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Locating services

5. What opportunities are you taking to locate health care provision in the heart of communities and in joining with other public services to create public spaces that all can use?

This question is about how you demonstrate that NHS services belong to the community in the spirit of 'Our health, our care, our say'. By making primary and community based services really accessible and by linking with LSP partners you can create valued community assets.

Self assessment questions

  • Do you have a vision to guide the location of health care provision within the area you serve? 
  • Have you engaged with all communities and with your partners in developing that vision?
  • Do you have a strategy for how you will achieve your vision? 
  • Have you engaged with all communities and with your partners in developing that strategy, recognising that it may involve closures and service changes that may be unpopular with some communities? 
  • Does your strategy include taking opportunities to co-locate heath services alongside other community facilities such as schools, libraries, day centres, places of worship etc?
  • Do you recognise the importance of health service premises, including waiting rooms, as community spaces and their potential use to encourage positive contact between people using the service?
  • Do you carry out health impact assessments and community cohesion impact assessments before deciding on the location of new facilities?
  • Do you take account of transport issues for staff and patients from all communities (including access by walking, wheelchair, public transport, cycling, motor car)?
  • Do you work with partners to agree joint management arrangements for shared facilities (e.g. one stop shops for reception and information, pooled budgets, shared facilities management)?

Some examples of good practice

There are numerous examples of co-location of facilities by partner agencies to make facilities more accessible. These include many centres which combine health facilities with sports provision creating public spaces focused on health and wellbeing. However, before developing such schemes, it is always important to be clear about the costs and benefits both to the agencies providing the services and to all groups in the wider community. Decisions on co-location or the development of new or redesigned health facilities need to take account of many factors including how to make services accessible to communities but also about wider issues such as the pattern of public transport, the possible displacement of low cost housing (which could be significant in the case of major hospital redevelopments or relocations) and the effect on minority communities. In many large schemes there will be gainers and losers. The proposal to establish polyclinics in London will alter the pattern of access and the continuity of care for many people. Whilst it is intended that this will improve accessibility overall, there will be some losers and it will be important to identify and address issues early in the process. The section on 'Needs assessments, impact assessments and audits' earlier in the guide discusses how Impact Assessments can be used to ensure all angles are covered.

Staffordshire Moorlands, one of the Community Cohesion Beacon council sites, has created integrated public access points in each of the district's three market towns: Leek, Biddulph and Cheadle. The sites offer a one stop shop service with trained staff who can provide a frontline service across a wide range of common services and provide a degree of anonymity and sensitivity. The shop plays host to PCT services, CABx, Connexions, Pensions service, Age Concern, Business Initiative, Turning point, Registration service and a range of  other statutory and voluntary services as well as the council's own services. Exit surveys undertaken twice a year for the past four years have achieved 100% customer satisfaction with the one stop service.