We all too often hear about communities not having a say about their health care. It is also widely reported that health services differ hugely from one area to the next.

As arguments rage over whether NHS users should pay a monthly fee for care to prevent it sliding into decline, one Bradford initiative is going from strength to strength, giving users exactly what they want.

More than a decade ago, healthcare providers became aware of a need to tackle and change the way services were delivered in one area of Bradford.

North Bradford Primary Care Trust, local GP practices and community organisations recognised that some communities were missing out on care for reasons including access difficulties and childcare problems. They pledged to change this by moving away from large and often remote settings into the heart of the areas they serve – and they asked local people to tell them what they wanted.

Today, the Health on the Streets (HOTS) project is a soaraway success, giving people in Eccleshill, Ravenscliffe, Thorpe Edge, Thackley, Idle, Greengates and Fagley a tailor-made service that addresses their needs.

Based at Eccleshill Clinic on the edge of Ravenscliffe estate in Bradford, it was initially funded by and continues to work with six GP practices, offering a range of support packages including help with breastfeeding, support to stop smoking, weight management, midwifery services and young people’s health services. People are able to access them in non-traditional settings such as community centres, which people find more convenient.

“We asked people what they felt would improve their health and what would make a difference,” says project manager Sue Hodgson. “We marry up information – for example we noticed that some women had not turned up for ante-natal appointments. Many said the times were inconvenient, it was a bus ride away, or they had other children to look after which made a visit to the doctor’s surgery difficult.

“We spoke to the midwives and together we set up a drop-in at the surgery that people could attend anytime it was open. We set up a play corner with a volunteer who supervises smaller children. We then found that women wanted post-natal drop-ins too.”

A drop-in service for young people run in conjunction with the Contraception and Sexual Health service and Bradford Youth Service covers any aspect of health that may trouble young people.

“HOTS runs every week of the year, across every age spectrum, and deals with any issue that people believe will improve their health,” adds Sue. “It is about us reaching out and making things accessible. People come up with a lot of ideas themselves.”

Community health development worker Pauline Bland works predominantly with older people. “Much of our work is about helping groups link up and share resources such as luncheon clubs, coffee mornings and other activities for the over-50s,” she says. “They are quite often run by volunteers and are not always connected with what is going on across the district or aware of funding opportunities.”

Other activities include weekly swimming sessions. “People who had not been swimming for years or who could not swim, told us they did not want a public session, so it was arranged so that they would have the pool to themselves.”

One-off events are often prompted by people’s suggestions. “We have looked at conditions such as leg health, diabetes and dementia awareness,” she adds. “If people want more information we will bring in key partners, such as the Alzheimer’s Society, to help.”

There was evidence in the communities of issues such as loneliness and isolation, which can in turn lead to depression. So-called ‘social prescribing’ has been applied to try to address such negative feelings. “We link people up to activities in their locality,” says community health adviser Janet Menebhi. “It is about non-medical sources of support such as centres holding tea dances and luncheon clubs, as well as befriending services. We use our local knowledge of these groups.” They also provide home visits.

Rachel Duxbury is a breastfeeding support worker. “My job sits alongside lots of different services,” she says. “It focuses on immediate post-delivery and supports women who want to continue to breastfeed. We see women in clinic and at home and get great feedback from the mums.”

Ravenscliffe resident Janice Maloney is a HOTS volunteer helping at Springdale Centre in Thorpe Edge. “People can depend on the HOTS team for anything. I learned to swim with them and now I’m supporting others.”