Healthy Communities Collaborative

Strategies to address health inequalities have, in recent years, focused on the need for partnership working which is vital in addressing some of the social, economic and environmental factors which contribute to poor health.

In many of these existing partnerships, however, an important element is missing - that of the community as a significant partner.

There are well recognised barriers to involving local people. Some of these emanate from the professionals involved and some from the community itself. These barriers in the community become apparent when attempting to engage people who are not the ‘usual suspects' in public and patient involvement, people who may well lack the confidence and self esteem to get involved. The Improvement Foundation has not only responded to this challenge, but capitalised on it. 

Improvement Foundation approach

The Improvement Foundation's Healthy Communities Collaborative (HCC) has won national awards for its innovative work and results, and has become internationally recognised as leading the field in the area of involving deprived communities in the improvement of their own health and wellbeing.

In a recent National Institute for Health and Clinical Excellence (NICE) review of the use of community engagement, our Healthy Communities Collaborative work was identified as one of the few national programmes that focus attention on measurement of outcomes and results.

An article about the Health Communities Collaborative has recently been published in the Journal of Integrated Care. Please click here to view a summary of this article.   


The results that can be achieved when local people work in partnership with a range of agencies are staggering. For example, the initial focus of the programme was Reducing Falls in Older People. In just three sites covering a population of 150,000, there has been a 32% reduction in falls (730 fewer falls over two years). This amounts to a reduction in hospital costs of £1.2m, ambulance costs of £120,000 and residential social care of £2.75m. This gives a total £4m over two years or £2m a year saved just for these small populations.

The Improvement Foundation's HCC also produces a gain in social capital within the overall community in which the improvement activity takes place. In the general population for Wave One sites in the reducing falls programme, following the work of the programme there was a:

  • 12% increase in people's perception of whether their area was a good place to live
  • 12% increase in people's perception of whether individuals show concern for each other
  • 22% increase in the number of people who knew where to get advice about falls

In the participants who were active in the programme there was:

  • A 48% increase in the number of people who thought they could change and improve things in their communities 


The Healthy Communities Collaborative was set up by the Improvement Foundation with the support of the Health Development Agency in 2002.

It aims are to:

1. Address health inequalities in areas of socio-economic disadvantage
2. Be the catalyst enabling communities and agencies to work together for common goals
3. Harness the skills and knowledge in communities and make them work to reduce inequalities
4. Recognise and change poorly functioning systems using rapid improvement techniques.

The collaborative is particularly focused on low-income groups, and the teams focus on the needs of older people, children and families.

HCC projects to date include:


The Improvement Foundation received the HSJ Award for reducing inequalities in September 2003 for the HCC work.

The HCC uses the collaborative model in its work with diverse communities, ranging from inner city urban areas to sparsely populated islands. It differs from other collaboratives in being led by local people. They are supported and enabled to improve their communities through partnerships with statutory and voluntary organisations.

The focus of the work is to make positive changes in health and wellbeing. To achieve this, all participants are taught how to use tools to effect change. Outcomes include improvement in a specific topic area and benefits to the community itself, which ignites the desire to affect other topics. This model, developed by the Improvement Foundation, is termed Community Action.

Key features of the Healthy Communities Collaborative:

  • An expert reference group develops ‘change principles' that when followed will secure the greatest gain in the chosen topic
  • Learning workshops during which the teams learn of best practice on the topic and are supported to understand this in a local context
  • Action periods when they meet regularly and use the Plan-Do-Study-Act (PDSA) learning cycles to test ideas for change and improvement. Teams are encouraged to test ideas on a small scale and continue taking small sequential steps
  • Tracking improvement with data collected monthly. Putting these key features together in a framework makes it easy for teams to get started, achieve results rapidly and demonstrate success. They bring about a creative environment in which testing ideas and measuring improvement becomes the norm

If you are interested in working with the Improvement Foundation please go to How we can help or click here to contact us.