What makes this work?

The case studies produced as part of compiling this report, and the wider literature review, offer strong examples of people working to transform health and wellbeing, reduce health inequalities and deliver stronger, happier and healthier communities. 

There are several common success factors:

• Trust. Investing time in building relationships and trust between communities, VCSE organisations and statutory partners. This is particularly important where residents have had poor experiences and are as a result understandably reluctant to engage with statutory services, and more likely (at least initially) to become involved with community or VCSE-led initiatives.  Developing an open, accessible and non-judgemental culture where everyone feels welcomed, able to share their story and bring their perspective was seen to be vital. This can require partners to step outside of their organisational comfort zone, enabled by a level of support and permission from senior leaders to do so.
• Applying existing methodologies and ways of working. A range of methodologies to support community development and neighbourhood-based working were identified, which are described further in this report. A ‘mix and match’ approach to the choice of methods had been taken by different sites, with a strong degree of pragmatism and a willingness to learn and adapt to the local context and needs. Where available, the use of more local-level data overlayed with community insight enabled a more effective understanding of neighbourhoods and their needs.
• Ongoing co-design and meaningful involvement. Listening to and co-designing solutions with community members helped to build trust and mutual respect. It strengthened the impact of interventions, as they reflected local expertise and insights into opportunities, issues, barriers, enablers and assets. This led to more bespoke interventions with buy-in from residents, which were more impactful and more likely to be sustainable, not least because local organisations were likely to be involved in support and delivery. It was important that this focus on co-design was maintained over time, to ensure interventions continued to respond to evolving neighbourhood assets and needs.
• Building on a foundation of a shared purpose and common goals.  This meant agreeing a shared purpose and common goals between partners at the outset, alongside a process for tracking progress and impact against these goals. Where possible, this helped to develop an evidence base (in turn, enabling better access to funding), to build momentum, and to provide a solid foundation for future collaborative working within neighbourhoods.
• Resource allocation.  Devolution of funding, responsibility and other resources to neighbourhoods was identified as a key facilitator of the development of new local delivery models. This often requires a high degree of confidence on the part of funders that investment will return long-term benefits, as well as a willingness of community leaders and VCSE organisations to place trust in statutory partners. There was a need for bravery, a willingness on all sides to take on a degree of risk, and for building bridges between communities and services, particularly in areas where relationships had previously been poor. However, without negotiating these complexities, many successful schemes would never have got off the ground or been able to impact in the way they have.
• Flexible, long-term funding. The funding required to establish and operate neighbourhood working is rarely large in the context of health and care budgets.  Nonetheless it is a key enabler of better neighbourhood working and to be effective requires a degree of flexibility and the ability to predict flows over the longer term. Providing flexible funding enables neighbourhoods to adapt and respond to needs as they arise and manage challenges such as increasing operating costs as interventions scale. Long-term funding provides the foundation and confidence for all partners to invest in the model, while being assured that the investment in relationship building will not be undermined by a lack of future funding. Locally sensitive commissioning that understands the dynamics of working in this way will be critical if the benefits of neighbourhood working are to both spread and be sustainable.
• Collaborative and stable governance.  Developing and implementing clear and inclusive governance structures, which involve stakeholders from across the neighbourhood including community members / residents, VCSE and statutory representation, was important for the sustainability, adaptability and effective co-ordination of efforts across a neighbourhood. ‘Governance in depth’, bringing in a range of people from across and within partnering organisations, and not relying on the motivation or goodwill of a handful of individuals, was a core part of ensuring local work could survive a change of personnel and continue to deliver impact over the longer term. 
• Management and administrative capacity.  While much of this work is around building on the existing commitment, energies and assets, bringing different organisations and cultures together takes time and capacity. Without investment in support to bring people together, co-ordinating efforts, dealing with administrative and other issues that arise, and evidencing success in a way that supports future funding, both the scale and pace of change are likely to be severely limited. How statutory partners provide this support to communities and smaller VCSE organisations, in a way that is enabling and empowering, is key. In reality it was relatively small investments that were needed to create the momentum to unlock and sustain neighbourhood working.  Such efforts produced significant impact for both the communities themselves and the statutory partners working with them.
• Access to community infrastructure. Having a physical ‘place to be’, alongside various other elements of community infrastructure, including access to community groups and social networks, was a key enabler to successful neighbourhood working.  Where this infrastructure is available, it provides the space for people to collaborate and can also be a driver of civic pride and a sense of ownership and permanence. Where this infrastructure is lacking, there is a key role for statutory partners in helping to develop it.