NICE Guidelines on Community Engagement

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NICE Guidelines on Community Engagement

• Professor Chris Drinkwater
• NICE Community Engagement PDG

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

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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?

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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.

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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.

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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

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Jennie Popay (2006)
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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.

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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.

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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.

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Why Bother - Paradigm Shift

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

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

• 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 Alzheimers by 40. Greatest benefit to
  the most physically frail.
• (600 words of newsprint)

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Joining-up Locally to Address Inequalities
LA
PCT
Health
Public Health Team
Engaging frontline staff
Public patient engagement
Needs Equity audits Evidence
Locality clusters valuing diversity
C O N T I N U I T Y
Locality clusters plurality of providers
T R U S T
Community development
Shared quality outcome data
Settings Staff Services
Community engagement
Training / employing local people
Collaborative approaches
Outcomes
Community action
New ways of working
Partnership
LSPs
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NICE Community EngagementWeb-link

• Quick Reference Guide
• www.nice.org.uk/nicemedia/pdf/PH009CommunityEngage
  mentQuickRefGuide.pdf
• Full Guidance
• www.nice.org.uk/nicemedia/pdf/PH009Guidance.pdf