Learn more about this course.

Making the case for working with people and communities

Why is it important to involve people and communities in primary care? Watch GP Dr Ollie Hart talk about the benefits he sees of patient engagement.

In the last step we asked you to list why working with people and communities in primary care was important to you.

These are some of the common reasons that we often hear in the comments. How many of them resonate with you?

To build relationships and understanding between primary care and the communities it serves;
To improve services by benefiting from the assets (resources) present in every community (including knowledge, skills, time, passion);
To hear from the people we don’t serve as well, so that we can create a more equitable service;
To continuously improve services in partnership with people with lived experience by identifying gaps that people experience;
To use resources more efficiently by providing the right services for the right people at the right time.
To ensure we understand what matters to people and communities and that the services meet these needs.

There are other reasons to engage such as because it’s fun, and because it’s an opportunity to talk to people outside our services and connect in different ways. This can re-engage you with the reason you got involved in healthcare – often to make a difference.

Patient activation and partnering with people and communities

In the video above, GP Dr Ollie Hart talks about the benefits he sees of patient activation, where people are encouraged to proactively be involved in their own self-care.

He also makes the connection between an individual helping themselves, helping a small group of other similar people, and helping a wider group of people through partnering in quality improvement. We regularly see people who partner to improve health care take a more active interest in their own health and wellbeing, and vice versa.

The benefits and our responsibility to partnership working with people and communities

Many of the reasons given above align with why the health service looks to engage with people and communities. As the Statutory Guidance on Working in Partnership with People and Communities, published in July 2022, states:

“The ambition is for health and care systems to build positive, trusted and enduring relationships with communities to improve services, support and outcomes for people.”

The Statutory Guidance, mentioned above, lists eight benefits of partnership with people and communities. They are:

Improved health outcomes
Value for money
Better decision-making
Improved quality
Accountability and transparency
Participating for health
Meeting legal duties
Addressing health inequalities

NHS England and systems also have a statutory duty to continuous improvement of quality NHS Act, 2006.

National Quality Board shared commitment to quality for those working in health and care systems (2021) which identifies 6 key principles which includes being population focused and co-production with people using services, communities and staff.

National Quality Board shared commitment to improving experiences of care (2022) which identifies 3 key principles for delivering the best possible experience of care in systems: using insight and feedback, co-production as the way we improve, ensuring improving experiences of care is at the core of priority programmes.

NHS Impact –(Improving Patient Care Together) is the new, single, shared NHS improvement approach which identifies co-production with people and communities as a key enabler of improvement.

Tackling specific issues

Too often, engagement with people and communities can be seen as a nice-to-have, optional extra, which sits alongside or outside of the “main job” of the NHS. Yet at the same time, many of the challenges that health service faces – the ones that take up resources and delay responses – are ones that people beyond the walls of the GP surgery are best placed to help answer. And, conversely, the cause of some of those challenges are because the NHS has not properly engaged with the people and communities that it serves.

Each GP practice may well have specific challenges that they are facing. Patient participation can be a useful way of tackling an issue that is directly affecting how well the GP practice is functioning. For example, they might want to focus locally on:

Addressing health inequalities through working with those who are less well served by the current system
Improving care through a better understanding of how different people experience the current options
Building relationships between the practice (or Primary Care Network) and local community

Effective partnership happens when there are real issues to be worked on.

A community-powered NHS

At the same time as the new Statutory Guidance was published, New Local, a public-sector thinktank, published their Community-Powered NHS report.

In it, the authors argue that the NHS in its current form is not sustainable. The solution, they say, is that the NHS needs to become much more community-centred.

“The community paradigm is based on the principle that communities themselves have valuable insights into their own circumstances and what they need to thrive. Communities should therefore be able to exercise genuine influence and where possible direct control, over the decisions, resource and services that support their lives.”

(A Community-Powered NHS, New Local, July 2022)

Primary Care, with its direct access into local communities throughout the country, is both best-placed to engage with the community directly outside of the surgery front-doors, and also the part of the health service who will see the most tangible benefits from a community-driven approach. People often choose to work in Primary Care, whether in clinical or non-clinical roles, because they want to serve and support a local community.