The goal of the Sláintecare Healthy Communities Programme is to improve the long-term health and wellbeing of 19 communities across Ireland. The programme takes a placed based approach to tackling health inequalities with a focus on the determinants of health.
Health inequality impacts on life expectancy, the risk of chronic disease and the general health of a person. The significant investment under the Sláintecare Healthy Communities programme allow us to work in partnership with local authorities and local community groups to further enhance supports for tobacco cessation, healthy eating, parenting and social prescribing in the area. This investment and partnership approach will empower people to make healthier lifestyle choices to improve their overall physical and mental health and wellbeing.
19 areas of greatest need have been identified by the Health Service Executive (HSE), the Department of Health and Local Authorities, using the HP deprivation index, based on the 2016 census. Some of these areas are located in our major cities, whilst others are in rural towns and areas. The communities identified have on average 24,000 people and a broad mix of population types.
This programme includes the provision of targeted supports by the HSE in areas including smoking cessation, parenting, nutrition and social prescribing. Local Authorities have employed Local Development Officers and have been provided funding to improve public realm and fund locally identified projects to improve health and wellbeing. The Department of Health are working across Government with the Slaintecare Oversight Group to coordinate interventions and policy responses.
Another support within the Programme is An Integrated Alcohol Service, being rolled out to provide support for people with harmful alcohol use and their families. The community-based team consists of four counsellors, a nurse, and a project worker. These services, being currently piloted in Cork and Limerick, are working closely with Alcohol Liaison Nurses in hospitals so that there is a joined-up approach to service delivery across community and hospital settings.
The Healthy Communities Programme supports not only the physical and mental health of people living in the Sláintecare Healthy Communities; but also supports improvement in the wider determinants of health, including education, social support and the built environment.
Each of the respective local authorities have signed a Service Level Agreement (SLA) to coordinate and support the Sláintecare Healthy Communities Programme with the Local Community Development Committees and their existing Healthy City and Healthy County plans as well as recruiting Healthy Community Local Development Officers to coordinate activity from a local authority perspective. This increase in resource for local authorities is aimed at integrating the health and wellbeing agenda with their broader agenda and supporting a social determinants approach to health inequalities. To support the work of the Local Development Officer, each local authority has been given a budget of €75,000 per community to fund projects identified within the community that will support health and wellbeing, 110 projects were funded in 2022.
Additionally, the Sláintecare Healthy Communities Programme Enhancement Fund is a scheme to support infrastructural projects that could positively impact on the health and wellbeing of those who live within the programme area. A fund of €250,000 was allocated to each Local Authority area under the Sláintecare Healthy Communities Programme to support projects that provided added value from a social determinants of health perspective, 63 enhancement projects commenced in 2022*
Minister of State with Responsibility for Public Health, Wellbeing and the National Drugs Strategy, Hildegarde Naughton TD, said: “Sláintecare Healthy Communities is a collective programme where we all work together to ensure that our communities in greatest need are supported to live longer, healthier lives. The health services cannot make these changes happen alone. To make real and lasting change we need to work together to create communities where people can thrive. Our local community partners know better than anyone else what challenges their community faces and the strengths within it. They have the relationships and trust of the community and will be a key to the success of this programme as they are already embedded into the local community.”
NOTES TO EDITOR
*See Case Studies below
Sláintecare Healthy Communities
In October 2021, Minister for Health, Stephen Donnelly TD and Minister for Public Health, Wellbeing and the National Drugs Strategy, Frank Feighan TD, launched a new Sláintecare initiative to support increased health and wellbeing services to 19 communities in Ireland.
Sláintecare Healthy Communities is a cross-Government initiative to deliver increased health and wellbeing services to 19 community areas across Ireland. This programme is being delivered locally in partnership with the HSE, local authorities, statutory, voluntary and community groups as well as the local community. The programme is also funding new posts including staff working at community level within the local authorities and the HSE to engage, support and coordinate support and services to the community in an effective manner.
The Healthy Communities programme is supporting not only the physical and mental health of the people of living in the Sláintecare Healthy Communities; but will also support improvement in the wider determinants of health such as in education, social support and the built environment.
