Building a Sustainable Health Community: Evaluation of the Growing Health Together Programme

Abstract Background Place-based approaches to improving population health and tackling inequalities are gaining attention, though evidence on their implementation and overall effectiveness remains limited. Growing Health Together (GHT) in East Surrey, UK, applies a collaborative, asset-based, neighbourhood model to co-create local health solutions. This mixed-methods evaluation explored GHT's implementation and impact, contributing to the growing evidence base on neighbourhood health creation. Methods A multiple-case study design was used across three of East Surrey's five Primary Care Networks (PCNs). The RE-AIM framework guided data collection and analysis, supported by Normalisation Process Theory (NPT) to explore adoption, implementation, and maintenance. Data collection included 49 semi-structured interviews with healthcare professionals, activity leads, and community members and group observations. 19 participants completed the NoMAD questionnaires assessing implementation processes. Results 'The Golden Thread’ of connection emerged as the central active ingredient underpinning GHT's success. Strong, reciprocal relationships across communities, health services, and voluntary groups drove programme reach, adoption, and outcomes. Reported benefits included improved health literacy, mental wellbeing, confidence, social capital, and trust in healthcare professionals. Participants described reduced isolation and increased community cohesion. Key enablers were shared aims, flexible leadership, inclusive practices, and embedding health creation within local prevention priorities. Conclusions The evaluation highlights the feasibility and value of a place-based, community-driven health creation model. Connection, co-production, and adaptability proved vital to implementation and outcomes. A transferable framework and practical recommendations are proposed to support the integration of health creation within neighbourhood health systems and future Integrated Care Systems. Key messages • Our evaluation shows that meaningful community connections are the vital ingredient for building healthier, fairer, and more resilient neighbourhoods. • Our findings offer a practical, scalable model for embedding health creation into Integrated Care Systems through neighbourhood partnerships.