Bulletin 5: March 2010: Joint Community Participation Primary Care Funding Initiative

Welcome to the fifth Bulletin of the Community Participation Primary Care Funding Initiative!

Update on the formative evaluation

The formative evaluation will be completed by the end of April. Second evaluation visits have been held with all projects since January and projects have completed evaluation forms documenting their key activities and learning. The evaluation visits have been held with members of Primary Care Teams, community projects and community representatives on Community Health Forums.

There have been huge achievements and there are now measures being built into to ensure that the projects continue their work. Overall it is found that:

All 19 projects have developed good working relationships and joint working between Primary Care Teams and community organisations.
Ten projects have established or are in the process of establishing Community Health Forums; in most cases two or three community representatives have been invited to attend Primary Care Team meetings, where community participation will be a regular agenda item.
Six projects have carried out joint training (with PCT members and community representatives). This has helped to establish joint working practices and in some cases a basis for further consultations in the community.
Two projects have dealt specifically with the needs of ethnic minority communities (Mayo Intercultural Action and Pavee Point).

The evaluation has found that there are four factors critical to community participation:

The extent to which the PCT is ready, prepared and willing to engage, and the role of the Transformation Development Officer (TDO) in supporting and championing community participation;
The readiness of the community to establish mechanisms for participation and structures developed to enable community participation;
The availability of support structures and resources in the community, as well as the presence of experienced community development workers to build capacity, motivation and interest.
The extent to which there are existing structures and forums for participation.

There are a number of key issues that are raised in the evaluation including:

The need for resources to sustain of community participation in the long term;
The importance of community consultation in disadvantaged communities and a focus on the wider context of health;
The importance of establishing representative structures in the form of Community Health Forums, which can nominate community representatives to sit on Primary Care Teams;
The need to understand the different backgrounds and roles of community and HSE representatives, and methods to promote joint working and reconcile different perspectives and working methods;
The role of external facilitation and support has been very important to project activities; in particular external facilitation can be very helpful as it brings objectivity and independence to meetings;
The HSE in the future can utilise expertise from its own staff, supports and networks, which in turn will be vital to supporting community participation in the future.

A number of recommendations are being drawn up in the evaluation report. These cover the following:

Dissemination of learning from the Initiative, including a guide to models and practices of community participation for Primary Care Teams and community organisations;
Resources for the ongoing technical assistance for and training of Primary Care Teams and community organisations in methods of community participation; in some cases this can be carried out jointly;
The development of community participation in needs assessments carried out by Primary Care Teams;
Resources to support community activities, including meetings, hiring of venues, publications, facilitation etc.
Establishment of robust guidelines and indicators on community participation for Primary Care Teams, and the inclusion of these in HSE policy.
Ensure that Irish health care policy continues to focus on disadvantaged communities and addresses issues of inequalities in health and poverty.

Networking event, 20 January 2010

A networking event was held in Dublin on 20 January 2010 by representatives from community participation projects and Primary Care Teams. Mary Culliton, Head of Consumer Affairs in the HSE also attended the event. The networking event provided participants with feedback on recent HSE developments (by Rachel McEvoy) and progress with the evaluation (Jane Pillinger).

Pat Tobin from Community Action Network (CAN) gave an overview of the training and technical assistance that has been provided for projects. The three most requested areas for training are: building community participation; developmental methods for working with large groups and sustaining partnerships. The last training event will be held in Castlebar in March.

