NICE Guidelines on Community Engagement Professor Chris Drinkwater NICE Community Engagement PDG

What are the challenges? What works? What should government and local statutory agencies do? Why should we bother?

Framework of NICE Guidance Aimed at policy makers, commissioners and providers including V & CS, community representatives and members. Prerequisites – challenges? Infrastructure – what do agencies need to put in place? Approaches – what works? Evaluation – why bother?

Prerequisites/Challenges Coordinated implementation of the relevant policy initiatives. Commitment to long term investment. Openness to organisational and cultural change. A willingness to share power, as appropriate, between statutory and community organisations. Development of trust and respect among all those involved.

Organisational and cultural change Identify how the culture of public sector organisations supports or prevents community engagement. Manage conflicts between communities (and within them) and the agencies that serve them. Incorporate community views into induction and in service training.

Levels of engagement and power Negotiate and agree how power will be shared and distributed - defining project objectives - resource allocation - decision making Jointly agree ways of working

Jennie Popay (2006)

Infrastructure/Challenges Partnership working – will LSPs, LAAs, and CAA make a difference? Joint training for staff and community members. Accessible local venues and need to think through wider accessibility issues. Area-based initiatives.

Approaches/What works? Recruit and train people from local communities to plan, design and deliver health promotion activities. Use existing forums and networks. Start with what the local community feels is important.

Evaluation Identify and agree objectives with members of the target community. Be clear about the theory of change required to achieve success. Use a mixed-method approach and make use of participatory research.

Why Bother - Paradigm Shift 20 th Century – formalising provision of professional knowledge through systems of training and provision (hierarchical/paternalistic) 21 st Century – need to “fully engage” the public as co-producers of health (collaborative partnership)

Health,individual and community oriented preventative action Health Hazards poverty poor housing unemployment poor food & nutrition poor education Environmental hazards Community oriented preventative action Individually oriented preventative action Intersectoral action for Health. WHO. 1986

Best Value for Alzheimer’s NICE – drugs to delay progression only available for people with moderate symptoms (MTS over 10). (5,000 + words of newsprint) Annals of Internal Medicine – 15 minutes of exercise 3x per week for people over 65 reduces risk of Alzheimer’s by 40%. Greatest benefit to the most physically frail. (600 + words of newsprint)

Joining-up Locally to Address Inequalities LAPCT Public & patient engagement Engaging frontline staff Public Health Team Health Needs Equity audits Evidence Settings Staff Services Outcomes Locality clusters valuing diversity Community development Community engagement Training / employing local people Community action Locality clusters plurality of providers Shared quality & outcome data Collaborative approaches New ways of working Partnership TRUSTTRUST CONTINUITYCONTINUITY LSPs

NICE Community Engagement Web-link Quick Reference Guide Full Guidance