In a bid to alleviate pressure on GPs and Accident & Emergency (A&E) departments, the NHS has rolled out a new initiative that sends community-based health workers door to door in underserved areas to identify health issues before they require urgent care.
The program, which currently operates in 12 regions across England with plans to expand to 13 more, aims to improve access to healthcare for vulnerable populations, particularly those facing socioeconomic challenges. Each community health and wellbeing worker (CHWW) is assigned to 120-150 households, typically on council estates, where they conduct monthly visits to assist residents with health concerns, as well as issues related to housing, isolation, and finances.
Health Secretary Wes Streeting is exploring the effectiveness of the scheme as part of broader efforts to “fix” the NHS. The initiative aligns with two key priorities in Streeting’s vision: shifting care from hospitals to community settings and transforming the NHS into a service focused on prevention rather than treatment.
Early findings from the program show promising results. According to the National Association of Primary Care (NAPC), individuals visited by CHWWs are 10% less likely to seek help at A&E and 7.3% less likely to make unplanned GP appointments for non-urgent medical issues.
The success of the initiative is further supported by data from Westminster, where the program was first introduced in 2021. Households engaged by CHWWs have shown significant improvements in health outcomes, including:
- An 82% increase in attendance for cancer screenings.
- A 47% increase in vaccination rates for major diseases.
- An 82% increase in participation in NHS health checks.
Cornwall, which adopted the model in 2023, has reported reductions in the demand for mental health services, community care, and urgent care interventions. The proactive approach has also decreased the need for district nurse visits.
Though CHWWs are not clinically trained professionals, they play a vital role in supporting residents and connecting them with appropriate health services. Most CHWWs are recruited from the communities they serve and receive training tailored to their role.
In Cornwall, Volunteer Cornwall, a local charity based in Truro, has been contracted to manage the program, employing 60 workers. Elsewhere in England, CHWWs are often employed by individual GP practices or small networks of surgeries.
Marcus McAlister, programme manager at NAPC, explained that the initiative helps reduce A&E visits by addressing minor health issues like infections, mental health concerns, and chronic conditions such as diabetes and hypertension through community-based services. He added that CHWWs also help tackle social determinants of health, such as housing instability, financial struggles, and loneliness—factors that often lead to worsening health and emergency care.
“By supporting residents with more timely and appropriate care, CHWWs are helping to prevent health issues from escalating to the point where emergency care is needed,” McAlister said.
Sarah Woolnough, CEO of the King’s Fund think tank, praised the model as a powerful example of preventative care. She highlighted the advantage of home visits, where healthcare workers can identify not just the symptoms of illness but also the underlying issues that contribute to poor health, such as poor living conditions and financial instability.
Streeting expressed optimism about the potential of this community-based approach to improve NHS efficiency, particularly for individuals who frequently rely on emergency services. “We’re seeing some really encouraging signs about what can happen if you’ve got the right care in the right place at the right time, especially among communities and families where they’re likely to become frequent users of the NHS,” he said.
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