The purpose of this research was to understand the current state of community services and to explore how the health and care system needs to change to enable these services to meet the needs of the population now and in the future.
Growing financial and workforce pressures are having an impact on the ability of community service providers to meet the needs of the population and to make a reality of the vision set out in the NHS five year forward view. Community services are often fragmented and poorly co-ordinated, and are frequently not well integrated with other services in the community. This results in duplication as well as gaps between teams delivering care.
There is a great deal of innovative work going on across the NHS and beyond to improve community-based care. This is mainly happening through innovative projects rather than system-wide transformations in care delivery. A radical transformation of community services is needed, making use of all the assets in each local community wherever these are to be found, breaking down silos between services and reducing fragmentation in service delivery.
The most promising possibilities in the short term are through sustainability and transformation partnerships (STPs) and accountable care systems (ACSs), where plans have already been developed to strengthen community services and improve population health. More work is needed to ensure that all STPs offer a credible basis for improving care for their populations and strengthening services in the community, drawing on the design principles set out in this report
The return on investment tool pulls together evidence on the effectiveness and associated costs for interventions aimed at preventing falls in older people living in the community. The flexible Excel sheet allows for results to be tailored to the local situation based on the knowledge of the user. All interventions are aimed at those aged 65 and over.
The tool comes with an accompanying report, which details how the tool was constructed and presents the main results.
The second report summarises the findings from a literature review carried out to identify cost-effective interventions.
Local authorities and Clinical Commissioning Groups (CCGs) can use results from the tool to protect and improve the health of their local populations when making commissioning decisions.
School children in the US, (n= 707) who participated in an short-term exercise programme experienced improvements in their body mass index (BMI) scores, significantly different than the comparison group. This group also had higher odds of being in a lower BMI category at follow-up; significantly different than the comparison group.
The 12-week initiative ran for an hour three times a week. Each session started with a warm-up, followed by a running activity, and incorporated a skills-based approach to teach a new skill each week. During the cool- down session there was discussion on nutrition for pupils.
By the end of the the programme the child participants had better body mass index scores, than the non- participants in the control group. There was also an additional benefit for those children who participated three times a week as their focus on schoolwork improved, and those who attended two sessions a week also had notable improvements in their mood and energy levels.
The journal article is published online and is available here
Full reference: Whooten, R. C. et al. |Effects of Before-School Physical Activity on Obesity Prevention and Wellness | American Journal of Preventative Medicine | 2018| doi: 10.1016/j.amepre.2018.01.017
Rosen, R. | (2018) | Divided we fall: getting the best out of general practice| Research report| Nuffield Trust
The traditional model of general practice, sometimes called ‘medical generalism’, involves GPs developing a relationship with a patient, and understanding their social and family background. It can make them more able to decide when medical treatment is not helpful or necessary, and to manage patients safely outside hospital. This report asks what might be lost as doctors and patients are reallocated to services focused on easy access, such as walk -in centres. Are general practitioners at risk of losing the value this delivers to patients and the wider NHS? (Nuffield Trust)
The report considers what GPs and national NHS bodies can do to get the best of both worlds.
It is available from the Nuffield Trust
This resource provides an overview of the different approaches to working with communities for improving health and illustrates the vital role that they have in improving health and wellbeing. The Kings Fund has produced this reading list for those who want to explore the topic of communities and health in more detail.
The following questions and areas are examined:
What is a ‘community’?
What is the role of communities in improving health?
Health policy and the role of communities in health
Guidance in documents from Public Health England support the national consensus statement, ‘Policing, Health and Social Care: working together to protect and prevent harm to vulnerable people’.
These papers showcase good practice between police and health colleagues within case studies, identifies obstacles to collaboration and enablers.
They have been developed to stimulate discussion and and to contribute to the evidence base that will help to shape future work programmes. They are intended as an information source for the wider public health system.
Volunteering in general practice: Opportunities and insights | The Kings Fund
The King’s Fund has published ‘Volunteering in general practice: opportunities and insights‘. This paper explores how volunteers can provide support for the role of general practice, and the opportunities for organisations that currently support volunteering to work more closely with general practice.
Interest is growing in the contribution that volunteering can make in health and social care. This paper builds on our previous work, which examined volunteering in hospitals, to explore ways in which volunteers are involved with, and are contributing to, general practice.
The authors identify four approaches to supporting volunteering in general practice: use of volunteers to enable general practice to carry out its activities; organisations using volunteer support that were located within general practice premises; social prescribing; and community-centred general practices.
10 case studies are explored, which demonstrate that approaches to supporting volunteering in general practice provide an opportunity for practices to engage beyond their traditional boundaries, creating an interface with voluntary and community sector organisations and with the wider community.
The practice examples highlight the importance of partnership work to support and sustain volunteering, the different design and resource considerations in choosing an appropriate approach, the support and management requirements for volunteers and strategic factors that influence success and sustainability.