Brian Fisher, Chair, New NHS Alliance
Have you been participating in the online experiences that have mushroomed in response to the pandemic? Have you been clapping for carers? Have you been contacted by a local group, perhaps offering support to collect food and medicines?
The astonishing outpouring of community solidarity, compassion and practical support has brought people together, encouraged confidence, and helped people take more control over their lives and their areas. These initiatives are undoubtedly life-saving in some instances, keeping people in the community when there would otherwise have had to have been an institutional response.
The pandemic has demonstrated the power of community action in health creation.
This insight is not new, but it may not have been so evident before, certainly not so evident to planners and decision-makers in the NHS. The pandemic is also taking us beyond what we knew before. We have long known that bringing people together, strengthening ties within communities, supporting people to collectively identify the issues that matter to them and then supporting them in finding solutions, in collaboration with the statutory sector – all that has a huge benefit to health. In fact, that face to face community action is about as beneficial as stopping smoking. It promotes both physical and mental health at all ages.
What this pandemic has taught us is that this benefit probably extends to non-face-to-face contact as well. The evidence on this point has never been clear. Actually, there has been little research on that at all. We can now see that any kind of benign contact can be health-enhancing.
Health is not just an individual, but also a social process.
We have made so many things happen in the last few weeks, with government’s recognition of the importance of society and the investment needed into the state sector. We must commit to embedding these insights. A healthy society requires a healthy state.
The NHS must now work with Local Authorities to make sure that every layer of out of hospital NHS provision is geared to support building community capital, community solidarity . There are many ways of doing this, but a common route is some form of health creating community development. This approach has a long pedigree.
Community development is an essential part of creating health
Community development is a technique that, at it’s best, helps people, usually in a geographical area, to identify the issues that matter most to them. The approach then supports them, often with the statutory sector, in finding solutions that work locally. It is the building up of control that is the key to health creation.
There are examples of community development in many different sectors across the country over many years. Now we need to recognise this activity as an essential part of creating health to understand what works and why and recognise this activity as an essential part of creating health. We need investment into communities to enable development of a systematic approach that enables each community to make it their own, tailored to their area and their communities. We know that that approach builds relationships and builds trust and also has impacts on health inequalities.
When our physical distancing ends, let’s make sure that our social approach shrinks distancing and builds a more human, community approach to keeping us well.