Childhood obesity remains high in the UK, with a higher prevalence among children from ethnic minority groups. The 'Healthy Madrasa' programme was developed and implemented in Bradford, UK, to support obesity prevention in Muslim children by working with Islamic religious settings such as madrasas. The aim of this study was to explore how the 'Healthy Madrasa' programme could be adapted for delivery in another UK city where the proportion of people from the Muslim faith is lower and the ethnic composition is more diverse. A qualitative study involving a co-production workshop and eight focus groups was conducted utilising topic guides guided by the normalisation process theory (NPT). Data were analysed thematically using NVivo software (V.15) and mapped onto the constructs of the NPT. Bristol City, UK (2024-2025). 34 participants took part, including representatives of Islamic organisations, voluntary sector organisations, public health experts and Muslim parents. Data were collected through one co-production workshop (n=15, 47% female) and eight focus groups (n=19, 100% female) of which two were conducted as individual interviews due to single attendance (n=1). Three constructs of the NPT have been identified. Participants showed positive engagement towards the programme 'cognitive participation, NPT', they highlighted an equity gap in current provision due to issues of inclusivity, safe space and the lack of culturally appropriate opportunities for Muslim girls 'coherence, NPT'. However, barriers to 'coherence, NPT' were noted by Muslim parents, stating that cultural and religious conservatism might hinder female participation in the programme. 'Collective action, NPT', included the practicalities of transferring the programme to Bristol and assigning the roles and responsibilities. Participants emphasised the importance of creating an 'Islamic community-led' steering group, inclusive of diverse communities, building effective partnerships with other relevant organisations and supporting the programme with sufficient resources, such as culturally acceptable funding, space and volunteers. This study generated a co-produced preliminary roadmap for implementation. Further collaboration with stakeholders is required to achieve coherence and collective action before the programme's operationalisation in Bristol.

Refugee and asylum-seeking parents face distinct challenges in supporting their children's mental health during resettlement. Although elevated child mental health risks and barriers to service access are well documented, less is known about how parents could best be supported to help their children. This study explored parent and stakeholder perspectives to inform family-centred support. Semi-structured interviews were conducted with 23 refugee parents (ENRICH) and 30 stakeholders across health, education, local authority and voluntary sectors (ESTEEM) in the UK. Data were analysed using Reflexive Template Analysis. Four levels of support were identified: basic stability; belonging through community, language and play; understanding and trust; and specialist psychological support. Three overarching system conditions shaped whether families could access and use support: coordination, communication and competence; responsiveness; and the right setting. Parents also identified specific specialist supports, including practical guidance, family-centred and joint parent-child approaches, and culturally responsive therapeutic spaces. Services were often described as reactive, fragmented and culturally mismatched, limiting engagement and reducing support effectiveness. Effective support for refugee parents to help their children requires attention not only to what is provided but how it is delivered. Coordinated systems, culturally and linguistically responsive practices, timely support, and delivery through trusted community settings are central to enabling parents to support their children's mental health. Together, these findings provide a practical framework to inform the development of family-centred approaches during resettlement.

In the context of the global shift towards primary prevention and behavioural change interventions for non-communicable diseases, this scoping review aimed to map the existing scientific literature on the Making Every Contact Count (MECC) programme implemented in healthcare settings for adult patients and identify remaining knowledge gaps. PubMed, Scopus, and Web of Science were searched for indexed articles published between 2010 and January 2026 using combinations of the terms "Making Every Contact Count", NOT "third and social economy sector", and NOT "voluntary and community sector". Studies were included if they investigated MECC implementation in healthcare settings for adult patients. Two reviewers independently extracted and appraised the data. A visual evidence mapping synthesis was then developed. Of the 304 references identified, 22 articles published between 2013 and 2025 were included. Studies were conducted in the United Kingdom and Ireland across diverse healthcare delivery sectors. Investigated dimensions included MECC training, implementation, and delivery from the perspectives of healthcare professionals, patients, and students, as well as document analyses. Outcomes mainly related to attitudes, perceptions, and implementation determinants. The methodological and reporting quality of the included studies was heterogeneous. Identified gaps concerned working conditions, the applicability of MECC across different implementation contexts, the intensity, duration, and content of MECC delivery, and its cost-effectiveness, particularly regarding specific behavioural risk factors. Interest in MECC is increasing. This scoping review synthesised the existing literature, mapped key evidence gaps, and highlighted the limited evidence currently available regarding the effectiveness and cost-effectiveness of MECC, particularly across different clinical and national implementation contexts. The findings also suggest that evidence supporting Screening, Brief Intervention and Referral to Treatment approaches cannot be directly extrapolated to MECC. The protocol was registered in PROSPERO under the number CRD420251044644.

