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Capacity Building in Health and Social
Fiona C Mackenzie
Edinburgh Napier University
• The ability to receive, hold or absorb content and new
information and knowledge.
• The maximum or optimum amount of production or output
that can be delivered.
• A measure of volume: the maximum of new knowledge
that can be held.
• The power, ability or potential of performing an activity.
• A continuous and participatory process to empower
organisations to systematically identify and respond to
institutional needs and the needs of the population it
serves in order to better meet its stated mission and goals,
solve problems, implement change and increase
efficiency. (Naccarella et al 2012)
• An approach to the development of sustainable skills,
structures, resources and commitment to health
improvement in health and other sectors to prolong and
multiply health gains. (Hawe et al 1998)
• An essential process for the survival of any organisation –
capacity being the sum of processes, values and climate
within an organisation. (Aroni 2012)
• An ongoing process by which individuals, groups and
organisations and societies increase their ability to
perform core functions, solve problems, define and
achieve objectives, and understand and deal with
development needs in a broad context and sustainable
manner. (Horton et al 2003)
• Community capacity building is a process by which people
gain knowledge, skills and confidence to improve their
own lives. (Rifkin 2003)
• Ongoing process
• Links to improvement
• Knowledge and skills acquisition
• Individual, organisational and community levels
• Existing structures of H&SC systems and their traditional
ways of functioning are no longer viable to meet current
and future demands of care for chronically ill, ageing
populations, co morbidities, fast advancing technology and
changes in inter professional delivery models.
• Financial resources constrained.
• Predicted and actual global and local shortages of specific
professional groups e.g. nurses, doctors, care workers.
• Population demographic - social fabric and infrastructure.
• Changes to incidence and prevalence of specific illnesses,
long term conditions, learning disabilities.
• Policy landscape and changes in reporting e.g. KPI’s in
Health and Social Care.
• Strategic planning.
• Minimize an overreliance on outside experts as resources
and solutions to community issues.
• Fosters a sense of ownership and empowerment so that
community partners can gain greater control over their
• To manage demand according to priorities and ensure
critical processes run effectively.
Good Capacity Planning.
• Manage demand according to priorities
• Ensure critical processes run effectively
• Appropriate staffing and other resources
• Improved outcomes.
Poor capacity planning:
• Exhausted resources and shortages
• Low morale
• Poor quality outcomes
• Out of control costs
• Failed objectives.
1. Top down organisational approach.
2. Bottom up organisational approach.
3. A partnerships approach.
4. Community organising approach
(Crisp et al 2000)
• Policies and practices e.g. structure and function of an
• Systems and processes.
• Standards and procedures.
• Legislation – Health and Social Care Integration.
• Collaboration with other organisations
• Partnerships with third sector organisations
• Collaboration with other professional groupings.
• Community development.
• Processes and programmes run by members of the
• Using existing knowledge of your own areas of work –
health social care third sector – what approach would you
use to build capacity and why?
• Feedback to the group.
Some examples of capacity building:
• Health and Social Care Integration
• Collaboration with third sector organisations
• Lean methodology and process mapping to identify
blockages in the system of admitting elderly people to
acute admissions unit.
• Role development and introduction of new roles to
maximise capacity in community care.
Capacity building examples:
• Patient pathway development e.g. frailty to improve
process for admission.
• Widening participation in nursing and midwifery education
• Nursing 2030 vision (Scottish Government)
• Productive series – ward, community.
Capacity Building examples
• Workforce capacity planning model.
• Management and Leadership Development.
• Masters in Health and Social Care.
Leadership and Management
• Leadership and management skills have a positive impact
on health and social care systems capacity building.
Good leadership and management can facilitate change
within health and social care and can achieve better
services through efficient and responsive deployment of
people and other resources. ( Aroni 2012).
IHI (2018) Institute of Healthcare Improvement – Building
Improvement Capacity and capability, Healthcare Executive
Naccarella,L.,Greenstock,L., Brooks,P.(2012) A framework
to support team based models of primary care within the
Australian healthcare system. Med J Aus 2012;1.22-5.
health workers talk about capacity building in health
promotion programmes. Health Policy:39-29-42.
Aroni, A. (2012) Health Management Capacity Building. An
integral component of Health Systems Improvement. EHMA.
Horton, D., Alexaki,A., Bennet-Lartey,S.(2003) Evaluating
capacity development: Experiences form Research
Development Organisations around the world>The
Netherlands: International Service for Agricultural
Research(ISNAR)/International Development Research
Rifkin,S. (2003) A framework linking community
empowerment and health equity: It is a matter of CHOICE.
Journal of Health, Population and Nutrition. 21,168-180.
Crisp,B.,Swerissen,H.,Duckett,S.J. (2000) Four approaches
to capacity building in health: consequences for
measurement and accountability.
Health Promotion International Vol 15,No2.
We know that the ageing population is increasing , people living longer with the multiple co morbidities – when they become ill , when they require acute hospital care its usually for a longer period of time. Technology is advancing as is the cost and of course as is drug costs. Still feeling the effects of austerity measures across EU. Shortages of professionals and care workers –
Changes in modes of healthcare delivery, increasing reporting for key performance indicators within Health and Social care as means of proving tax payers money is well spent. All H&SC and community systems should hahve a strategic plan based on all the above … capacity building required for sustainability
And more of the same…
Top down – might begin by changing agency policies or practices – or legislation? Bottom up – developing staff and provision of new skills education etc Partnerships approach – strengthening the relationships between organisations. Community organising approach – individual community members are drawn into forming new organisations or joining existing ones to improve healtha dn well being of community members.