The event really showed just how much had been achieved in the 19 projects during the year. The event enabled projects to meet together, to share experiences of the different models of community participation that they had developed, and also to feed ideas and recommendations into the evaluation. The following are some of the interesting areas of feedback given by projects in the group discussions held at the networking event:

Some of the most important things carried out include setting up Community Health Forums and sustaining the interest and engagement of participants in the process.
In many cases there has been excellent engagement between community organisations and Primary Care Teams. This has established a momentum an important basis upon which community participation in primary care can move forward. This has been carried out with enthusiasm and commitment. As one participant said this engagement “has exceeded my expectations”.
Community participation is now a buzz-word for Primary Care Teams and community participation is now an integral part of the agenda of many Primary Care Teams.
Community needs assessments have been carried out in a significant number of projects and these have formed an evidence base for further work. In some cases a joint action plan has been drawn up for this purpose, which sets out a plan for joint action.
Several projects have carried out joint training that has been facilitated by the Community Action Network (CAN) which has then been used as a basis for further training in the community.
Many projects have built sustainability into their work and there is a real commitment to continue to support community participation.
A number of recommendations were made for sustaining community participation and ensuring that there are robust and measurable indicators built into the Key Results Areas for Primary Care. It was suggested that these indicators should be qualitative and quantitative.
There is also a key role to be played by support staff in the HSE, including community workers and social workers. This expertise can be mobilised for other Primary Care Teams across the country.

Outcomes of projects

Now that most projects have come to an end of their funding phase there have been a number of ways in which projects have disseminated the learning and activities undertaken. This includes public and media events to launch community needs assessments and project findings, meetings with a wider range of stakeholders to disseminate project outcomes and the production of information booklets and leaflets.

Elaine Houlihan is putting together a brochure with summaries of each project and contact details. This will be widely circulated in order to enable new community participation in primary care projects to find out what existing projects have been doing over the last year.

Showcase event

As a final event for the Initiative, a Showcase Event will be held on 26 May, from 11-2.00, at Dublin Castle. The Event will provide an opportunity for the 19 community participation projects to showcase their projects and to provide information about what has been achieved. This will be a fantastic opportunity for a wide range of stakeholders to learn about the outcomes of the projects and to learn about how community participation can be realised in practice. For further information about the Showcase event contact Elaine Houlihan: elaine.houlihan@welfare.ie

Other news

Update on HSE Service Plan for 2010

The HSE’s Service Plan for 2010 was approved on 5^th February 2010. This sets out the plans for service developments in 2010. A key development has been the new framework for integrating services between hospital and community based care through a new regional structure. This means that services that were organised under in the area of PCCC (Primary, Community and Continuing Care) are now integrated into a national Integrated Services Directorate. These services are now organised through four regions: HSE Dublin Mid Leinster, HSE Dublin North East, HSE South and HSE West. These regions now have the responsibility for delivering and managing services at a regional level by the Regional Directors of Operations. In addition, services are organised by Care Group Leads, such as older people, mental health etc.

Update on Primary Care Services

Primary Care Teams are now being rolled-out across the country and it is anticipated that by the end of 2010 the majority of Primary Care Teams will have been established. By the end of 2009 210 Primary Care Teams had been established and were holding clinical meetings. In 2010 it is planned that a further 184 teams will be holding clinical meetings and a further 136 teams will have been established.

Community participation has been established as a requirement for all Primary Care Teams and is now a Key Result Area of the HSE 2010 Service Plan. The Key Result Area states that community participation will be a deliverable in 2010 through:

“Opportunities for engagement with local communities provided through PCTs in a systematic way in accordance with the principles and guidelines endorsed in the National Strategy for Service User Involvement in the Irish Health Service 2008-2013”. (HSE Service Plan, 2010, page 15).

In addition, a performance indicator is established based on “% of PCTs with engagement with the local community” (HSE Service Plan, 2010, page 12).

Mapping of HSE support and resources

A sub-group of the project’s Steering Committee has been established to map existing resources in the HSE that can be used to support future community participation activities. These resources include Community Workers, Social Workers and Health Promotion Officers who have expertise in the area of community participation and community development and who skills can be utilised in the future to support community participation projects.

European Year Against Poverty and Social Exclusion

2010 has been designated as European Year Against Poverty and Social Exclusion. Over 500 organisations have applied for funding and decisions about which projects will be funded will be made soon.