Power in partnerships: Communities leading the way to better health

It is well understood that health is shaped as much by our environments as by clinical interventions. From secure housing to strong social connections, the social determinants of health have been recognised by the NHS’ leadership for a long time and service planning is increasingly reflecting this appreciation. However, the NHS remains unable to address this alone and attempts to empower communities are far too often undermined by its own infrastructure and competing priorities.  

To help bridge that gap, the NHS Confederation and Local Trust are working together to launch a new 18-month programme of action research. The initiative will explore how to support more community-led, hyperlocal approaches to health - putting power in the hands of the people who know their neighbourhoods best to drive change and co-design solutions in partnership with local health systems. 

It will be supported by Innovation Unit, as the action research delivery partner, and Health Innovation South West to help capture and share learning.  

The programme 

Six Big Local and legacy areas will take part in the programme over the next 18 months, each receiving up to £25,000 in grant funding to test, adapt, and deliver new models of community-led health. These areas are: These areas are: 

A new way of working 

The programme builds on years of learning from Big Local areas – 150 communities across England funded to lead their own local change. One such example is Par Bay in Cornwall, a coastal community of 9,000 residents, which has faced significant challenges following industrial decline and underinvestment. In response, the locally-led Par Bay Community Trust has brought local organisations, health professionals, and volunteers together to run initiatives to tackle health inequalities, including community transport schemes, warm hubs and STEM training to enhance professional skills and employability.  

With nearly 6,000 visits to the Warm Hub annually and over 2,000 meals provided, their work has shown how a whole-place approach built on trust and led by the community, can genuinely shift the dial on local health outcomes 

However, working with the health system can still feel overly complex and hierarchical, designed in ways that make genuine collaboration difficult. Shifting towards a model of neighbourhood health - where the community takes the lead - means we need to better understand the conditions that allow this to flourish. 

Ruth Rankine, director of the Primary Care Network at the NHS Confederation said: 

“Working with and for communities can be a challenge for a sector that is dominated by organisational structures creating a sense of a power imbalance. 

“Top-down approaches can impact a community’s agency and make it harder for frontline workers to collaborate effectively with and for communities. 

“Together with Local Trust, we will support the NHS to move from a position of accurately diagnosing the problem to having the support and connections to co-design solutions, so communities are shaping their local neighbourhood health initiatives.

“This research will build on a strong foundation of our joint work so far, including reports like The case for neighbourhood health and care, which is filled with examples from across the country and highlights the growing evidence that community-led approaches are not only possible but powerful.

“This isn’t research for research’s sake — it’s about learning from communities and local partners through real examples.” 

What we’re aiming to learn 

The research will focus on understanding what it takes to create genuinely collaborative, community-led approaches to neighbourhood health, asking questions such as:  

Find out more about this work here.