ABSTRACTBackgroundObesity is a leading cause of ill health in England and places a substantial burden on health systems and the economy. Behavioral weight management services (WMS) are central to reducing obesity‐related risk, but their reach remains limited. Electronic signposting (eSignposting), which uses electronic health records and digital communication to connect patients with appropriate services, may improve access to behavioral WMS. Effective and equitable implementation of eSignposting requires a comprehensive understanding of the behavioral WMS ecosystem, including its key components and interdependencies.ObjectiveThis study aimed to characterize the behavioral WMS ecosystem in the East of England (Norfolk, Suffolk, and North‐East Essex) to identify opportunities and considerations for implementing eSignposting.MethodsA qualitative study was conducted using semi‐structured interviews with professional stakeholders (n = 11) involved in the commissioning, referral, and delivery of behavioral WMS. Directed content analysis was used to develop ecosystem maps and a comprehensive inventory of services across the region.ResultsThe findings revealed a complex behavioral WMS landscape spanning the local authority, national, commercial, and voluntary sectors. Self‐referral and primary care referral emerged as the predominant routes to accessing behavioral WMS. Ecosystem maps identified key entry points where eSignposting could maximize reach and impact. Analysis of inter‐stakeholder relationships also highlighted potential unintended consequences of eSignposting, including increased pressure on local services, preferential uptake of digitally accessible commercial programmes, and the risk of digital exclusion among underserved populations, enabling these issues to be proactively addressed in the future design and implementation of eSignposting.ConclusionThe behavioral WMS ecosystem in East England is multifaceted and interconnected. Ecosystem mapping provides valuable insight into referral pathways and stakeholder relationships, supporting the development of effective and equitable eSignposting strategies to improve access to behavioral WMS while minimizing risks to service equity and sustainability.

Background: Cultural, religious, and spiritual (CRS) needs are central to holistic palliative and end-of-life care (PEoLC), yet the confidence and perceived preparedness of community and voluntary sector staff in addressing them remain underexplored. As PEoLC increasingly occurs in community settings, understanding staff preparedness for culturally and spiritually sensitive care is vital. Objective: This service evaluation examined CRS perceived preparedness and confidence among staff across Leicester, Leicestershire, and Rutland (LLR), exploring perceived challenges and available resources. Methods: A modified Confidence and Perceived preparedness in the CRS Care Survey was distributed to healthcare, hospice, charity, and community staff (May–August 2025). Likert scale data (n = 39) were analysed descriptively; qualitative responses underwent thematic analysis using Braun and Clarke’s framework, which was co-produced with stakeholders. Results: Staff placed high importance on CRS needs (cultural M = 4.48, SD = 0.61; religious/spiritual M = 4.66, SD = 0.53) but reported lower confidence in the organisational capacity to meet them (M = 3.15 and M = 3.05). Qualitative survey findings showed that staff recognised CRS needs as central to holistic, individualised care, emphasising proactive assessment and avoiding assumptions. Barriers included fear of causing offence, organisational constraints, and challenges in supporting families, alongside concerns about unmet needs. Participants highlighted reliance on informal resources and a clear need for accessible, lived-experience-based training and practical guidance. A prototype CRS resource toolkit, including lived-experience videos and guidance for supporting Muslim patients, was co-developed and reviewed by healthcare, community, and public contributors. Conclusions: Staff commitment to CRS-sensitive PEoLC is strong, but practical tools and training are lacking. A virtual CRS toolkit could enhance confidence, communication, and culturally responsive care across multidisciplinary settings.

