Twelve years of bridging the gap between healthcare and community

Colette reflects on the last 12 years of the Community Links Worker programme, as well as her own experience of being a CLW.

In early 2014,the ALLIANCE Community Links Worker Programme (CLW) was first established in collaboration with the GPs at the Scottish Deep End Project. The role was created in response to large rates of people experience unmet need in areas like housing, isolation, and debt. The idea was to encompass aspects of community development, holistic models of care, empowerment, self management and supporting people to “live well” in their communities.

The ALLIANCE was approached by the GPs at the Deep End to develop and support the pilot of the CLW programme. It was novelfor Primary Care to have workers within the third sector situated within a GP surgery, and a new venture for ALLIANCE to run a front facing service’ but it was exciting.The programme started as a Scottish Government-funded Pilot project with seven Community Links Workers (CLWs) based in seven practices across some the most deprived areas of Glasgow with eight control practices supporting the research conducted by the University of Glasgow for the pilot.

Initially, there was a clear clash of cultures. It took some time for both parties to get used to; but the traditional medical model of Primary Care and the person led approach of the CLWs brought took a while to embed. Initial challenges in integrating into some practices were addressed via shared learning events and reflections of best practice. The GP practices taking part were willing to trial something new and work together to ensure the approach was adopted. But eventually, we worked together to ensure that the practical aspects of implementation were easily navigated.

The common goal to support those in areas of high unmet need, as well as a clear understanding from the Deep End GPs of the impact of Social Determinants of Health and the Inverse Care law, meant there was a willingness to collaborate and embed these new workers into Primary Care despite the difference in background and approach. The hour-long appointments our CLWs had and flexible ways of working, supporting people in practice and in communities, took some adjusting for practices. But the joint focus for all involved was evident; and that ensuring the voices of lived experience of individuals in those communities were heard, supported and empowered.

During the first three years of the pilot project the focus on shared learning, encouraging a culture of collaboration and development was key. Jointly we took part in learning events with GPs, Practice Managers and CLWs. CLWs kept weekly blogs of activities to share learning across practices, two series of Record of Learning were published and from the ground up the programme was developed, established and embedded. As one of the “OG” CLWs, it was a thrilling time; exciting, yet daunting, a learning experience for all involved and I am very grateful to have been part of those days.

The first expansion happened in 2017, taking on the eight other practices involved in the pilot, closely followed by three in Govanhill. As time progressed the programme grew and grew, the number of practices increased to 31 in Glasgow, and we took on the West Dunbartonshire contract in 2021, covering another 16 practices.In 2022, we partnered with SGN to increase support for those in fuel and food poverty and trialed workers based in Trussel foodbanks. In 2024,we saw a significant increase in staff as we took the full Glasgow City contract, with CLWs now covering 80 “Deep End” practices in Glasgow, two thematic CLW roles specialising in working with the homeless population,asylum seekers and refugees.

Maintaining the core values of the programme is and always has been important to all involved, ensuring the service is truly person-led, flexible when needed and of course ensuring people were at the heart of the care they received. With an expanding staffing team, balancing process with flexibility was essential. Ensuring we area person-led service while still being able to measure impact, demonstrate effectiveness were all things which took a while to navigate.

At present we are based in over 100 GPs Practices in Glasgow and West Dunbartonshire, 80 of which are in “Deep End” areas across Glasgow. We have thematic posts working with homeless population and one with the Asylum and Refugee Health Team, we work with the Trussel in five foodbanks in Southwest Glasgow, SGN around fuel and food poverty, including an upcoming Schools CLW project due to start in August.

It’s been an exciting, educational and wonderful journey to be part of, the development of the ALLIANCE’s LWP from sevento over 80 CLWs, the involvement in sharing learning, collaboration and common aims around Health Equity, Inclusion Health and Person-Led Care has been truly a blessing for me personally.

Here’s to another 12 years – and beyond!

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