Overview of project:

Since 2008, Bristol Public Health’s inner city team has been working to build a strong model of community engagement and long term relationship with local population through social networks, work and faith places and schools to engage disadvantaged population in health promotion initiatives. The Bristol Public Health Inner City Wellbeing Hubs and Communication Centres were nationally recognized as an excellent community based health project. The project won the NHS Alliance Excellence Award in 2008 as best community health engagement project in the UK.

The centres have now developed, we gather complaints and intelligence on health and run an effective partnership of Public Health and voluntary and community organizations to deliver health and wellbeing projects. It becomes a two way communication method. The network has developed into 50 hubs/communications centres. They are in a strong position to support the delivery of public health messages and interventions and also know when health services have let a community member down. They have become communication centres and wellbeing hubs where we disseminate information on public health messages, actively deliver health and wellbeing interventions, run physical activities, healthy eating projects and awareness campaigns. We run targeted health workshops and campaigns through the centres to our community members.

It is an effective model to reach out to “hard to reach “ population and through it Public health has succeeded in reaching around 2000 people each year in the inner city with preventative health messages and intervention such as cycling, healthy eating and physical activities. We then identified key members within these networks and trained them as health champions and now we have 50 trained health champions in the inner city working in projects such as stop smoking, diabetes awareness, asthma control, cancer awareness workshops, health checks and other projects.

How was the need for this project identified?

There are many socio-economic and cultural factors preventing people in deprived areas from engaging with health promotion, healthy lifestyle services and self-care support services such as diabetes education service. There is strong evidence of correlation between deprivation, low socio-economic status and cultural beliefs and lower health outcomes, greater health inequalities and higher mortality rate. Townsend (1987) highlights two types of deprivation: material and social deprivation. Material deprivation is the material apparatus: goods, services, resources, amenities, physical environment, and place of residence. Social deprivation refers to the roles, relationships, functions, customs, rights, and responsibilities of membership of society and its subgroups. Material factors include dietary, clothing, housing, household facilities, environment, and work (conditions, security, and amenities). Social factors include family activities, social support and integration, recreation, and education.

The inner city is one of Bristol most deprived areas and suffers from multiple layers of deprivation both material (poor housing, high level of pollution, high level of unemployment) and social deprivation combined with less social integration. Bristol’s Joint Strategic Needs Assessment (JSNA) published in 2014 shows the impact of such multiple layers of deprivation on population in form of  lower life expectancy of 8.2 years lower for inner city men and 6.1 years lower for women compared to the residents of the most affluent wards in the city.

In spite of such health inequalities, for decades Bristol NHS and public health services have been struggling to reach out and engage inner city population in health promotion, health education, preventative measures and self-care initiatives (diabetes education programmes). The services conveniently used the term “hard to reach communities” to describe such population. On the other hand disengaged or easily overlooked communities describe the health services as hard to access, insensitive, inappropriate and adopt one size fits all approach as supported by Riggers E et al, 2014. This research is to assess the effectiveness of a local solution and a community based model for health promotion and engagement which has been developed by Bristol Public Health’s Inner City Health Improvement Team to reach out and engage Bristol inner city population in health promotion, preventative and wellbeing projects. The model essence is to identify up- skill and build the capacity of local social networks to function as health and wellbeing hubs.

Please give an overview of the project’s benefits, and the aspects of public health it addresses.

It is an innovative and effective model to engage deprived and hard to reach population in health project, it supports health promotion and health awareness campaigns, it utilises community social assets to promote health and identify champions, it builds trust between health services and disengage communities and develops health staff knowledge and intelligence on local population.

What was the biggest challenge faced by your project? How was this overcome?

The biggest challenge was building trust amongst the social groups of the health services.
This was overcome by maintaining the existence of such smaller groups which involve community development efforts from public health staff.

What advice would you give to a team managing a similar project?

Develop skills and knowledge of local population through interacting with local social networks.
Invest time and resources to understand the local dynamics and build alliance with gate keepers and key individuals and institution in the said region or area.
Be prepared to put resources into and form long term relationships with the local groups.

Have you had any feedback (e.g. from colleagues, third-sector partners, members of the public)?

The project won the NHS Alliance Excellence Award in 2008 as best community health engagement project in the UK.

Dr Felicity Harvey CBE Director General for Public and International Health (PIHD), Department of Health says about the work on her visit to the centres “Thank you so much for Friday. I was tremendously impressed by the work being done across the community centres, and the afternoon provided an invaluable opportunity to see the successes and challenges of public health work on the ground. Connecting experiences such as these are immensely important for policy makers, and I am very grateful for all of your hard work in setting this up and your hospitality on the day. I took a lot away from it, and am sure that Tim and Hugo feel the same”.

Dhek Bhal South Asian Organization “I believe that the Public Health, by developing the Communication centres Project, has not only proved that it is listening to the concerns and the pressing issues related to BME patients, but it has shown a commitment to change and improve access to services”.

Which aspect of this project makes you most proud?

The ability to utilize social assets and engage and work with all parts of our local communities in such a long-term partnership is impressive.
It has equipped us with full understanding of the socio-economic, cultural dynamics of our local population.
Building a strong mutual beneficial partnership with local networks to support their members’ health and wellbeing has also made me proud.

How can your public health colleagues get more information about this project?

For more specific information, contact me via email