manage non-clinical need and raised awareness of community assets
As well as promoting uptake and widening access to services, community-centred approaches may increase health literacy and give individuals the confidence to engage in their health care. Engaged communities can provide supportive environments and positive social norms that help individuals gain motivation, confidence and skills to self-care.
What works well?
There are 4 main elements of advice for commissioning this via public health in a local authority setting:
- communicating the benefits of the programme especially with all the relevant stakeholders before and continuously throughout the project, including members
- demonstrating continuous year on year improvement with community and service user engagement
- demonstrating robust evaluation, tangible outcomes and quality of a range of health improvement programmes to secure sustainable resources in a time of reduced public funding
- setting clear and measurable outcomes for each year and building robust project management and leadership into all stages of the process
Next steps
The current contract commissioned by Buckinghamshire county council Public Health team, started on 1 January 2017 and is due to expire on 31 December 2019.
Further information
Public Health Leads
Angie Blackmore, Public Health Principal, Buckinghamshire County Council Tel: 01296 387472
Susie Cook, Public Health Practitioner (Advanced), Buckinghamshire county council Tel: 01296 387626
Healthy Living Centre Lead
Jan Webster, Chief Executive Officer, Healthy Living Centre Tel: 01296 334562
Website:
Details of the range of programmes and the centre facilities can be found on the Healthy Living Centre website.