Benefits of a community-based approach to healthcare

Deirdre Garvey, The Wheel’s Chief Executive explains the role of these organisations in promoting health and well-being in communities.

Ireland has a very vibrant nonprofit sector with over 12,000 community and voluntary organisations (8,500 of which are registered charities) active in communities across the country. These organisations employ more than 100,000 people, and together they have total annual income of more than €5.7 billion.  Around half of this income (€2.88 billion) goes to 778 nonprofits that are primary involved in healthcare. (info from

The majority of these 778 healthcare organisations are funded by the HSE under funding schemes called ‘section 38’ and ‘section 39’ of the Health Act 2004. The bulk going to 44 ‘section 38 agencies’ primarily in the acute hospital and disability sectors. The HSE also provides grants to smaller community-based health charities (so called ‘section 39 organisations’).These are community-based health charities, which are deeply embedded in communities, and as such, they have unique insight into the needs of their service users.

In primary health-care settings services are often structured around institutions rather than individuals. In contrast, a community-led approach to healthcare involves communities experiencing disadvantage and poor health outcomes in identifying and defining the issues that influence their well-being and in developing and implementing solutions.

The key features of the community-led approach are:

  • responsive, tailored and holistic approaches to identifying and meeting needs;
  • flexibility, innovation, integration and collaboration in delivery;
  • ownership, involvement and empowerment of service beneficiaries and the wider community;
  • contributing to building social capital and social cohesion and
  • contributing additional sources of funding to support their work that would not be available to the State.

The community-based approach also delivers significant Societal Value. This comprises both financial and non-financial value creation by using resources to produce positive outcomes. These contributions represent the added value of the community-based approach: the energy, endeavour and commitment of all involved; the extent of funds added; all the other additional resources contributed (like premises, equipment etc.) – none of which would otherwise be available to the State.

There is an opportunity for public bodies and other stakeholders to work in conjunction with the community and voluntary sector to develop an enabling framework and ecosystem for the funding and regulation of services delivered by the sector: one that is focused on maximising Societal Value creation, is explicitly supportive of the unique community-based approach, and that utilises and reinforces its strengths.

This is just a short summary of how community-based health organisations augment our healthcare-system to help ensure better outcomes for service users. Programmes like the GSK IMPACT Awards provide much-needed support and recognition for these organisations.

The Wheel is a national support and representative body for community, voluntary and charitable organisations.  Its membership encompasses 1,350 organisations, including many community-based charities. The Wheel is supporting the GSK IMPACT Award, which provides support and recognition to community-based health charities.