Participatory collaboration to identify barriers, enablers and priorities for Primary Care in a highly disadvantaged urban area in Ireland

• Background: Ensuring equitable access to healthcare in deprived areas is challenging. This participatory research engaged diverse healthcare and community stakeholders to identify challenges and pragmatic solutions to improve access to primary care.

 

Approach: The paradigm of Participatory Health Research (PHR) informed the consultation design of this engagement project, which sought to produce evidence that is locally situated, collectively owned and potentially transformative if stakeholders continue to be involved in decision making on health matters that effect their community.

 

Mixed methods of data collection and analysis included qualitative and quantitative methods. 277 diverse individuals, service providers and community members from 14 community groups were consulted through 12 meetings and 3 surveys conducted by HSE partners.

The research team independently verified and analysed this secondary data and thematically summarised it to present the consultation findings back to the stakeholder community, inclusive of health care providers, service users and patient advocates.

 

The research team also extracted socio-demographic and health data from the Central Statistic Office 2022 and Health Atlas to produce a brief report on key population health indicators. This was presented as context for stakeholders to understand the challenging social determinants of health impacting communities living in the deprived area.

The research team co-designed with the HSE healthcare staff, and facilitated a day long area based participatory event with 22 service leaders and community advocates to discuss the consultation findings and the socio-demographic data.

The research team then co-designed a priority setting event, where health and community stakeholders were facilitated to choose priority solutions to the challenges identified and invited to identify what priority actions they would commit to progressing in partnership with their local primary health care service.

These participatory area based events yielded a significant amount of valuable data and insights into how primary care services are being experienced by diverse service users, service providers and community members as well as pragmatic and aspirational recommendations for service improvement.

 

Results: Challenges, solutions and bright ideas were identified by stakeholders to improve primary care services in the deprived communtiy area.

Findings: were thematically analysed, written up and presented back to stakeholders as well as to HSE Regional and National Executive Management. This report and subsequent presentations at meetings resulted in the inclusion of a number of recommendations in the annual service plan by the local primary health care service.

The research project was also awared the annual conference poster prize at the Patient Partnership Conference (2024).

 

The HSE at national level approved co-creation of a new post to liaise between the HSE and the community as a Primary Care Link worker. To the best of the authors’ knowledge, this is a unique role in the Irish healthcare system and has been co-designed by health care staff and community partners.

Most importantly, the priority projects and work identified continues to be carried out in partnership with health care staff and community partners to improve access to and quality of primary health care in this community.