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New Brazilian health scheme improves the health of one of the UK’s most deprived neighbourhoods

A new scheme, inspired by a successful long-standing health initiative in Brazil, is improving the health and wellbeing of residents of Churchill Gardens - one of the most deprived communities in London. ZPB have been working with the National Association for Primary Care to highlight the scheme to a wider audience, with hopes of it being rolled out in more locations across the country.

The scheme, which involves Community Health and Wellbeing Workers (CHWW) visiting families in their own homes and providing health and wellbeing advice and connecting them with NHS services and other support in the community, has led to significant improvements in health service utilisation by residents in the Westminster neighbourhood.

New analysis of the first year of the project has shown health service uptake, such as cancer screenings and vaccinations, was 40% higher in households that had received at least one visit by the CHWW, compared to those who hadn’t. Looking specifically at cancer screenings and NHS Health Checks, the scheme improved uptake by 82%, while immunisation uptake was 47% higher amongst those supported by the scheme.

At a time when the NHS is struggling to meet demand, the report also suggests that the project can help to ease pressures on local services. GP services in the local area saw an average 7.4% drop in appointments per household, attributed to the community health and wellbeing workers efficiently directing people to the right service for their need, rather than relying on general practice.

The scheme was launched in Churchill Gardens in 2021 – an area with urgent need for interventions to improve the community’s health and wellbeing and to tackle the high levels of health inequalities experienced by its residents. This is illustrated by a 15-year difference in life expectancy between Churchill Gardens and the neighbouring borough of Belgravia. The scheme involved 500 households registered at the Pimlico Health at the Marven GP Practice.

Following launch in London, the scheme has been successfully implemented in Calderdale, West Yorkshire and Warrington, Cheshire with further roll-out planned in Bridgewater, Norfolk and Waveney and parts of Cornwall.

The origins of the scheme can be found in Brazil, where Community Health and Wellbeing Workers have been a fundamental part of the country’s health service for more than a decade. The country has seen numerous health benefits as a direct result of these interventions, including cutting cardiovascular disease mortality by 34% in areas that receive community health worker intervention compared to areas that don’t.

The Churchill Gardens initiative is a unique partnership in Westminster involving Primary Care Networks, the National Association of Primary Care and Imperial College London.

Dr Matt Harris is Clinical Senior Lecturer in Public Health Medicine at Imperial College London, and was responsible for bringing the scheme across from Brazil:

“The UK health system can learn so much from successful initiatives in other countries. When I worked as a GP in the favelas of Brazil, I experienced the impact of the CHWW initiative first hand and the improvements it has led to in the health of the population.

“It is incredible to see the positive effects it is having on the health and wellbeing of the residents at Churchill Gardens. The community health and wellbeing workers become experts in the needs of their individual micro-area, and deliver proactive care which offers a solution to the fragmented and reactive care system that we so often have to navigate.”

Dr Caroline Taylor, GP in Calderdale, West Yorkshire and Chair of the National Association of Primary Care:

“Health and wellbeing inequalities experienced by communities up and down the country are now more evident than ever. Urgent, proactive and tailored action is needed to support those who are most at risk. This uncomplicated and cost-effective scheme from Brazil has shown to significantly improve outcomes by offering residents personalised support to navigate and access the health and wellbeing services they need.

“Health and care services are under tremendous pressure, but we must make sure that patients do not bear the brunt of these challenges. We are calling for this initiative to be rolled out to even more neighbourhoods and communities, helping to improve the nations’ health and wellbeing, and reduce the pressure on overstretched healthcare services.”

Nahima Begum, Community Health and Wellbeing Worker:

“We improve healthcare understanding and engagement of the community by bringing healthcare to residents’ front doors. We aren’t constrained by booked appointments, so we have the flexibility to give people exactly what they need and at a time that is convenient for them. If they just want to speak to us for five minutes, we can do that, if they feel lonely and want to speak to us for an hour, we can do that too. We never give up on our residents and we never take them off our list."

"As a local resident myself, I’ve been able to gain the trust of the community I work for, meaning they’re more likely to confide in me and feel comfortable discussing their health. This has meant I’ve been able to help many people address their health concerns as early as possible before they get worse.”


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