Promoting Community Cohesion
through Health and wellbeing scrutiny
CFPS Healthy Accountability Forum
13 July 2009
What is community cohesion and why is it an important
issue for people in the Health service?
“Better Together” guide
Is the NHS making an effective contribution to Community
How can Scrutiny raise the bar?
Ten challenging questions
• A guide for people in the Health service on how they
can help to build more cohesive communities.
• Published report, web-based guide, journal articles,
• Defines Community Cohesion,
• Explains why it’s important to people in Health service,
• Identifies ten key activities and asks ten challenging
questions about how NHS can influence cohesion,
• Identifies key issues and recommends actions that can
be taken by NHS bodies to have maximum impact.
What is Community
“Community cohesion is what must happen in all communities to enable
different groups of people to get on well together. A key contributor to
community cohesion is integration which is what must happen to enable
new residents and existing residents to adjust to one another.
• Three foundations:
• People from different backgrounds having similar life opportunities
• People knowing their rights and responsibilities
• People trusting one another and trusting local institutions to act fairly
• Three ways of living together:
• A shared future vision and sense of belonging
• A focus on what new and existing communities have in common,
alongside a recognition of the value of diversity
• Strong and positive relationships between people from different
• Source: The Government’s Response to the Commission on
Integration and Cohesion”, DCLG, Feb 2008.
Why should people working in
Health be interested?
• Community Cohesion affects people’s health and health
• It is part of our stock of social capital. In cohesive
communities people look out for each other and reduce
costs of dependency and institutional care.
• NHS is a sleeping giant. Could do much more.
• Partnerships need the benefit of Health experience,
particularly in Equality and Diversity and in sharing
• It helps NHS comply with several legal duties.
• It helps them to achieve other NHS priorities.
What barriers need to be
• Terminology – It’s more than Equalities and Diversity.
• It’s not just about race and faith. Need to address all
aspects of perceived difference.
• Need to arouse the sleeping giant.
• Not enough is known about how communities are
• Community engagement needs to include finding out
how different communities feel about each other and
how that impacts on health.
• Challenge the practice of single group funding.
• Making patient choice fairer for all communities.
Ten challenging questions
Developed in discussions with a group in the North West region.
1. Leadership and partnership,
2. Promoting positive relations between people from different
3. Celebrating all aspects of equality and diversity
4. Engaging with everyone in our communities
5. Making services accessible to all
6. Involving service providers
7. Publicity and myth busting
8. Using and sharing the best information
9. Investing in workforce skills
10. Promoting NHS jobs to all
What does good practice look
1. Programmes to challenge perceptions about difference and to
bust myths (not just race and faith but also disability, age, etc.)
2. Promoting interaction between people who have differences
through: volunteering, challenging single group funding,
changing the format of community engagement, changing the
way public spaces are managed, inter-generational projects,
integrating disabled people.
3. Taking a much higher profile in Local Strategic Partnerships.
4. Working with partners on improved information strategies to
understand better how communities are changing.
5. Designing the commissioning process so that it includes the
needs of all communities and ensures that service providers
deliver services in inclusive and integrated ways.
6. Promoting interaction within the workforce and promoting NHS
jobs to under-represented communities.