Groundbreaking initiative addresses antimicrobial resistance (AMR) and health inequalities affecting refugee and asylum seeker populations in Liverpool. Primary Care 24 (PC24) is a social enterprise delivering a range of urgent and primary care NHS services. In collaboration with the Liverpool School of Tropical Medicine (LSTM), PC24 spearheaded a programme which tackled both systemic barriers to healthcare and misinformation surrounding antibiotics. This service, co-produced and co-delivered by community members themselves, not only empowered marginalised groups but also laid the foundation for scalable, sustainable models of culturally competent public health intervention. It is rooted in the World Health Organisation’s ReCITE framework. The challenge The initiative emerged from a growing recognition that traditional models of healthcare delivery were failing newly arrived communities. Refugees and asylum seekers often faced linguistic, cultural, and legal confusion, particularly regarding their healthcare rights and the appropriate use of medications like antibiotics. These gaps in understanding posed a serious public health risk by contributing to the misuse of antibiotics and exacerbating AMR. Standard NHS messaging and clinical interactions had proven inadequate to address these layered challenges, underscoring the urgent need for an innovative, inclusive approach. How the service was developed and co-designed To address these gaps, the service was carefully co-designed and delivered over four structured phases. The initial phase focused on identifying target communities and establishing trust through relationship-building. Community champions, trusted individuals from within refugee and asylum seeker populations, were recruited and trained to support all stages of the programme. Their role as cultural navigators and educators was vital to overcoming barriers of language, mistrust, and social exclusion. In the second phase, they helped co-design and administer surveys that captured baseline knowledge and attitudes around antibiotic use and AMR, ensuring the data was community-led and representative. Insights from this research led directly into a creative, multilingual education campaign during phase three. A short film and a suite of illustrated, accessible leaflets were produced in five key languages, narrated and presented by the champions themselves. These materials were not only linguistically inclusive but emotionally resonant, building familiarity and trust. Champions then hosted screenings, facilitated discussions, and led workshops at community centres, faith institutions, and other local gathering points. Scroll down for details of the programme’s evaluation, innovation, impact and scalability. The final phase focused on evaluation Follow-up surveys and interviews showed a significant shift in knowledge and behaviour, with community members demonstrating better understanding of antibiotic use and reduced confusion around prescriptions. Healthcare professionals also reported more effective consultations, fewer misunderstandings, and more appropriate use of antibiotics among refugee patients. Innovation The innovation at the heart of this programme lies in its community-first design. Rather than delivering messages top-down, it empowered refugee and asylum seeker communities to educate and lead from within. This approach achieved measurable outcomes: enhanced health literacy, better public health outcomes, and a reduction in health system strain caused by antibiotic misuse. Impact Key metrics underline the project’s success: over 1,000 community members engaged, documented increases in appropriate antibiotic knowledge, and improved clinical interactions as reported by frontline staff. Perhaps even more significantly, the programme’s success led the Home Office to invite PC24 to co-lead a mental health screening pilot for asylum seekers, indicating national-level policy influence. This approach aligns directly with key government priorities including reducing health disparities, tackling AMR, and supporting sustainable, community-based healthcare models. It promotes inclusive economic participation and enhances the capacity of public services through community leadership. How to scale this more widely Policy changes that could help scale this innovation include more flexible funding for co-produced community health interventions, official recognition of lived experience roles within NHS commissioning frameworks and strengthened mandates around cultural competence training for healthcare providers. “Before, people didn’t know how to get help or whether they even could. Now, they come to us, not just for information, but because they trust us. We’ve become bridges between our communities and the NHS.” Testimonial from one community champion. Policymakers, take note: Investing in community-led models isn’t just compassionate, it’s cost-effective, scalable, and transformative. PC24 and LSTM have shown that when people are empowered to lead change from within, public services become more effective for all. What next? • More case studies of social enterprise innovation
Groundbreaking initiative addresses antimicrobial resistance (AMR) and health inequalities affecting refugee and asylum seeker populations in Liverpool. Primary Care 24 (PC24) is a social enterprise delivering a range of urgent and primary care NHS services. In collaboration with the Liverpool School of Tropical Medicine (LSTM), PC24 spearheaded a programme which tackled both systemic barriers to healthcare and misinformation surrounding antibiotics. This service, co-produced and co-delivered by community members themselves, not only empowered marginalised groups but also laid the foundation for scalable, sustainable models of culturally competent public health intervention. It is rooted in the World Health Organisation’s ReCITE framework. The challenge The initiative emerged from a growing recognition that traditional models of healthcare delivery were failing newly arrived communities. Refugees and asylum seekers often faced linguistic, cultural, and legal confusion, particularly regarding their healthcare rights and the appropriate use of medications like antibiotics. These gaps in understanding posed a serious public health risk by contributing to the misuse of antibiotics and exacerbating AMR. Standard NHS messaging and clinical interactions had proven inadequate to address these layered challenges, underscoring the urgent need for an innovative, inclusive approach. How the service was developed and co-designed To address these gaps, the service was carefully co-designed and delivered over four structured phases. The initial phase focused on identifying target communities and establishing trust through relationship-building. Community champions, trusted individuals from within refugee and asylum seeker populations, were recruited and trained to support all stages of the programme. Their role as cultural navigators and educators was vital to overcoming barriers of language, mistrust, and social exclusion. In the second phase, they helped co-design and administer surveys that captured baseline knowledge and attitudes around antibiotic use and AMR, ensuring the data was community-led and representative. Insights from this research led directly into a creative, multilingual education campaign during phase three. A short film and a suite of illustrated, accessible leaflets were produced in five key languages, narrated and presented by the champions themselves. These materials were not only linguistically inclusive but emotionally resonant, building familiarity and trust. Champions then hosted screenings, facilitated discussions, and led workshops at community centres, faith institutions, and other local gathering points. Scroll down for details of the programme’s evaluation, innovation, impact and scalability. The final phase focused on evaluation Follow-up surveys and interviews showed a significant shift in knowledge and behaviour, with community members demonstrating better understanding of antibiotic use and reduced confusion around prescriptions. Healthcare professionals also reported more effective consultations, fewer misunderstandings, and more appropriate use of antibiotics among refugee patients. Innovation The innovation at the heart of this programme lies in its community-first design. Rather than delivering messages top-down, it empowered refugee and asylum seeker communities to educate and lead from within. This approach achieved measurable outcomes: enhanced health literacy, better public health outcomes, and a reduction in health system strain caused by antibiotic misuse. Impact Key metrics underline the project’s success: over 1,000 community members engaged, documented increases in appropriate antibiotic knowledge, and improved clinical interactions as reported by frontline staff. Perhaps even more significantly, the programme’s success led the Home Office to invite PC24 to co-lead a mental health screening pilot for asylum seekers, indicating national-level policy influence. This approach aligns directly with key government priorities including reducing health disparities, tackling AMR, and supporting sustainable, community-based healthcare models. It promotes inclusive economic participation and enhances the capacity of public services through community leadership. How to scale this more widely Policy changes that could help scale this innovation include more flexible funding for co-produced community health interventions, official recognition of lived experience roles within NHS commissioning frameworks and strengthened mandates around cultural competence training for healthcare providers. “Before, people didn’t know how to get help or whether they even could. Now, they come to us, not just for information, but because they trust us. We’ve become bridges between our communities and the NHS.” Testimonial from one community champion. Policymakers, take note: Investing in community-led models isn’t just compassionate, it’s cost-effective, scalable, and transformative. PC24 and LSTM have shown that when people are empowered to lead change from within, public services become more effective for all. What next? • More case studies of social enterprise innovation