Community support versus health care services: time to change our definition of impact
Author: Janet Harris and Alexis Foster
This post was originally published by the Evidence & Policy blog on November 3, 2021.
We have re-issued the article that has already been published by the Evidence & Policy blog. We would like to express gratitude to the kind offer of the editorial board of the Evidence & Policy blog.
Original article URL: https://bit.ly/3cbHtw8
This blog post is based on the Evidence & Policy article ‘Using knowledge brokering to produce community-generated evidence’
Non-profit community anchor organisations in England typically provide a range of support to local people, including wellbeing support, advocacy, social activities, and training and employment advice. This array of services takes a wider perspective on the determinants of health than the approach taken within the National Health Service (NHS), which generally focuses on mental and physical ill health.
Despite the different approaches, the funding for community anchor organisations is often dependent on the impact they have on health outcomes. Is this a good basis for judging the value of holistic support?
Over a four year period, we set out to build cross-sector partnerships between funders/commissioners and the community sector in order to demonstrate what communities organisations do and reach agreement on a relevant evidence base for community support. The challenges to agreeing an evidence base included:
Identifying appropriate tools to measure outcomes and impact: Most organisations were required to use tools developed in clinical settings and it was agreed that these were unsuitable to use in neighbourhood settings.
Reaching agreement on client-valued outcomes: Community organisations produced a list of relevant outcomes, but these did not reflect those required by commissioners.
A lack of resources to pilot evaluation tools and assess impact: On both national and local levels, there are few sources of funding for evaluating community support.
Considerable progress was made between the community anchor organisations on adapting tools and agreeing outcomes. Barriers continue to exist, however, in relation to getting commissioners to accept that impact includes getting people to manage the ‘upstream’ life circumstances that lead to poor health.
Since the completion of our initiative, the need to shift our definition of community impact is becoming more urgent. As we continue to work with the same groups during the pandemic, we have seen how smaller community groups can work alongside larger neighbourhood anchor organisations to draw upon their existing knowledge and skills. They help people with everything from making decisions about testing and vaccines to self-isolating.
Prior relationships with local people and trust have been critical components of mobilising in the face of COVID-19, equipping people to deal with major upheavals. Although this is informally recognised, the funding needs to reflect the scale and coverage of the work. Furthermore, at present funding is short-term for specific projects. Community organisations need funders also to pay for ongoing running costs to enable them to respond to community needs, as they did in the pandemic.
Janet Harris is a retired Reader in Knowledge Mobilisation who is continuing to work in an honorary capacity at the University of Sheffield School of Health & Related Research.
Alexis Foster is a Research Fellow at the University of Sheffield School of Health & Related Research.
You can read the original research in Evidence & Policy:
Harris J, Springett J, Mathews D, Weston G, Foster A. (2021) Using knowledge brokering to produce community-generated evidence. Evidence & Policy, DOI: https://doi.org/10.1332/174426421X16190024737973 [Open Access]
If you enjoyed this blog post, you may also be interested to read: