St Pauls Trust approach highlighted as crucial for tackling health inequalities in new report
Ignoring local community groups is harming our health, says new report.
- Community organisations reach people statutory services cannot, but are “missing in health and wellbeing strategies”
- Community organisations vital for delivering preventative health services, especially through arts, culture, and nature-based activities.
- These organisations are trusted by their communities and provide holistic support in a way that tackles health inequalities.
A new report, to be launched on Tuesday 16th April, argues that the failure of health and local authority commissioners to recognise and utilise the expertise of community organisations is stifling progress in tackling health inequalities and improving health outcomes.
The report, by ARCHES (Arts and Culture in Health Ecosystems – a project run by Locality, Leeds Beckett University and Social Life), found that although community organisations reach people statutory services fail to, they are usually “missing in health and wellbeing strategies”.
The report found that local community organisations:
· Understand their people and places ensuring their services are inclusive and culturally competent.
· Provide “whole person” support – understanding that people have multiple, interwoven needs.
· Understand the importance of providing activities that do not patronise or stigmatise participants.
· Build on people’s strengths and interests as a first step to developing a relationship. This often involves engaging people through access to the natural environment or creative activity.
· Are started and staffed by passionate local people and have partnerships with local businesses, government, and community leaders.
However, the knowledge and expertise of community organisations is seldom included in health service design. The research found that:
· Predesigned projects are often “parachuted” in and do not take into account community needs.
· Insufficient, inappropriate, and short-term funding and reporting mechanisms leave community organisations over-stretched.
· Community organisations find themselves subsidising contracts in order to provide the quality of service necessary.
· This prevents them being able to provide the person-centred, holistic support they specialise in, causes staff and volunteer burn out and poor staff retention.
Read the full report, commissioner guide, and case studies here: Adapting, expanding and embedding community and culture into health ecosystems – Locality
The report draws on examples from Bedford, Halifax, Birmingham and London.
· Charity ACCM (UK) in Bedford supports girls and women affected by illegal traditional cultural practices and addresses wider health inequalities. Many of the communities they serve lack trust in mainstream health services. ACCM organise inclusive events like their African celebration, providing a platform to engage people in health services and get them support from mental health workers and pharmacists in an informal setting.
· Halifax Opportunities Trust (HOT) provide help with employability, skills development, entrepreneurship, and family support. Recognising the limitations of the traditional classroom, HOT established a community garden as a way for adults and young people to improve their wellbeing and acquire skills in cooking, gardening, and social interaction.
· St Pauls Community Development Trust in Birmingham provide a nursery, Childrens’ centre, school and city farm. Through accessing the different services over time, people build trusting relationships with local staff and volunteers, and improve their health and wellbeing. However, the loss of reliable funding is making it increasingly difficult to “knit-together” this holistic support.
· Pembroke House in London provide safe, creative spaces and arts activities for their diverse community. While offering wrap-around services including health and nutrition, activities avoid an explicit health focus to mitigate stigma.
Tony Armstrong, Chief Executive of Locality, said: “These findings show the critical role played by community organisations in addressing health inequalities. It provides the evidence for what Locality members know – that trust is the key to reaching those most in need. But trust isn’t inherent; it must be earned. Community organisations have deep roots and are driven by passionate local people – they have an acute understanding of the interests, needs and barriers facing local people.
Despite their unique ability to reach some of our most marginalised communities, these organisations struggle to find funding and are rarely involved in the development of health strategies. If we are serious about addressing the huge health inequalities we face, we must collaborate better across sectors. This means sharing assets, spaces and resources and building robust, respectful partnerships for the long-term.”
Professor Mark Gamsu, from Leeds Beckett University who led the Arches research team said: “The way that local community organisations work in communities who experience inequalities is often a tremendously positive story, building relationships and trust through engaging with local people sometimes over generations. Like the communities they serve this role is seldom acknowledged and poorly understood by commissioners – particularly the NHS. If the NHS is to make progress on reducing inequality the important contribution made be community anchor organisations must be better understood and supported.”
Alison Haskins, Chief Executive of Halifax Opportunities Trust said: “Halifax Opportunities Trust is a local charity that has worked alongside our community for over 21 years to make positive changes with the people who live and work here. We are not a traditional ‘health service’, rather we run a whole range of activities which interact to improve economic, social and well-being. We know that having a decent job, access to services and good social connections are all crucial to good health and so this is what we provide via our charity.”
To make the most of the value that community organisations can bring in health and wellbeing provision, they must be included in health system design.”
For this reason, this ARCHES report, echoing recent calls by Locality in their Manifesto calls for:
· Better cross-sector collaboration – including sharing of assets, spaces and resources.
· Fairer funding and commissioning that accommodates community organisations.
· Increase NHS budgets at Integrated Care System level going towards prevention by at least five per cent over the next five years. Key to this is a sustainable strategy and funding for social prescribing that prioritises community development and localised approaches.
The findings in this research reinforce and extend the findings in Creating inclusive services, a report released by Locality in March 2024 exploring the role of community organisations in creating services that meet the needs of their local population and address health inequalities.