To ensure the 19 areas have access to the full enhanced health and wellbeing programme, a core group of services are being established and operated by the HSE. These services include Stop Smoking Advisors, QUIT smoking services, Parenting Programmes, Healthy Food Made Easy, Social Prescribing, and Make Every Contact Count (MECC). Better access to this range of services will help improve and promote healthier lifestyle behaviours with the aim of supporting the community’s wellbeing.
A once off total fund of €250,000 has been made available for each of the 19 community areas. The focus of this fund, the Sláintecare Healthy Communities Community Enhancement Scheme, is to support local authorities to deliver projects that will positively impact on the health and wellbeing of those who live within the area.
The 19 Healthy community are all Social Inclusion and Community Activation Programme (SICAP) areas and the Department of Health worked alongside the HSE Health Intelligence Unit with their expertise in the development of Health Atlas Ireland in choosing the communities. The 19 communities span 14 local authorities and are a mix of urban and rural areas.
The 19 communities chosen are:
- Athlone and Mullingar (Westmeath)
- Athy (Kildare)
- Ballymun (Dublin)
- Bray (Wicklow)
- Cavan Town and County (Cavan)
- Cherry Orchard (Dublin)
- Clondalkin (Dublin)
- Clonmel (Tipperary)
- Enniscorthy & Wexford Town (Wexford)
- Finglas and Cabra (Dublin)
- Gaeltacht (Donegal)
- Inishowen (Donegal)
- Kilmore and Priorswood (Dublin)
- Limerick City (Limerick)
- Longford Town (Longford)
- North Cork City (Cork)
- Tallaght (Dublin)
- Waterford City (Waterford)
- West Mayo (Mayo)
Key HSE Health and Wellbeing components
Social Prescribing: A Social Prescribing link worker will provide interventions and referrals to community-based services in the statutory and non-statutory sector. Social prescribing offers GPs and other health professionals a means of referring people to a range of non-clinical community supports which can have significant benefits for their overall health and wellbeing and has been used to target social isolation, loneliness and emerging mental health difficulties.
Stop Smoking Advisor: A Stop Smoking Advisor will provide one-to-one support to quit smoking including the provision of NRT or other Stop Smoking medication. They will also promote and support the extension of smoke free environments. While Ireland has made great strides in reducing tobacco consumption, levels of smoking in Ireland continue to require concerted effort to support the continued development of a tobacco-free society where people can live longer and healthier lives free from the detrimental effects of tobacco.
We Can Quit: We Can Quit is a friendly and supportive 12-week programme, providing group behavioural support, nicotine replacement therapy and other stop smoking medication, to help attendees quit smoking and stay quit for good. This group programme has been proven to support people around their smoking by utilising peer and social support as well as professional input.
Parenting Programmes: Parenting Programmes will provide families with greater access to evidence-based parenting programmes. Parenting programmes have been shown to be one of the most effective ways to improve child and parental mental health and wellbeing.
Healthy Food Made Easy: The Healthy Food Made Easy (HFME) programme will provide a user-friendly nutrition and cookery course that helps people increase their skills to implement a healthy diet, plan meals on a budget and make easy to cook meals.
MECC: The Making Every Contact Count (MECC) programme will work with local health professionals to ensure they have the up-to-date skills to deliver brief interventions and advice for all patients regarding healthy behaviours (smoking, alcohol use, physical activity, diet and nutrition). This will see an increase in service users and patients being advised to make healthy lifestyle choices and directed to supporting resources and programmes to do so.
Key local authority components
Each of the respective local authorities will coordinate and support the Sláintecare Healthy Communities Programme with the Local Community Development Committees and their existing Healthy City and Healthy County plans as well as recruiting Healthy Community Local Development Officers to coordinate activity from a local authority perspective. This increase in resource for local authorities is aimed at integrating the health and wellbeing agenda with their broader agenda and supporting a social determinants approach to health inequalities, including inputting into the Local Authority’s development of each Local Economic and Development Plan (LECP).
Local Partner components
Key to local operational delivery are the locally commissioned community partners such as the Local Partnership Companies, Family Resource Centres and others who have an existing reach and engagement into these communities. The Healthy Food Made Easy (HFME) as well as the Social Prescribing initiatives are delivered by local community agencies such as these to build on existing programmes and assets at community level.
