A national report outlining principles and case studies showing how community participation can support integrated care and address wider determinants of health.
Key messages
Policy implications
Gaps
Commentary
This report positions community participation as a foundational element of neighbourhood health and care. By emphasising co-production and asset-based approaches, it reframes integration as something built with communities rather than delivered to them.
The case studies illustrate how engaging residents can improve trust, relevance and responsiveness of services. From a care equity perspective, these approaches are particularly important for addressing social determinants of health that sit beyond the reach of clinical services alone.
The report also highlights the role of voluntary and community organisations as connectors between statutory services and local populations. Their involvement can support prevention, early intervention and more holistic responses to need.
However, the evidence base remains largely qualitative. While the principles are clearly articulated, there is limited evaluative data on outcomes or how community-powered approaches reduce inequalities over time. For neighbourhood health and care, this underlines the importance of pairing community participation with robust evaluation to understand impact and sustainability.
A study examining how geographical location and economic disadvantage shape access to community palliative care in rural, coastal and low-income communities in southwest England.
Key statistics
Key messages
Policy implications
Gaps
Commentary
This study explores how geographical location and socioeconomic disadvantage shape access to palliative and end-of-life care in rural, coastal and low-income communities in southwest England. The South West Peninsula has one of the oldest populations in England, with more than a quarter of residents aged 65 or older. This ageing population increases the need for palliative care and community support services.
People living in rural and coastal areas often face practical barriers to accessing care. Services may be located far from where people live, and public transport options can be limited. For people with serious illness or reduced mobility, travelling long distances for care can be particularly difficult. These barriers can delay access to support or make it harder for people to receive care in their preferred setting.
Economic disadvantage can further increase these challenges. Some rural and coastal communities experience higher levels of deprivation alongside limited service availability. This combination can make it harder for individuals and families to access consistent and high-quality end-of-life care.
The study highlights the value of working directly with local communities when planning services. Through partnerships between researchers, healthcare providers and community organisations, the project gathered insights into the specific needs and priorities of different communities. This approach helped identify gaps in services and possible ways to improve care delivery.
From a care equity perspective, the findings show how location can shape access to health and social care services. People living in rural and coastal communities may experience structural barriers that are less common in urban areas. Without targeted policies and investment, these barriers can lead to inequities in access to palliative care and support at the end of life.
Overall, the report suggests that improving palliative care access requires locally tailored solutions. Strengthening community services, improving transport and addressing workforce shortages could help ensure that people living in rural and coastal areas receive equitable support at the end of life.
