How micro-funding can unlock health improvements for communities

The shift to neighbourhood health is an opportunity for primary care teams to make the improvements they know are needed for patients and staff. What they need is the funding, training, time and permission to make the ambitions for neighbourhood health a reality.

I’ve been fortunate to be involved with so many amazing projects that highlight this potential. In 2023/24 I was involved in a Supporting Q Connections project that showed how much can be done with just a small amount of funding and support.

The project offered the workforce within primary care across Cheshire and Merseyside the chance to apply for small pots of funding to enable small improvement projects to develop or emerge.

In total, our Supporting Q Connections funding enabled us to subsequently fund 20 projects that received micro-funding of up to £1,000 each. This enabled connections and improvements to be made that directly reached 900 people within primary care, including patients.

This built on a project I led at the Innovation Agency before I moved to the Cheshire and Merseyside Training Hub. With access to small pots of funding, people who weren’t budget holders but were doing improvement work were able to get their ideas off the ground.

The people we were supporting knew the problems they needed to solve and who they needed to connect with. More importantly, they had an established reputation in the place where they worked.

I brought that learning into primary care and began to support small innovation projects aligned to place needs. The projects ranged from understanding the value of social prescribing for patients waiting for mental health support to creating emergency care packs for stabbing victims seeking help from GP services.

We were able to link the Supporting Q Connections funding to our fellowship programme, which included mentorship and one day per week away for fellows to work away from their practice on an improvement project.

Outcomes of the projects included GPs offering extended hours, a Parkrun event aimed at promoting the wider determinants of health and a nurse mentoring programme that improved connections within the team, ultimately improving patient care.

One deprescribing project was working to implement greener practices. The micro-funding we provided enabled them to collect the evidence to go to the Integrated Care Board and say, look what we’ve been able to do with £1,000. They’ve now agreed for it to be run at a Cheshire and Mersey level so it’s enabled wider, more strategic working.

Across the projects, networking was one of the biggest things clinicians were missing. In our GP surveys, 50% of GPs said they were lonely in their role and nurse surveys also highlighted loneliness and isolation. So, making connections – both within multidisciplinary teams and between clinicians across teams – is very much needed and this need will only increase with the shifting focus to neighbourhood health.

A key learning was that those who identify improvement needs and are closest to the issue they are trying to solve are the best people to initiate and drive change. However, they rarely have access to budgets to mobilise their ideas and often lack the remit or permission to make the change. One of the gaps we need to bridge is this hierarchy and with the training hub we were able to give them that permission.

In quite a few meetings I’ve attended recently there has been a focus on integrated neighbourhood teams and looking at the already thriving multiple disciplinary team meetings. People are talking about bringing all the practice leads in and talking about what’s needed, having corridor conversations and things like that. 

One of the things we didn’t do with our projects was scare people off with methodologies and theories. Some people don’t particularly recognise that they’re doing improvement work, but they can see that there needs to be a change. They plan something, they research how to do it, they do it and they get an outcome. Joining Q is one of the easiest ways to get involved because it is a great way to connect with others working in health and care improvement across the UK and Ireland.

We can take a step back and say, that’s a SWOT (strengths, weaknesses, opportunities, threats) analysis or that’s a Lean process but it’s really about active doing. They definitely use Plan, Do, Study, Act (PDSA) but we would discourage using too much terminology because we want to make it accessible.

I’ve just started a new project called Joy at Work. I’m nicknamed the Director of Joy, and part of my role is sharing the creativity and innovation happening across our teams.

Recently, I met a practitioner from Primary Care 24 who saw a gap in homelessness support in the local community. While heading to Parliament with the CEO to present the organisation’s work with asylum seekers, the practitioner shared how they’d been tracking homeless patient registrations, getting the meds team to review them, and seeing those patients themselves. 

This wasn’t something the CEO was aware was happening.  When the CEO asked why this practitioner was taking on so much, they simply said: ​‘Because it’s the right thing to do.’ The CEO’s response? ​‘What do you need to make it work?’

Now, Primary Care 24’s team is connecting with shelters and multidisciplinary teams. They even allowed a patient to set up a tent nearby for a few hours because he felt safe there.

This approach embodies what neighbourhood working is all about: teamwork, compassion, and knowing your community. It’s a reminder that when we act with integrity and play to our strengths we create real change, because it’s the right thing to do.

Making health improvement shifts at neighbourhood level is about setting up local teams with the right conditions for success. Where there are productive working relationships, community insight, and professional expertise, we can deliver. The people involved in this work came together in the common interest of their patients and it has been inspiring to watch this play out in our area.