Impact case study database

The CHPR body of research has driven an evidence-led decision process that has changed policy and practice in the design and delivery of community-centred approaches to health and wellbeing. Impactful change has occurred in the UK at national governmental, local governmental, local provider and practitioner levels and internationally with the adoption of these research findings by the Spanish public healthcare system. The ultimate beneficiaries of the impact of this research are the general public, through improvement in government policy and societal practice in relation to ownership of one’s health. Changes in societal practice relating to public health is far-reaching, both from the perspective of a general improvement in health and wellbeing throughout society to the subsequent financial savings to public health services such as the NHS.

a). Changing national policy and practice in community engagement with public health

In 2015 PHE and NHSE jointly published the document “A guide to community-centred approaches for health and wellbeing” [ IM1]. This report was prepared by South and colleagues and condenses the key findings from the body of underpinning research [R1-6] into a usable guide for all stakeholders to follow and adapt. The Guide [ IM1] is endorsed [Page 4] by Duncan Selbie [then CEO, PHE] and Simon Stevens [CEO, NHSE] who state “ As part of our joint commitment to community approaches and harnessing this renewable energy [community volunteers], NHSE and PHE have set out what works. Through this guide we outline a ‘family of approaches’ for evidence-based community-centred approaches to health and wellbeing”. The guide has been cited over 100 times in public health journal articles and directly underpins community-engagement policy and practice at national and international scales as evidenced below.

The research has driven policy and practice within NHSE. The Guide [ IM1] was implicit in the NHSE’s People and Communities Board development of the “Six principles for engaging people and communities” [ IM2, IM1 referenced on p12]. The six principles [ IM2] were adopted by NHSE in its New Models for Care Programme focused on empowering patients and communities [ IM3, p8]. The New Models of Care programme Directory [ IM3] recommends using The Guide [ IM1] as a resource to help Vanguards develop new services and implement community-centred approaches [ IM3, p.32]. In 2019, NHSE published a “Menu of evidence-based interventions and approaches for reducing health inequalities” to meet the ambitions of the NHS Long Term Plan [ IM4], the section on community-centred approaches was underpinned significantly by and referenced The Guide [ IM1].

LBU research has underpinned community-engagement strategies with health in the UK. This claim is supported by a testimonial from PHE that states, “ The research has driven PHE strategic approach to community engagement in health” [ IM5]. The adoption of The Guide [ IM1] by PHE was formally announced in an official PHE blog, which highlighted its contribution to the knowledge base and encouraged its use by local leaders and commissioners. The “family of community-centred approaches” [R6] was adopted as a taxonomy for PHE to organise evidence and resources on Healthy Communities for the newly developed PHE Knowledge platform. Subsequently, “Creating healthy communities” was stated as one of six opportunities within PHE’s new Strategy 2020-2025, for improving public health within the UK [ IM5].

b) Changing national guidelines and quality standards in community engagement with public health

Changes in National Institute for Health Care Excellence (NICE) guidance on community engagement resulted directly from the underpinning research. NICE guideline “Community engagement: improving health and wellbeing and reducing health inequalities” (NG44) ( IM6) was published in March 2016 and replaced guideline PH9. The Guide [ IM1] is referred to extensively throughout NG44 and is specifically cited on pages 8, 9 and 20. Subsequently, NG44 is the sole source document for development of NICE Quality Standard (QS) 148 “Community engagement: improving health and wellbeing” ( IM7) and NG44 contributed to development of NICE QS167 “Promoting health and preventing premature mortality in black, Asian and other minority ethnic groups”.

The Guide [ IM1] and NG44 [ IM6], which both directly emanate from the underpinning research, are the key documents utilised by national and international public health stakeholders in driving their strategies in engaging communities with public health.

c). Changing international policy and strategy in engaging communities with public health

NG44 has been utilised extensively to develop the national guidance strategies for community engagement in public health in Spain. The Library of Clinical Practice Guidelines of the National Health System (guiasalud.es) developed the 2018 document “Participacion Comunitaria: Mejorando la salud y el bienestar y reduciendo desigualdades en salud” [ IM8] [“Community Participation: Improving health and wellbeing and reducing health inequalities”]. The document is endorsed by Ministerio de Sanidad, Consumo y Bienestar Social [Ministry of Heath, Consumption and Social Welfare]. This guide states on the cover page it is adapted from NG44. This national-level document was used to create the 2019 document “Particpar para ganar salud” [ IM9] [“Participate to gain health”, p2 cites IM6 and IM8, as underpinning documents], with a localised focus for adoption of the guidance at municipal levels across the whole country. This document is endorsed by Federacion Espanola de Municipios y Provincias [Spanish Federation of Municipalities and Provinces and Red Espanola de Ciudad Saludables [Spanish Healthy City Network]. Thus, the strategy for engaging communities in public health adopted by the Spanish healthcare system, can be directly traced to the underpinning research from the CHPR at Leeds Beckett University.

d). Changing UK local government policy and strategies in community-engagement with public health, and increasing uptake of these innovative approaches by community organisations

NICE NG44 [ IM6] and The Guide [ IM1] has been utilised extensively by local councils across the UK to inform and develop their strategies to engage their local communities in public health initiatives. Currently in excess of 30 local councils across the length and breadth of Britain have completed or are developing community-health strategy documents, staff training and health audits, that utilise and cite NG44 [ IM6] or The Guide [ IM1] as a gold standard [ IM5]. Councils, and diverse examples of utilisation include; guidance on management of long-term conditions [Cornwall County Council]; health impact assessments [York, Wirral, Cumbria, Doncaster, Glasgow & Clyde Councils]; social worker training [Brent Council]; weight management programme [Rutland Council] and the “Physical Activity Strategy 2019-22” [South Tyneside Council]. NG44 [ IM6] is utilised and cited in numerous public health documentation from PH Wales. As representative evidence for local government impact we include Tower Hamlets Council, “Public Engagement Strategy 2018-2021” [ IM10], which is underpinned by The Guide [ IM1] and NG44 [ IM6, cited on p36, reference 16]. The research has also resulted in changes in practice from community organisations in how they promote community engagement with public health. PHE publishes in excess of 50 practice examples of local projects that illustrate uptake of innovative community -centred approaches and document impact through outcomes and learning [ IM5].