Woman checking on and talking to elderly male neighbour on doorstep. Shutterstock 374195662
The UK is a leader in the production of innovative products and approaches to healthcare delivery such as medical devices or new ways to structure services. However, while many innovations are made, it has proved harder to meaningfully adopt and spread innovations across the NHS, meaning that many good ideas once implemented do not perform as expected. In recognition of this issue, much research in recent years has focused on factors associated with the introduction of novel products rather than just the products themselves. It is recognised that people in the most disadvantaged areas typically are least likely to be participate in and receive the benefits of innovations introduced to the NHS. 
The Health Foundation’s Adopting Innovation programme speaks to this challenge and has funded Royal Cornwall Hospitals NHS Trust and Cornwall Partnership Foundation Trust to carry out a 12-month project to understand the conditions required for successful innovation adoption and spread. As part of the project, learning and evaluation of a new Community Health and Wellbeing Worker role adopted within Cornwall’s Central Integrated Care Area, is taking place.  


The Community Health and Wellbeing Worker (CHWW) model covers 70% of the Brazilian population as part of the country’s family health strategy developed over thirty years ago and has achieved well evidenced outcomes. It is a community household approach to population health which offers insights into the factors that determine an individual’s health and wellbeing. The model is also able to identify and understand the factors that create inequalities along with what can positively impact on inequalities.
The model centres on the deployment of CHWWs to households within clearly defined geographical areas (between 80-150 households dependent on population density). These well-respected members of the local community visit every household at least monthly, irrespective of need and deliver a broad range of activities including promotion of healthy lifestyles, support with accessing services and reminders for vaccination schedules and screening services. In addition, they empower and engage communities in health-related activities.
This systematic, comprehensive, and integrated approach ensures that a new illness, or problem in a household, is identified in a proactive manner. By being fully integrated into the community and the statutory primary care services, they improve access to care and links to wider professional services. The model is being adopted on a small scale within Central Integrated Care Area (ICA) in Cornwall, with a total of 10 CHWW’s being deployed to identified households across Falmouth, Truro, St Austell and Newquay. 

Study aim

The aim of the study is to capture the journeys of the CHWWs from recruitment and training through to starting delivery, with a focus on learning and reflection. Furthermore, the process evaluation will capture insights to allow the model to spread to a wider area in the future. Our primary goals are to:   
  1. Trial healthcare innovations in Cornwall in order to spread and scale them Duchy-wide
  2. Build the infrastructure within the NHS and voluntary sector for implementing innovative approaches to health and social care.


Evaluation of the early feasibility of the CHWW model is taking place working with partners from the National Institute for Health and Care Research’s Applied Research Collaboration South West Peninsula (PenARC). This evaluation will use the MRC process evaluation of complex intervention framework. The adoption of the CHWW model has received funding for a period of three years to February 2026, early feasibility evaluation will be completed in 2023 in line with the close down date for the Health Foundation funded adopting innovation project.  

Plymouth collaborators

External collaborators

Mrs Tamsyn Brown
Royal Cornwall Hospitals NHS Trust
Mrs Donna Chapman
NHS Cornwall and the Isles of Scilly Health Integrated Care Board
Mr Tim Atkins
Cornwall Partnership NHS Foundation Trust