To examine the opportunities and challenges of applying a public health approach to violence prevention within a ten-year youth violence reduction strategy in an inner-London region. Multi method study within a process evaluation. The study investigated: (a) the influence of a public health approach on strategy design through documentary analysis and two focus groups with local government staff and community leaders (n=11); (b) contextual factors shaping engagement with the approach via two actor-mapping workshops (n=18) and narrative interviews (n=7); (c) implementation of the public health approach in strategy delivery through four focus groups and one interview with staff and community leaders (n=19), and interviews with participating young people or their carers (n=10); and (d) a review of key performance indicators and a focus group discussion (n=9). The public health approach supported an evidence-based strategy but was inconsistently articulated and understood, creating implementation challenges. Despite a complex violence-reduction landscape, the voluntary and community sector sustained productive relationships with the strategy. Data challenges included limited outcome measurement, with mostly quantitative indicators largely focused on tracking intervention activity. While the public health approach remains the dominant model for violence prevention, challenges persist in shared understanding, inter-agency collaboration, and data generation and sharing. Findings highlight the need to engage with local complexity through a place- and asset-based approach to youth violence narratives.

Youth mental health services are struggling to meet demand, highlighting the need for changes aligned with young people's needs. The CATALYST project (Co-designing and testing an Asset-based TAsk-sharing modeL for Youth mental health Services in deprived communiTies) uses place-based approaches to inform improvements to mental health support for 16-25-year-olds. In addition to improving access to care, there is an urgent need to prevent escalation of mental health issues through earlier, community-based interventions. This paper presents a situational analysis of Brighton and Hove, UK, a coastal area with high levels of socioeconomic inequality, to explore why young people are not being reached by existing services, and what could improve access. We conducted a desk-based review of 21 policy, strategy, and research documents, and a series of interviews and focus groups. Participants (N = 34) included young people, community members, and professional stakeholders. Data were analysed using a framework analysis guided by the research questions. We identified eight barriers and five facilitators to accessing support across system-, service-, and individual-levels. Participants described a system under strain, characterised by a lack of funding, workforce capacity, siloed referrals, and high access thresholds. Young people described low levels of trust in the system and experiences of exclusion and isolation. However, a strong voluntary sector, and community-based models like Single Points of Access (SPOAs) were seen as promising facilitators for accessible mental health support. The findings align with other areas with high levels of deprivation, but Brighton and Hove's vibrant voluntary sector offers unique opportunities. Mobilising these assets through increased community partnership and use of task-sharing could enhance access to timely and appropriate mental health support. These approaches have implications for prevention practice by facilitating earlier identification of emerging mental health difficulties and providing ongoing, community-based support to prevent escalation.

Purpose Integrating health and social care services is a longstanding aspiration in England, but the question remains as to how to achieve it. This article compares the implementation approaches and its enablers and barriers of a strengths-based intervention (community-led support, CLS) in two sites, one led by a health organisation, i.e. National Health Service (NHS) and the other by a social care organisation, i.e. local authority. Design/methodology/approach This study was part of a wider research project that examined the implementation of CLS within five areas in England. A qualitative research design was adopted, drawing on seventeen semi-structured interviews with managers and frontline staff leading the implementation of CLS across health, social care and voluntary sector organisations. Data was analysed inductively for each site before comparing emerging codes between the sites. Findings Supportive leadership structures at various levels, a shared vision, pre-existing relationships with other sectors and introducing champions were helpful factors to adopt CLS. However, staff anxieties towards creative ways of working, the lack of involvement of individuals with lived experience and the insufficient integration of processes and systems hindered embedding CLS across the whole system. Originality/value Emphasis on a community oriented approach encourages local innovation based on the needs of a community. This study provides helpful insights into aspects supportive of implementation while highlighting unique challenges arising from integration.

