The government has set out bold commitments for improving the NHS, centred on three key shifts in care - including shifting from treatment to prevention and into the community. While rhetoric around the prevention of ill health is not new, arguably, there is a renewed sense of urgency and ambition to act. Waiting lists are growing, patient acuity is increasing, and health inequalities are widening. Alongside this, the government has recognised the value of providing healthcare at the neighbourhood level and is considering ways to bring together expertise from multiple healthcare professionals to improve access to healthcare services. We expect the upcoming 10-year health plan to provide a strategy and framework for how NHS services can support in the delivery of these shifts.
We know that NHS trusts are already leading the way in implementing preventative, community-based initiatives, as highlighted in our recent Providers Deliver series Shifting upstream. In this collection of case studies, we have highlighted examples of health hubs, where trusts are delivering community-based services, to improve patient access and experience, ultimately with the goal of reducing demand for secondary services.
In our long-read on health hubs, we provided a definition for health hubs and explored how they can improve access to services for groups experiencing health inequalities. By nature, health hubs will all vary, as they are designed locally to meet the needs of different communities. At their core, health hubs offer services in convenient locations within the community. Largely, services are preventative, ranging from health checks, to wellbeing support, to broader support with social circumstances. Health hubs are typically run in collaboration with wider system partners, local authorities and the voluntary, community, faith and social enterprise sector (VCFSE).
Benefits of health hubs include improved patient outcomes and reduced demand for other healthcare services, cost savings for patients and services, improved communication with patients, and broader social and economic impacts. Crucially, health hubs are particularly effective at tackling health inequalities, as they provide safe spaces, in non-traditional healthcare settings, allowing staff to build trust with communities that may not usually engage with traditional healthcare services. Barriers to accessing services are removed, such as transport costs and waiting lists. They are also more responsive and reflective of community needs and so can target preventative initiatives at specific population groups. Working with and alongside communities is crucial, as highlighted in our report Co-production and engagement with communities as a solution to reducing health inequalities.
The case studies presented here provide more detail on how these services operate at different trusts and the impact they have had.
- Mersey Care NHS Foundation Trust – The Life Rooms project provides open-access holistic, wrap-around mental health support services in community-based settings in four locations across Merseyside, including in libraries and further education colleges within deprived neighbourhoods.
- Kent Community Health NHS Foundation Trust – The trust's Public Health Bus offers community outreach in a range of locations across the region, such as supermarkets, Pride events, and rough sleeper locations. The bus has been adapted to provide a range of clinical and non-clinical services, including health checks, immunisations and health visiting.
- South London Listens – The Be Well programme, delivered collaboratively by a range of system partners, uses a community organising model to bring together community organisations with health services, to provide access to wellbeing support and to scale-up the power of community organisations to advocate for local community needs.
We hope that these examples provide practical insights for others providing community-based prevention initiatives, such as health hubs, with the aim of reducing health inequalities. The examples given here demonstrate the variety of approaches being utilised by NHS trusts, highlighting the importance of responding to local community need. More resources and information on tackling health inequalities is available through our Health Inequalities programme.