The Community Chest model
A Community Chest for social prescribing is a shared investment fund which supports the voluntary and community sector to deliver local activities:
- It takes a “needs-led” approach to commissioning; responding to both the unmet needs of residents and the strengths of local groups and initiatives to address them.
- It’s co-produced and co-owned; with a wide range of stakeholders developing the approach and setting priorities. This includes: link workers, Voluntary, Community and Social Enterprise (VCSE) representatives, clinicians, public health teams and residents. Community chests build on the existing partnership infrastructure to enable these groups to work together locally.
- It’s equitable; ensuring funding is inclusive and accessible to previously under-served groups.
- The community chest is not a prescriptive model but a shared set of principles that can be adapted to meet a local population’s needs.
- Community chests take a “needs-led” approach to commissioning: responding to both the unmet needs of residents and the strengths of local groups and initiatives to address them
- Community chests are co-produced and co-owned: involving a wide range of stakeholders and build on existing infrastructure for these groups to work together locally
- Community chests are equitable: ensuring funding is inclusive and easily accessible to groups that may have been excluded in the past
- They can foster integrated ways of working through place-based Partnerships (convening and combined investments by the NHS, local authorities and other stakeholders).
- They are designed to address health inequalities at both local and hyperlocal levels, responding to community intelligence and promoting sustainable outcomes for communities.
- They support the evolution of social prescribing through better data and investment in, and empowerment of, the VCSE sector.
We piloted a community chest approach for social prescribing across each of the 7 boroughs of North East London. Early evaluation has highlighted the huge impact of these pilots, including preventing multiple appointments with GP & A&E services because they have been supported by these funded activities.
Other impacts included:
- People had improved physical, mental health and wellbeing through support with social determinants such as loneliness and cost of living.
- Many felt the support to the activities was critical, they were likely to attend GPs, social care, hospital or go without help if they didn’t exist. People also felt more like they could play a more active part in their community.
- In Redbridge, statistically significant improvements in wellbeing, anxiety, and life satisfaction were seen in residents (70% of the recipients of the interventions rated their life satisfaction at above 8 out of 10 compared to below 4 out of 10 before).
- In Havering, 1 in 5 people would have done nothing, gone without support or wouldn’t have known where to turn
On VCFSE organisations:
- Increased capacity or address gaps within their services. E.g. expanding a service to include under 5 year olds. It especially allowed small grassroots orgs to access funding where they wouldn’t usually be eligible.
- Many were led in partnership, developing new skills and relationships to the NHS and local authority
On the system:
- Improved partnership working between statutory and non-statutory services, more people and orgs aware of social prescribing. Only 5/15 VCSE orgs receiving funds in Barking and Dagenham were aware of Social Prescribing previously.
- Prevented residents from accessing GP or A&E services. Over a quarter of people would have attended the GP surgery in Havering if they hadn’t accessed the activities.
The community chest is not a prescriptive model but a shared set of principles that can be adapted to meet a local population’s needs.
There are number of ways in which the community chest model can be implemented:
- A participatory budgeting approach: where voluntary and community representatives and residents collectively decide how to distribute the money.
- An open application approach: where bids are assessed by a panel made up of stakeholders from across the community.
- They may also build on existing partnership work taking place within boroughs and neighbourhoods.
The community chest aims to bring together funding from the NHS and local authorities, and other sources, to support the voluntary and community sector to deliver local health and wellbeing activities. Examples of activities that have been funded include:
- A walking club targeted towards men to support with mental health and social isolation issues
- A wellbeing café that provides a safe space for people with long term health conditions – an occupational therapist was on site to provide individual support.
- Cooking classes targeted towards Asian people who were at risk of developing diabetes
- Workshops to support Tigrayan refugees and asylum seekers become aware of the health system and how they need to access the health services.