It is important to understand the underrepresented experiences of self-harm and accessing support among Black British African and Caribbean individuals because of the low uptake of support from formal healthcare providers. This study aimed to explore Black British individuals' thoughts, feelings and experiences of self-harm, and to understand their lived experience of seeking, or not seeking, support from voluntary and community sector organisations. Purposive sampling was utilised to identify Black British people that self-harm and have either accessed community-based services or never sought support. Six people took part in semi-structured interviews. Interpretative Phenomenological Analysis was used to analyse the data. Three group experiential themes were found. Firstly, the complexities of self-harm manifested in diverse ways and was something participants had a complex relationship with. Secondly, participants described navigating expectations; they concealed self-harm to protect against stigma and to uphold valued cultural norms of strength and success. Finally, promoting equity: community-based services were a preferred means of support but noted unaddressed hardships and a need for more culturally sensitive support. Findings highlight the need for community-based services to develop equity-focused resources to achieve more culturally responsive care. Key findings, limitations and implications are discussed in relation to existing theory and suggestions for future research are made.

ABSTRACT Based on ethnographic fieldwork in Athens’ social clinics of solidarity, I explore how the volunteers redefined pharmaceuticals as they moved from state-licensed pharmacies to households and into the grassroots voluntary sector. Therefore, I trace how their value, status and meaning shifted in the process: medicines were no longer seen as commodities but treated as sociable objects of care. In showing how state policies and market forces made pharmaceuticals increasingly central to social relations and care practices in times of austerity, I argue that pharmaceuticalization can develop alongside and even arise from grassroots, collective efforts to pool and redistribute medicines.

Background:Multi-agency public health interventions to address violence, including hospital-based initiatives, are increasingly being implemented. Nurses occupy a critical early-intervention role, identifying at-risk individuals, facilitating referral to community support and contributing to ongoing care pathways. However, evidence relating specifically to children and young people remains limited.Aims:To examine the relationships between age, referral reasons, engagement and Emergency Department (ED) reattendance of the multi-site Hospital Navigator scheme implemented in five EDs in the United Kingdom.Methods:Two hundred and nineteen participants (6–24 years) presenting to EDs with violent injuries or vulnerabilities associated with violence (including mental health needs, substance misuse or homelessness) participated between March 2021 and July 2022. Variables included age, index ED attendance reason, scheme referral reason, engagement and future ED reattendance. Descriptive and exploratory analyses were undertaken.Results:Mental health and violence were the most common referral reasons. Over half (55%) engaged with the scheme, most on a short-term basis, with younger participants less likely to engage. Although most (87.7%) did not reattend the ED, mental health was the predominant reason for those who did.Conclusions:Policy and practice should prioritise EDs as early-intervention hubs, embedding Hospital Navigator Schemes and co-locating voluntary sector partners, with nurse-led coordination.

