Community Health Melas

The concept is simple; give people the opportunity to have a Health MOT in a friendly, safe environment and provide them with the advice required to make appropriate lifestyle choices.

Mela, a Sanskrit word for a gathering, meeting or fair, has been developed as a Community Health initiative by the National Forum for Health & Wellbeing (NfHW) based in Preston during their 16-year experience in running such events in Lancashire. Rotarians have been involved in many of these events providing organisational skills, volunteer helpers and local funding. In 2016 we brought the initiative to Carlisle, providing Body Mass Index (BMI) assessments, blood pressure tests and blood tests for sugar and cholesterol.

The events offer an opportunity for health care and wellbeing teams to engage with the public in an informal setting. They are also a great opportunity for professionals from across the sector to meet up and network, something they rarely get an opportunity to do in their busy day-to-day working lives.

The project management, preparation and implementation on the day has generally been provided by community volunteers. However, two events in North West Cumbria were arranged by the local public health teams supported by Rotarians.

Outcomes

The events provide a valuable service to the communities in which they are held with some 30 to 40 per cent of people who take advantage of the Health MOT being referred to their GP for further advice and support. Many of those who attend our events say they will change some aspect of their existing lifestyle.

These outcomes support many of the goals that local authorities and the NHS have in relation to public health and wellbeing.

Costs

Smaller scale events can be managed at little or no cost if the venue is provided free of charge and local GP practices or others provide the clinical support. The basic cost of running a larger scale event is in the region of £3,000. This includes for PR and marketing, refreshments for all those taking part, sundries for the Health MOT’s. In addition, there may be costs for the venue ranging for £500 for the hire of a hall to £4000 for tents and gazebos for an outside event.

Aspirations

The NfHW and many of the “special guests” who have attended Melas over the years understand the need for this type of event to be provided more widely across our communities. Sir Peter Dixon, Chairman of Diabetes UK, said in 2016 “We could do with something like this on a wider scale throughout the country and I hope that others will follow the great example you have in Lancashire”.

Rotarians have similar aspirations to help improve the Health and Wellbeing of our communities around the world. It is one of our 6 areas of focus which we use to support much of the humanitarian work we are involved in.

Sustainability

Our Rotary International advisor from the Rotary Club of Falkirk noted in his report on the Carlisle event in May 2016 that “My concern relates to the long-term sustainability over the years as much of the success depends on many volunteers “.

The ability to engage with local clinicians, nurse & medical student training organisations, decision makers and politicians to make sure that appropriate approaches are taken for their areas will vary from area to area. It is hoped that the introduction of the Integrated Care Communities approach in North Cumbria may help over time.

Rotary funds may not always be available. Other partners and sources of funding need to be found. The involvement of the Cumbria Community Foundation and Cumbria County Council is a positive move towards this in the medium term but is not be sustainable in the long term.

Each community has its own set of priorities to be met to improve the health and wellbeing of its people. Successful events in Preston & Leyland, held in schools and community centres, may not be an appropriate model for other areas. The “open air” event in Carlisle, where we took advantage of an existing Saturday shopping footfall, is an example of this. The activities in Auction Marts in North Cumbria, something that is also being undertaken in East Lancashire, may be a better model for rural areas.

We need to ensure that each local NHS Trust, regional medical and nursing schools and other relevant partners in local health partnerships make it possible for their staff and students to have the opportunity to be involved in these community-based events.

This sort of event is an ideal way for Rotary and similar service organisations to get involved in their local community. Given the limited funding available, volunteer time will be required not just for organisers but from those groups providing advice and support. Community leaders need to understand the need to galvanise such support.

Next Steps

The Community Health Mela concept provides a framework for the NHS and local government to work with volunteers around priorities highlighted in the NHS Long Term Plan – particularly around early diagnosis and prevention.

Changing people’s ideas of how communities can help themselves, and securing funding for work in communities, cannot be undertaken by one or two groups in isolation. In south and central Lancashire lots of good partnerships have been built up over 16 years to make sure that the existing events can continue. There is much to be learnt from the wide range of professionals and volunteers who have been involved.