Community Enhancement Fund
As part of our investment in the 19 communities, we have made available a total fund of €4.75 million which equates to up to €250,000 per community. The focus of this fund, the Sláintecare Healthy Communities Community Enhancement Scheme, is to support projects that will positively impact on the health and wellbeing of those who live within the 19 communities. This scheme has demonstrated a collaborative approach with local authorities working together with the local community and stakeholders to identify projects that support the increased use of, and access to, amenities in their areas and that invoke an improved sense of community. We have seen some excellent applications as part of this process. Among the projects to receive funding are Community Garden and Growing initiatives, Health Activity Hubs and social spaces and recreational development and enhancement initiatives. These include outdoor table-tennis tables, upgraded walking and running trails which are accessible for all, innovative natural play areas for children, additional outdoor furniture, bike fleets, and many more interesting and noteworthy projects.
To support the work of the Local Development Officer, each local authority has been given a budget of €75,000 in 2022 and for 2023 for each community to fund projects identified within the community that will support health and wellbeing.
Case Study 1 – Donegal Food Response Network
The Department of Health provided seed funding to the local authority in delivering the Sláintecare Healthy Community Programme in 2022 in two targeted sites in Donegal – Northwest Gaeltacht and Inishowen.
Expressions of interest were sought from the community in the two pilot areas, from one expression from the Donegal Local Development Company (DLDC) a new partnership was developed between the existing Donegal Food Response Network supported by DLDC, Sláintecare Healthy Communities Programme and Healthy Ireland – Healthy Donegal.
The aim was to create greater awareness around food insecurity, provide information on how to avail of support and information about the community and voluntary organisations who provide that support across Donegal to ensure that those most in need are better able to avail of their services.
The project contained two parts: - to develop a designated website for the Donegal Food Response Network and to source marketing expertise to drive fundraising campaigns.
The project serves to promote and publicise the Donegal Food Response Network, the great work that the members do and ensure that people who need to avail of the services know who to contact discreetly and confidentially as well as strengthen the network in raising awareness of food insecurity.
It was also anticipated that by having an online presence for the network including a donate function on the website that this may generate an increased support directly into the services.
Given the targeted areas the Sláintecare Healthy Communities Programme focus on within the county and Healthy Ireland working across the county they agreed to come on board to work in partnership to deliver this project for a county wide approach. Both programmes hold a shared responsibility in addressing the social determinants of health and wellbeing and addressing risk factors associated with poverty.
The investment was focused on improving awareness and equity of access for all peoples across the county. This partnership approach has established a strong connection, a shared understanding and scope to build upon the amazing work already being completed through the Donegal Food Response Network with further initiatives into the future. The project serves to enhance communication and connectedness as well as increased visibility and not only raises the issue of food insecurity faced by many people and access issues in relation to healthy, fresh foods but now provides a platform for the Donegal Food Response Network to increase their capacity to work further on food insecurity issues with various funders and partners. The website https://donegalfoodresponse.ie/ was launched in December 2022.
Case Study 2 – Grange Community Hub
Youth Work Ireland Midlands (Mullingar) is based in the Grange Resource Centre Mullingar and works in partnership with the local community groups to provide a holistic wrap around service to all residents in the seven adjoining local authority housing estates on the west side of Mullingar.
Working together the local community groups provide local activities, programmes and interest groups for all the community from the young to the not so young with a strong focus on achieving better outcomes in the area of physical health, mental health and wellbeing through facilitating talks, interagency interventions, interest groups and supported activities.
Through the above mediums we had recognised the need for additional dedicated space to address small group and individual interventions and programmes that would provide a positive impact on the health outcomes of individual member of the community and the wider community in general. The Healthy Communities Enhancement funding provided the opportunity to realise this ambition and following community consultation it was agreed to apply for a modular style unit which could be placed in the grounds of the existing community centre but would still provide a dedicated space for health initiatives in the wider sense. The Enhancement Fund provided €55,000 for the modular unit.
The Grange Community Hub has been in place since March 2022 and in hindsight we cannot see how we managed before we had this facility. The Hub is in constant use facilitating initiatives such as one to one session with external services which include MIDAS and Merchants key substance support sessions, Traveller health clinics, Tusla family meetings and small group and individual interventions to young people from the local community.
The Hub is still connected to the local community centre but also allows a degree of privacy where more acute interventions can be facilitated. The benefit has already been seen in the community but the real impact will become more visible as the services develop and cascade down to the next generation, their peers, family and wider community.