Could Brazil’s community health model ease pressure on NHS general practice?

In a GP surgery in Pimlico, London, Cornelia Junghans-Minton meets with a small group. The subject under discussion is their community: chiefly, residents who need health services but often don’t engage with the health system.

“At the moment [health] services rely on people to reach out to get help,” says Junghans-Minton, a GP—“but a lot of people are not even aware that they have a problem, or they find it really difficult to reach out. And so, everything we do is at a late stage when it’s already in crisis, and it’s expensive to fix.”

The group she is talking to is Westminster’s “community health and wellbeing workers” (CHWWs), who visit families in their own homes on the borough’s Churchill Gardens housing estate to provide health and wellbeing advice, connecting residents with NHS services and other community support. These salaried members of the local community regularly go from door to door to discuss residents’ specific health needs as well as wider issues determining health. As one of the most deprived communities in London, the estate has a persistently low vaccination uptake, a low cancer screening uptake, high comorbidities, and an overall poor life expectancy.

These CHWWs are the UK vanguard of a proactive and hyperlocal approach to …