Process for Community Participation and Primary Care Teams

Rather than presenting a prescriptive approach, the purpose of this reference guide for 'Community Participation and Primary Care Teams' is to provide HSE employees with an understanding of community participation within primary care and the basic stages that can be navigated through. The steps are not 'air tight' compartments and hence the line between the steps is arbitrarily drawn to allow people to move back and forth between the different stages.

This work will as always throw up challenges regarding expectations, methods of working and organisational constraints. However, this process of engagement allows all stakeholders to openly discuss such constraints and expectations and can reinforce learning from and between community and HSE participants.

Key structures and audit

• A list of Community Development Projects (CDPs) in your area is available from: www.changingireland.ie
• A list of Family Resource Centres (FRCs) in your area is available from: www.familyresource.ie/
• A list of local authorities can be accessed at: www.citizensinformation.ie
• 'Finding your way around the community and voluntary sector' by Hilary Curley

An audit of community research, needs assessment and consultations carried out to date might also be of benefit and a valuable resource.

Establishing and maintaining effective links

• 'Community Participation in Primary Care': Dr Philip Crowley, Combat Poverty Agency identifies some lessons from the Building Healthy Communities pilot programme in Combat Poverty.
• 'A Model for Partnerships in Health': Institute of Public Health.
• 'Toolkit on engagement for commissioners': Community Development and Health Network.
• 'Community development resource pack': HSE
• 'Towards Standards for Quality Community Work: An All Ireland Statement of Values, Principles and Work Standards, Community Workers Co-operative'.

Forming a small intermediary working group

This group will advise and support on community participation in the local area.

• 'Indicators for the working together standard': Community Scotland.
• 'The Guide to Effective Participation': by David Wilcox

Community participation process

Methods for bringing together all local groups/persons with an interest in health and how the community can best engage with the PCT and vice versa can range from simple, yet successful, open evenings to more sophisticated community assessments that are carried out with a wide range of local groups and local people.

The meetings may be used to as a vehicle to:

• Present information on PCT and services, increasing awareness and understanding.
• Discuss with all present how health is effected in your community (e.g. SWOT analysis).
• Select community representatives and preferred structure for community participation.

It is important to include those whose voice are seldom heard. This will need to be supported and resourced, and can be built on over time.

Local community groups have a wide breath of knowledge and many community groups will be skilled in various consultation techniques as will many social inclusion, community workers and health promotion staff in the HSE. Organisations like the Community Action Network may also assist you. It may be useful to agree a time framework at this particular stage in the process.

• Best practice guidelines for establishing and developing service user panels in a health setting:

Needs analysis

The HSE will conduct broader health services needs assessment at network level. Pilot work is underway in a few sites. The Institute of Public Health (IPH) has also developed an all Ireland health and well being dataset; It will be important to build on and avoid duplication of work already completed in this area.

Prioritising and action planning

The PCT will be unable to act on every wish expressed by the community. It is important to select a few actions that can be achieved easily and are early wins. Remember preparation and maximisation of clarity are essential:

• 'Participation in Anti Poverty and Regeneration Work and Research': Peter Beresford and Martin Hoban.
• The Western Health and Social Services Guide to Public Involvement: Western Health and Social Services Board, Northern Ireland 2005.

Establishment of Particpation Forum or similar representative structure

It is important to support a broad community forum that is as inclusive as possible and that can select representatives who will be involved in the PCT. Training and support for representatives is important and projects like those in Lifford/Castlefinn have a number of reps in place. If it is not possible to establish a community health forum, ascertain whether or not there is another representative structure in existence with a health remit that could be useful to feed into primary care and vice versa, as in West and South Offaly.

Guidelines, standards and training

• Community Action Network (CAN)
• Institute of Public Health
• Health Promotion
• Social Inclusion

Actions implemented and evaluation

• Get involved: guide to evaluation
• Partnership tool
• Combat Poverty: A Guide To Self Evaluation
• Community Participation Question Set

Case study examples:

• Building healthy communities which included a range of communities of interest such as the Deaf community, ethnic monitory groups, Travellers and women with mental health issues:
• Lifford and Castlefinn
• Combat Poverty Joint funding initiative
• The West Offaly Way

There are a number of useful resources available on the HSE website and in the www.lenus.ie repository.
The Combat Poverty Agency's publications catalogue is at http://www.combatpoverty.ie/publications/index.htm and all publications are available for download