HomeHealth is a home-based, voluntary sector service supporting older people with mild frailty to maintain independence through behaviour change. Support workers discuss the person's priorities and enable setting/achieving goals around mobility, nutrition, socialising and/or psychological well-being. We tested clinical and cost-effectiveness of HomeHealth for maintaining independence in older people with mild frailty in a randomised controlled trial. Design: Single-blind, parallel randomised controlled trial open between 18 January 2021 and 4 July 2023, with mixed-methods process evaluation. Setting: Community-dwelling older people aged 65+ years with mild frailty from 27 general practices and community settings in London, Yorkshire and Hertfordshire. Randomisation: Participants were randomised 1 : 1 to receive HomeHealth or treatment as usual. Outcomes: Primary outcome was independence in activities of daily living (modified Barthel Index), analysed using linear mixed models. Secondary outcomes included frailty phenotype score, extended activities of daily living, well-being, psychological distress, loneliness, cognition, falls and mortality. Health economic outcomes included quality of life, capability and service use, including hospital admissions. Cost-effectiveness acceptability curves and cost-effectiveness planes were used to represent the probability of cost-effectiveness compared to treatment as usual. Process evaluation: We conducted semistructured interviews with participants receiving the intervention, HomeHealth workers and other stakeholders supporting service delivery. Interviews were thematically analysed. Fidelity of audio-recorded appointments was assessed by two independent raters. We evaluated potential mechanisms of impact using data from appointments attended, types of goals set and progress towards goals. We recruited 388 participants, mean age 81.4 years (standard deviation 6.5), 64% female and 94% White British/European. HomeHealth did not improve Barthel Index scores at 12 months (0.250, 95% confidence interval -0.932 to 1.432). At 6 months, we found small significant reductions in psychological distress (-1.237, 95% confidence interval -2.127 to -0.348), and frailty phenotype score (-0.252, 95% confidence interval -0.487 to -0.017). At 12 months, we found significant improvements in well-being (1.449, 95% confidence interval 0.124 to 2.775), reduced unplanned admissions (incidence rate ratio 0.65, 95% confidence interval 0.54 to 0.92) with lower associated costs (-£586/participant, 95% confidence interval -351 to -821). There were no differences in other outcomes. HomeHealth dominates treatment as usual with a negative point estimate for incremental costs (-796, 95% confidence interval -2016 to 424), positive point estimate for incremental quality-adjusted life-years (0.009, -0.021 to 0.039) and high probability of cost-effectiveness. Process evaluation: Sixty-four semistructured interviews were completed, including 49 participants and 15 HomeHealth workers/stakeholders. The service was acceptable and safe, with good fidelity of delivery. Participants made progress on personalised goals, most working on enhancing mobility. They found the service empowering, and received emotional/practical support. Engagement was more challenging when participants identified no need for change, had significant memory impairment or new/declining illness. Flexibility around varying symptoms and incorporating behaviour change into existing routines promoted engagement. HomeHealth did not improve independent functioning for older people with mild frailty. There were small significant improvements in frailty status, psychological distress and well-being and a 35% reduction in unplanned admissions, with high probability of cost-effectiveness. We used a pragmatic design with intervention delivery in real-world settings during/after the COVID-19 pandemic, potentially with more variability in delivery. Our findings might not apply to other geographical settings/healthcare systems. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR128334.

James Rees and Carol Jacklin-Jarvis, Reimagining Voluntary Sector Leadership, Policy Press, Bristol, UK, 2025, pp. 238, notes on contributors, acknowledgments, and index, $127.95.

Research investigating the experiences of women experiencing homelessness often highlights the prevalence of (sexual/domestic) violence and abuse in their trajectories. Drawing on observations across a sample of English statutory and voluntary sector homelessness services and 60 semi-structured interviews with practitioners and with women with homelessness experiences, this study explores these experiences of gender-based violence and the relational impact these may have had on women's help-seeking. Findings suggest that experiences of violence are often normalized, leading some of the women to develop informal, often risky, strategies to protect themselves from violence, using precarious social capital to find ways out of homelessness.

This article summarises the opening plenary talk presented at the Voluntary Sector and Volunteering Research Network conference (September 2024). It takes practical lessons from Organising For Change (Bristol University Press), by the authors, and presents them as Ten Talking Points easily accessible to practitioners. It posits that careful resourcing, collaboration and multipronged tactical approaches are coconstitutive and crucial for delivering desirable, or preventing undesirable, social change. Panel respondents’ perspectives are presented in an accompanying article.

