Building health together across services, communities and local organisations – Manchester Settlement.

What do WE mean by the term ‘Health Creation’ in North Manchester?

You may have heard the term ‘Health Creation’ used in the NHS, public health, schools, community organisations and councils. Across these settings, the core message is the same: health is shaped not only by services, but by the conditions people live in every day.

Different sectors use the term in different ways, but the meaning is broadly shared.

So, what does Health Creation mean across different sectors?

In health, it means looking beyond treatment to what helps people stay well, such as connection, confidence, purpose and control. In public health, it means addressing the wider causes of ill health, including poverty, isolation, housing, discrimination and unequal access to opportunities.

This aligns with the vision of The Health Creation Alliance (THCA), a national cross-sector movement working to improve wellbeing and reduce health inequity through Health Creation.

Health Creation is an asset-based approach that sees health as something that can be built through everyday relationships, environments and opportunities, not only through treatment.

It describes how people and communities gain purpose, hope, mastery and control over their lives and surroundings, improving health and wellbeing as a result.

Quote from project lead “We were told what to do and achieve but not how to do it. The freedom to try out new ways of communicating with our own minority audiences was crucial. It was motivating and we worked hard to do the best we could because it was our project. We were aware of the outputs and evaluation from the start so it felt as if we had ownership but not left alone. Our trainer offered support in very concrete ways, setting aside time and meeting with us individually if we wanted. Her encouragement and permission giving has been a significant part of our successful MMR promotion project. Her timing has pushed us gently, being always a few steps ahead of us”, Jane – Rainbow Haven

Communities consistently tell us that people feel more engaged, respected and able to act when work is rooted in listening, honesty, strengths, mutual support and shared power. These are the Features of Health Creation:

• Listening and responding — hearing what matters to people and acting on it.
• Truth-telling — being open about the barriers people face and what needs to change.
• Strengths-focus — recognising the skills, experience and assets already within communities.
• Self-organising — helping people connect, act together and find local solutions.
• Reciprocity — creating relationships where everyone can contribute and benefit.
• Power-sharing — making sure decisions are shaped with communities, not just around them.

The Framework for Health Creation highlights the relationship-based ingredients that make the biggest difference to people’s journey to better health.

This is the definition we use in our Health Creation projects in North Manchester, shaped through our partnership and learning journey with THCA.

What does Health Creation look like in North Manchester?

Since 2023, we have delivered Health Creation projects in North Manchester, mainly commissioned by the Manchester Local Care Organisation and delivered with grassroots organisations. Our work is shaped by the following principles:

Our learning journey – We continue to learn with THCA using the Framework for Health Creation, and we share that learning with partners.

Commissioning practice – We support grassroots organisations through grants for community-based projects.

Shared learning – We build capacity so partners can apply Health Creation principles confidently in practice.

Developing relationships – We strengthen relationships between our Manchester Local Care Organisation, partners and grassroots communities. The Framework for Health Creation gives us a shared language for trust, fairness, local strengths and the quality of relationships. The 3Cs: Health Creation grows through Connections, Confidence and Control. When people feel connected to others, their confidence grows, and they are more able to shape their health, their choices and the conditions around them.

Common language – We are building a shared understanding of Health Creation across North Manchester, including a local Health Creation identity.

Improving health – We share good practice and use evaluation findings to improve projects.

Health Creation focuses on what helps people and communities feel hopeful, connected and in control, so health and wellbeing can improve in lasting ways.

What does Health Creation look like on the ground with grassroot communities?

Our work with grassroots communities over the past three years has shown what helps Health Creation projects have the greatest impact.

Creating the right conditions for people to take control of their health has supported positive outcomes in areas such as winter health, vaccination, diabetes prevention and management and currently on our long term Conditions project!

• We work with grassroots organisations that know their communities and have trusted local leaders.
• We build a shared understanding of project outcomes, Health Creation and evidence-based practice through training and support locally
• We co-produce project plans and offer ongoing guidance and troubleshooting
• We encourage openness, learning and adaptation so communities can find what works best locally.
• We support trusted, respectful relationships and honest conversations about challenges.
• We use the Framework for Health Creation to support power-sharing and collective agency.
• We listen, respond and adapt to meet changing community needs.
• We provide grant funding so communities can deliver projects in a supportive environment
• We raise awareness of the benefits of the framework to tackle health inequalities strategically at meetings, conference, summits and events.

What does this mean for North Manchester?

• Developing stronger, healthier communities
• Supporting culture change across services and organisations
• Developing confident and compassionate local grassroot leadership
• Helping services and partners work better together.
• Redesigning frontline support around people’s real lives
• Strengthening integrated teamwork across neighbourhoods

Why does it matter?

• It supports genuine co-production with communities, spaces of support (i.e. community hubs) and NHS partners.
• It strengthens prevention by focusing on what keeps people well.
• It helps address health inequalities in a practical and relational way.
• It fits with trauma-informed and compassionate approaches.
• It encourages anti-discriminatory and inclusive practice.

We can evidence the impact of our projects on people experiencing health inequalities in North Manchester through reports, briefings and presentations.

For more information, please contact Maqbul Rose, Health and Wellbeing Manager at Manchester Settlement: maqbulrose@manchestersettlement.org.uk or visit our ‘Health Creation’ page on our Manchester Settlement website: www.manchestersettlement.org.uk/health-creation