The long road to fixing the NHS begins with building on what works. Shahida Begum, Health Programme Manager at Community Links, and Elizabeth Booker, Director of Communities at Catch22, explore how community-based initiatives are pivotal to smart and effective healthcare reform.
The government vision for NHS reform
The government’s vision for the NHS, as outlined by Wes Streeting, Minister for Health, charts a bold course for reform. At its core is the recognition that “a strong economy relies on a healthy workforce, and a healthy workforce depends on a well-functioning NHS.” In his November speech, Streeting outlined three key shifts:
- Transitioning from hospital-centred care to community-based services;
- Embracing digital and technological innovations for efficiency; and
- Prioritising prevention over reactive treatment.
A cornerstone of this reform is the creation of ‘Neighbourhood Health Services’, designed to bring care closer to communities.
At Community Links, we’ve spent over two decades delivering health programmes across East London, including cancer screening awareness and outreach campaigns. Our experience shows that successful community-based healthcare requires more than relocating services to underused spaces. True transformation demands Integrated Care Boards (ICBs) and providers to work hand-in-hand with local organisations embedded in communities.
While decentralising services is a step forward, achieving true health equity requires direct, culturally tailored engagement with underserved populations. Programmes like our Health Facilitator and Calling Interventions go beyond decentralisation, proving that locally driven, grassroots approaches can meaningfully improve access and outcomes.
For the NHS to realise its ambitions for ‘Neighbourhood Health Services’, proven community-led models like these must be scaled and integrated, ensuring equitable care delivery and stronger health outcomes for all.
Community Links: a model of smart practice for early cancer screening
Community Links (Catch22) works in partnership with NHS and Cancer Alliances, to exemplify best practice through its Health Facilitator and Calling Intervention Programmes.
The North East London Cancer Facilitator deploys facilitators within Primary Care Networks (PCNs) to improve screening rates and reduce health inequalities by engaging local practices and communities.
In Tower Hamlets, facilitators have implemented tailored interventions, like multilingual outreach, that have contributed to the boosted bowel screening uptake by 4-6% in one year. This work demonstrates the impact of personalised, community-oriented approaches on participation rates.
The Calling Intervention Project expands on this success by employing bilingual Health Facilitators trained in motivational interviewing to contact patients eligible for cervical, breast, or bowel screening who haven’t responded to invites.
In North, South, and West London, this project has part-driven a 64% increase in breast screening, identifying critical health issues earlier and directly enhancing patient outcomes.
Through these proactive outreach efforts, facilitators have helped solve logistical barriers to screening—such as by addressing issues with kit distribution for bowel screening—while addressing cultural and informational gaps. In a recent project across Tower Hamlets, Newham, and Waltham Forest, 14% of those initially declining bowel screening went on to participate after further support and intervention, revealing significant health abnormalities in some cases. This works, not only because our staff often speak multiple languages, but because they are part of the communities they serve.
The need for culturally aware and localised reform
Streeting has indicated, in response to calls from Cancer Research, that the government may adopt a long-term cancer strategy separate from the broader health policy, which would enhance the focus on addressing cancer-related health disparities. Adopting a targeted cancer strategy must ensure that critical community-centred interventions, like those offered by Community Links, remain a central part of NHS modernisation efforts.
Labour’s vision for the NHS is promising, but real impact depends on deep community engagement, trust, and breaking down barriers. At Community Links, we know that culturally tailored, local approaches effectively bridge gaps in care. These proven models are essential for the success of the new ‘Neighbourhood Health Services’ to ensure we reduce health inequalities and set the NHS on a course toward an inclusive, modernised future that meets the needs of all communities.