In the last decade, social prescribing through link workers based in general practice has become a major policy in the UK, but little is known about the implementation of this strategy. We aimed to explore the roles, challenges, and effects of social prescribing link workers (SPLWs) across different models of employment, organisation, and management in England and Scotland. In this qualitative study, we conducted semi-structured interviews with stakeholders in two regions in England (National Institute for Health and care Research [NIHR] Applied Research Collaboration [ARC] West and NIHR ARC North East and North Cumbria) and two in Scotland (National Health Service [NHS] Greater Glasgow & Clyde and NHS Lothian). Stakeholders were participants actively involved in SPLW activities and comprised patients aged 18 years or older receiving SPLW support; individual SPLWs; general practice staff who referred patients to the SPLW; leads of voluntary, community, and social enterprises (VCSEs) employing or hosting SPLWs; VCSE leads not employing or hosting SPLWs but supporting referred patients; and strategic leaders working with SPLW services. Purposive sampling was used to ensure diversity in patients' age, gender, and socioeconomic deprivation (according to the Index of Multiple Deprivation in England or Sottish Index of Multiple Deprivation in Scotland) and variation in stakeholder roles. Interviews were continued until data saturation was reached. Transcribed interviews were analysed reflexively using inductive thematic analysis. Between Feb 16 and Nov 15, 2024, we conducted interviews with 130 stakeholders: 36 SPLWs, 28 patients, 28 referring professionals, ten VCSE leads hosting SPLWs, 14 VCSE leads not hosting SPLWs, and 14 strategic leads. Patient ages ranged from 18 years to older than 65 years; 16 (57%) patients were female, 12 (43%) were male, 26 (93%) were of White British or Scottish ethnicity, one (4%) was of south Asian ethnicity, and one (4%) was of mixed or multiple ethnicity. Six key themes emerged. The first was varied backgrounds, with SPLWs typically coming from the voluntary sector or NHS, driven by a desire to empower patients. The second was changing role, with SPLWs now seeing many more patients with highly complex needs, including the social determinants of health in deprived areas, than they did previously. The third theme was therapeutic relationship, whereby building empathic relationships was crucial but depended on SPLWs' backgrounds, training, and support. The fourth theme, benefits of the SPLWs, was based on SPLWs helping patients to build confidence and increase their independence and, in general practitioners, reducing moral distress and possibly reducing workload. The fifth theme was employment models, organisation, and management, with integration into general practices facilitated by SPLWs working in one or two practices and with robust organisational support. For the final theme, challenges and sustainability, the challenges of the SPLW role included job retention, burnout, variable pay levels, and few opportunities for career progression; the sustainability of this role was threatened by short-term funding, increased service demand, and financial cuts to essential services. This study highlights the vital role of SPLWs in England and Scotland and the need for stable support and funding amid ongoing financial challenges in the statutory and voluntary sectors. National Institute for Health and Care Research.

People experiencing homelessness face up to 12 times higher mortality rates than the general population. People experiencing homelessness have multiple, unmet health and care needs, including poor physical and mental health, substance use disorder and lack of stable and safe housing, yet they do not find services accessible or tailored to their needs. The aim of this study was to assess the feasibility of conducting a larger, definitive trial evaluating an integrated clinical pharmacist/homeless third-sector support (Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx) for people experiencing homelessness, in a community pharmacy setting. Randomised, multicentre, open, parallel group external pilot trial with parallel economic and qualitative process evaluation. People experiencing homelessness ≥ 18 years were recruited from community pharmacies in Glasgow and Birmingham, United Kingdom. Participants were randomised 1 : 1 to receive Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx intervention in addition to usual care or usual care only. The Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx intervention is a collaboration between National Health Service pharmacist independent prescribers and third-sector homelessness charity workers offering weekly community pharmacy and/or outreach-based consultations for people experiencing homelessness to address health (e.g. health screening, treatment and prescribing), housing and social needs (e.g. welfare benefits, housing support). A range of health, social and care outcomes were evaluated at baseline, 3 and 6 months from both usual-care and intervention participants. The primary outcome was to evaluate the feasibility of a subsequent definitive randomised controlled trial according to pre-specified progression criteria classified as green (go ahead), amber (minor amendment in procedures required for definitive trial) and red (substantial changes needed). These related to recruitment; retention; intervention adherence; and collection of clinical and social outcomes data, including emergency department visits, rough sleeping and criminal justice encounters. Progression criteria were met (4 green and 1 amber) as follows: (1) recruitment (target 55% conversion rate): 100 people experiencing homelessness were recruited as planned from 5 community pharmacies, 100/183, that is, 55% eligible consented to participate - green; (2) retention (target 60%): 72 (72%) participants remained in the study at 6 months - green; (3) collection of routine healthcare utilisation data (target 60%): 91 (91%) had emergency department visit and mortality data available at 6 months - green; (4) completion of questionnaire booklet (target 60%): 72 (72%) completed the booklet at 6 months - green; (5) intervention adherence (target 60%). Twenty-six (53%) participants had over half of the planned weekly contacts with the Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx team - amber. Signals of improvements were observed, as there were fewer ambulance call-outs, fewer emergency department visits and hospitalisations; fewer nights slept rough; and improved health-related quality of life in Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx participants compared to the usual-care group at 6 months' follow-up. Qualitative interviews conducted with participants and stakeholders. Participants suggested the Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx intervention was characterised by holistic approach, comprehensiveness, consistency and care. Challenges identified included resource constraints, integration with existing services and concerns about long-term sustainability. Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx community pharmacy pilot randomised controlled trial successfully achieved key progression criteria. If found to be effective and cost-effective in a subsequent definitive randomised controlled trial, it offers promise as an adaptable (United Kingdom and internationally) model of integrated care provision for people experiencing homelessness. While small sample size limits generalisability of the, it fulfils the purpose of a pilot study. Temporary absence of intervention worker in one of the study settings constrained intervention delivery. Future trials should plan for contingency measures. Future research should seek to test and evaluate care models integrating health and voluntary sector care for people experiencing homelessness in various settings, including community pharmacy, street outreach and temporary accommodations. This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133060.

