NHS & Community Health Partnerships
The Silas Mkoba Foundation works alongside health, social care and community partners to provide early, community-based support for people and families experiencing bereavement, loneliness, long-term illness, caring responsibilities and wider social difficulties.
Our approach is to listen early, identify concerns, provide practical and emotional support, connect people with appropriate services and follow up where appropriate.
Our aim is to help people remain well and supported in their communities and reduce the risk of difficulties escalating into crisis.
Community Social Responders (CSR)
Supporting people beyond the point of discharge
Our prevention approach
Notice early → Listen → Support → Connect → Refer → Follow up
Our Community Social Responders provide early, community-based support to people who may be vulnerable following illness, hospital discharge, bereavement, mental health difficulties, loneliness or other challenging circumstances.
We recognise that being discharged from hospital does not necessarily mean that a person feels ready to manage everything alone.
Our role is to help people feel supported mentally and emotionally, reduce isolation and identify concerns early.
After hospital discharge
Where appropriate, our Community Social Responders can:
Check in with people after they return home.
Provide a listening ear and emotional support.
Help reduce loneliness and isolation.
Identify concerns that may need further attention.
support after hospital discharge
mental and emotional support
quick referral when needed
reducing isolation for people with mental health difficulties
inviting people to Foundation events
encouraging mingling and community connection
Refer or signpost quickly to appropriate services when additional support is needed.
Encourage people to reconnect with their community.
Invite people to appropriate Foundation events and activities to encourage social connection and positive interaction.
Follow up where appropriate to help people remain connected and supported.
Supporting people experiencing mental health difficulties
For people living with mental health difficulties, isolation can make recovery and wellbeing more difficult.
Our approach is to encourage connection rather than leaving people alone with their difficulties.
Where appropriate, we can provide companionship, encourage participation in community activities and invite people to our events, creating opportunities to mingle, build relationships and feel part of a community.
We do not replace clinical mental health services. Where someone needs specialist or urgent help, we support them to access or reconnect with the appropriate professional service quickly.
Our aim is to help people stay connected, supported and safe in the community, while helping ensure that concerns are identified and referred appropriately before they become more serious.
Who we support
Our Community Social Responders support people who may be vulnerable, isolated or struggling to cope in the community, particularly following illness, hospital discharge, bereavement or other difficult circumstances.
We can support people who may need someone to listen, practical encouragement, help to reconnect with their community or support to access the right services.
We work alongside existing health, social care and community services. Our role is not to replace professional or clinical services, but to provide early, compassionate support and help people connect with the appropriate help when needed.
Our community-based role
Early listening and identification of concerns
Emotional and practical support
Reducing loneliness and isolation
Encouraging community connection and participation
Signposting and referral to appropriate services
Following up where appropriate