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

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

3. 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?

4. 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.

5. 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.

6. 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

7. Jennie Popay (2006)

8. 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.

9. 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.

10. 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.

11. 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)

12. 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

13. Best Value for Alzheimer’s NICE – drugs todelay 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)

14. 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

15. NICE Community EngagementWeb-link Quick Reference Guide www.nice.org.uk/nicemedia/pdf/PH009CommunityEngagementQuickRefGuide.pdf Full Guidance www.nice.org.uk/nicemedia/pdf/PH009Guidance.pdf