ObjectivesIntegrated neighbourhood teams (INTs) are central to health system reforms in England, aiming to deliver local, coordinated, and personalised care. Understanding the factors that influence their successful functioning is crucial for informing local policy and practice. This rapid evidence synthesis aimed to answer the research question: What factors influence service integration and delivery by INTs operating across health, care, and voluntary sector organisations?MethodsIn February 2025, we searched Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant UK-based primary research and international evidence syntheses published within the last 10years. The database searches were complemented by searches in Google Scholar and the Google search engine. Eligible studies reported evidence on factors shaping the successful functioning of local and neighbourhood-level integrated teams. Data were rapidly synthesised qualitatively.ResultsDatabase searches identified 5139 articles (4954 after duplicates were removed). Of these, 26 were eligible for inclusion, comprising nine primary studies and 17 evidence syntheses published between 2015 and 2025. The findings were highly consistent. Key factors supporting INT functioning included a clear, shared vision; effective leadership; strong working relationships based on trust and mutual respect; clarity on interprofessional roles and responsibilities; appropriate and sustained resources and funding; opportunities for staff learning and development; co-location, dedicated time for multidisciplinary team meetings; and interoperable information technology systems to support data sharing.ConclusionsThere is strong agreement on key relational and organisational factors that support INT functioning. Our practical framework can be used to support policymakers, commissioners, and professionals when planning and implementing INTs.

ABSTRACTIntroductionFamilial imprisonment is one of ten recognised adverse childhood experiences (ACE), with established long‐term impacts on health, care and wellbeing. Where safe and appropriate, the right of a child to protect and maintain family life (and therefore visit and/or remain in contact with a family member in prison) is protected in the United Nations Convention on the Rights of the Child (UNCRC). Despite this, families face many barriers when visiting prison, and children and young people's experiences of doing so, in their own words, are less widely reported.MethodsDrawing on serial longitudinal interviews and the curation of creative methods with 19 children and young people (age 7–16) who have a family member in prison across Northern England and Scotland, the aim of this study was to explore the impact of familial imprisonment on children and young people's health and wellbeing, and to utilise our findings to develop a rights‐based framework for prison social visits.ResultsReflexive thematic analysis identified three intersecting themes: (1) navigating complex, adult systems; (2) distress, grief and trauma; (3) acceptance, normalisation and coping mechanisms. In this paper, we illustrate how these themes were harnessed to co‐produce a child‐centred framework for social visits based on children and young people's priorities for change, a framework we articulate as ‘The Three Cs’.ConclusionContact, which strengthens family ties and protects health and wellbeing, requires approaches which are child‐centred, consistent and compassionate. Crucial to this are enhancements to prison officer mandatory training on family ties and the impact of family imprisonment as well as exploration of how to harness existing support pathways designed for vulnerable children and young people to ensure that those experiencing familial justice‐involvement do not fall through gaps in service provision.Patient or Public ContributionFrom its inception, this project was a partnership between academia and two voluntary sector organisations that support families experiencing imprisonment with the core project team being split between academic and practice‐based partners (reflected in this article's authorship). An international stakeholder group was also convened to support the study across its duration and who supported the research team in the development of research questions, topic guides and participant materials, guided the interpretation of our findings, and provided input into our impact and dissemination strategy. This group met quarterly and included representation from voluntary sector and grassroots organisations, academics with experience of working with children, families and justice‐involved populations, prison and probation service colleagues and creative practitioners. Aligned with this partnership approach, we established regular satellite check‐ins with other voluntary sector organisations across the United Kingdom who support families experiencing imprisonment to embed relationality and feedback loops for actionable change. Five study participants were involved in the co‐creation of comics, illustrated by Jack Brougham (see ‘Materials and methods’ section for further insight). Finally, during the analysis, dissemination and impact phases of the project, we worked with a youth board of children with experience of familial imprisonment (recruited through a partner organisation) to sense‐check our findings and to develop a campaign video (an approach chosen by the board). The video was based on the analysis of project data and the youth board's own experiences. This process was held over 3 full‐day sessions, co‐facilitated by a locally based arts organisation and involved a range of creative activities. Participants were thanked for their time with gift vouchers. Both processes with young people (data collection and engagement activity) further informed our analysis and were fundamental to shaping our three Cs framework, a framework co‐produced with our core voluntary sector partners and illustrated by Nifty Fox.

