A study has found that the voluntary, community, faith and social enterprise (VCFSE) sector played a “crucial” role supporting Greater Manchester communities during the COVID-19 pandemic and vaccine rollout—but that their contribution has been undervalued and under-recognized by the wider health system.

The researchpublished in BMC Health Services Researchexamines the unmet health care needs of marginalized communities in Greater Manchester during the pandemic and how community-based organizations and networks stepped up to help address these challenges.

Led by researchers at the University of Manchester and the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Greater Manchester (ARC-GM), the study highlights the frustration, fear and loss of faith in the health care system from people within these communities, who felt they were not supported sufficiently by mainstream services.

VCFSE organizations and community networks mobilized to meet health and well-being needs, such as providing food and care packages to vulnerable households, food bank services, support for people experiencing homelessness, and online support groups.

The research found that these community-based approaches were deemed crucial to the success of the vaccination drive thanks to the unique position to reach members of diverse communities to boost uptake of the vaccine.

These efforts included VCFSE group helping run vaccine pop-up sites in community spaces, such as mosques and other religious sites, children’s centers, and local specialist charities such as refugee and sex worker charities.

The findings suggest that the support delivered by the VCFSE sector remains under-recognized and under-valued by the health system and decision-makers, and has prompted calls for more inclusive, community-driven solutions in future health crises.

Lead author Stephanie Gillibrand from The University of Manchester and NIHR ARC-GM, said, “The important contribution of community engagement initiatives during the pandemic and vaccine rollout is made clear in this study. Not only did VCFSE organizations and community-led networks provide significant health and well-being support to people across Greater Manchester, but they also played a pivotal role in building trust within hard-to-reach communities to help boost vaccine uptake.

“The value of this work needs to be recognized and learned from so steps can be taken to remove the current barriers within the health system that are stifling effective joined-up working with VCFSEs.

“Our study underscores the need to create a broader, more inclusive system which allows and promotes cross-sector collaboration, with flexibility and adaptability at the heart of future service delivery.

“With the right mechanisms in place, there is real potential to harness capacity to tackle inequalities and build trust through shared learning and greater collaborative working. The important contribution of community engagement initiatives during the pandemic and vaccine rollout is made clear in this study.

“Not only did VCFSE organizations and community-led networks provide significant health and well-being support to people across Greater Manchester, but they also played a pivotal role in building trust within hard-to-reach communities to help boost vaccine uptake.”

The qualitative study drew insights from interviews and focus groups with people from local marginalized communities, health and care system stakeholders and VCFSE representatives.

Community participants involved groups that had been disproportionately affected by the COVID-19 pandemic in England, including ethnic minority groups, young adults, and those with long-term physical and mental health conditions.

During the research, concerns were raised about inability to access health services during the pandemic, including GP and specialist services. Participants also described their fear of catching the virus if they did attend health care settings, as well as fear of insufficient care due to well-publicized pressures in NHS settings.

The study also found that:

• Participants felt strongly that this increased support provided by the VCFSE sector and community networks remains under-recognized and under-valued by the health system and wider public.
• Operational and logistical barriers created dissonance between communities and the system. This included difficulties with decision-making and power-sharing between VCFSE and commissioning or clinical organisations, organizational cultural clashes, red-tape and bureaucracy, and complex systems and power structures to navigate.
• Health systems should engage with the full breadth of the VCFSE sector, encouraging the involvement of smaller scale and less formal organizations as partners.
• Traditional health and care partners such as the NHS and local authorities should consider how their ways of working may need to change to foster full VCFSE inclusion on an equal standing.