In Bulwell and Top Valley, local organisations are working together to improve health by focusing on the needs of the neighbourhood. This work shows how services can better support people by working closely with communities and coordinating help across different organisations.
In 2022, a Local Design Team (LDT) was set up within the Bulwell and Top Valley Primary Care Network. This was supported by the local Place‑Based Partnership. The role of the team was to understand the main health needs of local people. Bulwell and Top Valley have high levels of deprivation, which has a strong impact on health.
The team looked at data such as how common different conditions are, how many people may have conditions without knowing it, and how often people use hospital services. This showed that Type 2 diabetes was a major concern in Bulwell. Rates were high, many people were likely to be undiagnosed, and attendance at diabetes clinics was low.
To respond to this, the team brought together NHS staff, voluntary and community organisations, and local residents. By working together with people who had lived experience, they designed a programme that fitted the needs of the neighbourhood and was delivered in places people trusted.
The programme included:
- Outreach sessions in familiar places such as Bulwell Market and local supermarkets. These gave people easy access to health checks, information and advice in places they already visit.
- A diabetes support group led by people with lived experience, held in a trusted community space at the Mellish Sports Centre.
- Work with Bulwell Forest Garden to support inclusive gardening and healthy eating, including cookery sessions.
- Support from Momenta Newcastle to encourage people to take part in the NHS Type 2 Diabetes Path to Remission Programme.
- Weight management sessions provided by Thriving Nottingham.
- Exercise programmes provided by TravelWell to help people lead more active, healthy lives.
In Nottingham and Nottinghamshire, most people with Type 2 diabetes also have other long‑term health conditions. Many have two or more. Working together across organisations made it possible to support people’s health in a more joined‑up and holistic way, rather than treating diabetes on its own.
As one member of the Local Design Team said, working in isolation does not help residents. Working together makes support more meaningful and effective.