Ealing is a municipal borough situated in West London. Ealing Borough Based Partnership is an informal local collaboration between an acute and community NHS Trust, the Local Council, Primary Care, voluntary sector and health commissioners (NWL ICB). Approach: We held a population health summit to understand public health information derived from all health and care partners, to inform our priorities. This highlighted that Ealing: - is experiencing substantial population growth residents currently access acute care in hospitals in neighbouring boroughs - life expectancy and health inequalities differ significantly across the our neighbourhoods - has the highest rate of alcohol admissions in London - has a high prevalence of diabetes and hypertension - is a net importer of residents into care homes, boasting the largest care home bed base with increasing acuity and complexity - is the most ethnically diverse borough in London has the second highest rates of homelessness in NWL. The above factors highlighted the complex health and social challenges facing our population, necessitating strategic planning of resource allocation to address the needs of its growing and diverse population. System partners and local people from heath and care met to review progress against priorities and identify key deliverables for 2025-26. This poster summarises the review of partnership activities delivered under the banner of Ealing’s (integrated) Borough Based Partnership and plans. Achievements: Homeless Pathway: £63k in savings have been achieved through step-down and community support. Bridging Care Service: reduced delays in inpatient settings to improve patient flow. Care Home Inreach and Liaison Service: deployed to manage challenging patient behaviours. High Intensity User MDTs have conducted 117 holistic case reviews, addressing unmet needs. Ealing Care Navigation Network is an active social movement with 75 members from nine partner organisations. An Alcohol Intervention Pilot has been launched. Ealing has made significant strides in Cervical Cancer Screening, achieving rates that are 64% above the NWL / London average. Ealing has co-produced and published a Public Data Dashboard empowering stakeholders to make informed decisions and track progress. Agreed priorities: Integrated Neighbourhood Teams (INTs) to serve 50-100k residents with a transparent approach that involves all health and social care services. Primary care access enhanced through partnerships with providers. Child Health Hubs are being rolled out into all INTs across Ealing, with four out of eight hubs established so far. Community Frailty Model. Healthy Ealing Team to support vulnerable groups, including migrants. System flow is optimised through continuous improvement to manage seasonal demand. Co-production is being embedded in all projects. Challenges: Limited resources to coordinate partnership activities are a significant barrier to delivering further upon our ambitions. Inadequate health care estates (aging facilities and high costs) impede the provision of high quality care, with limited opportunities for physical co-location. Ealing’s diverse community presents unique health and social care challenges, requiring investment in a diverse workforce which is culturally competent and able to communicate in multiple languages. Implications: Data informed collaboration between health and care partners can establish priorities for integration in a local borough.