A community may be defined in many different ways. Community care can also be defined differentially, maybe in relation to a fundamental philosophy, may in terms of imposed limitations and definitions of community delineation.
One definition of;community’ is “A social group of any size whose members reside in a specific locality, share government, and often have a common cultural and historical heritage This notion of community identifies the key elements of community in relation to healthcare that concern healthcare service providers and policy makers. Communities can be defined in terms of their location, but it is not enough to delineate communities in terms of specific areas, because communities are not simply collections of people who are in close proximity with each other by happenstance (Webb, 1986). Communities occur because of features which bring people together, often because of need, such as family support, or because of common interest, such as healthcare support groups. However, not all groups which share a common interest are communities (Trevilion, 1993). Location and purpose seem to be aspects of community, sharing not only common interest but common activities and common purposes, common concerns and common needs (Sines et al, 2005).
Culture, ethnicity, age, gender, sexuality, all of these can be characteristics which define a community, but they could also be different elements of identities and needs within a particular community. For example, it is possible to talk of traveller community health, traveller women’s health, gay men’s health, and the like, and thus we are referring to communities which may exist within geographical communities, or despite geographical boundaries (McMurray, 2003).
Within the United Kingdom, issues surrounding community health and wellbeing have concerned healthcare providers, particularly in defining distinct communities or sectors of communities, in order to identify health needs and develop and mobilise services in order to meet those needs (Lewis, 1999). However, these needs and the communities focused on have been traditionally limited to government-defined communities or definitions of who belongs to what community (Lewis, 1999). More recently, the re-orientation of UK healthcare services towards a more patient-centred model has led to the upsurge of service user involvement in design, development and evaluation of services (Pickar et al, 2002; Simpson et al, 2006; Tait and Lester, 2005; Telford and Faulkner, 2004; Humphreys, 2005).
This could be viewed as a means of breaking down the traditional hierarchical barriers between ‘the community’ or communities being served by healthcare providers, and the providers themselves (Telford and Faulkner, 2004). Addressing community needs can be informal, local, or national and formal, and seems to form part of governance strategies in the UK and Ireland (DoHC, 2001). Such strategies also now seem to focus not only on the service user information role, through gathering feedback and through service user involvement (Poulton, 1997), but also the need for greater collaboration, within and between healthcare and community/ social care/ voluntary sector agencies (Cumberledge, 1986; Fisher et al, 1999). These are all very good ideals, but in order to make user involvement and collaborative approaches work, information needs to be applied to practice, and practice needs to be changed for the better. This requires staff at some level to enforce these changes.