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Insights into people navigating their way to community supports

Using the opportunity of developing the concept of a Community Front Door to involve people in communities working with primary care staff to improve community supports and navigators.

Read comments 4
  • Idea
  • 2018

Meet the team: #openfrontdoor


  • Bryony Murray, Innovation and Improvement Advisor, NHS Forth Valley
  • Lesley Middlemiss, Primary CarevTransformation Programme Manager, Clackmannanshie and Stirling and Falkirk Health And Social Care Partnerships
  • Bette Locke, Interim AHP Associate Director, NHS Forth Valley

The shortage of GPs in some areas is driving better use of others’ skills. However, time is needed to grow the number of professionals needed. At the same time there are untapped, or unnavigated assets in the community. There are people who support each other and people who could support peers, but would benefit from formal and informal health, social care, housing and business supports. There are also people who could help navigate the wide and varied array of supports available.

In Scotland, policies that support improvement of peer support whether that be professionals or patients and people who use services include Realistic Medicine. This calls the medical profession to share decision making and focus on value managed care I.e.making the most of resources to do the right thing, at the right time for each person. There is a Link Worker policy that hasn’t yet gained traction. Primary Care Improvement Plans are being developed and a Primary Care Adminstrative Collaborative is intended to build skills for improvement and has implementing navigator roles as a key objective.

In Forth Valley, which has a population of ~ 370,000 the concept of a Community Front Door is being developed, with finding solutions to how peers, whether that be people who need and use services and health and social care professionals, housing and local authority supports and third sector and informal neighbourhood supports, find their way to each other.

Linking these two – primary care collaboration and building a community front door – is a great opportunity to learn about and find solutions to peer support and care navigation working together to meet needs of people in our communities.

The need for navigation to supports is a nationwide issue, but there is limited accessible learning about solutions ,how to scale them and balance consistency of standard with tailored responses. We have the opportunity to link up people in communities with each other and supports and provide a truly person centred service. Learning at every stage would feed into the Q community and we would be looking for input and contribution at each stage.

How you can contribute

  • Contributing insights from work to improve support to navigate the health and social care system
  • Provide information about failed and successful attempts to improve use of primary care based multi skilled, multiagency team support
  • Any evidence of including education and housing colleagues in supporting navigating of the health and social care system
  • Existing peer support organisations views on the proposals and work as it develops
  • Evaluation of visual illustration as a tool to support understanding of health and social care systems and opportunities to improve

Further information

Q Fund – Care Navigation (PPTX, 2MB)


  1. Hi Susan and Ann,

    We currently have a PhD student - Rebecca Turner based at University of Lincoln, funded by NIHR - CLAHRC East Midlands studying community navigators in two sites in England. It would be great to share our findings and hear about your experience.


  2. Thanks Ann. Recognise the challenges you mention. Will help us to focus.


  3. Hi Susan, and my apologies for taking so long to comment on your proposal. I think there is a real need for what your proposal is seeking to do, but it's also a massive challenge. My perspective is that for a couple of the peer support areas I have been involved in  there has been a reluctance either passively or actively to signpost people to peer support. The reasons for this are probably varied - its not easy for primary care to know everything that is available, there may be a fear of recommending something which isn't health professional led. Where primary care has been good at pointing people in the direction of other forms of support it seems to be because an individual health professional has good connections with a peer support provider and therefore has good knowledge of them or confidence in them or has come to the end of the line in terms of finding other avenues to refer people to. Many peer support providers want to have info available in surgeries and whether surgeries are receptive to this is very mixed. Navigation support has the potential to help address all of this.

  4. We'd really welcome and want to learn from Q members and Q Lab participants about your experiences of GP Practice based attempts to refer to peer support and responding to request for help as well as more formal referrals. What have you learned from what didn't work??

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