Community Centres: a guide to using them – how citizens can make their voices heard

Not merely service users in need of support, but individuals called upon to contribute to the design, delivery and even evaluation of services. This is the shift in perspective outlined in the document by Agenas – the Agency for Regional Health Services – on participation and co-production in Community Centres, as highlighted in the update of 11 September 2026, following the final approval of the text on professional multidisciplinarity on 8 September. The new text translates one of the mandatory organisational standards of Ministerial Decree 77 into operational guidelines: community participation and the promotion of co-production in hub-and-spoke centres.

A Community Centre should not, therefore, merely bring together clinics and professionals, but should become a place where the local population helps to define needs, priorities and solutions. According to Agenas, participation takes place at several levels: information, consultation, active participation and empowerment. The extent to which citizens are involved in decision-making varies at each level: citizens can be involved throughout the entire process, from identifying needs to designing services, right through to evaluating the results.

Community centres must explain what services they offer, how to access them, which professionals work there and what support pathways are available. The guidance is to use not only digital tools, but also helpdesks, printed materials, the local press and public meetings. Particular attention should be paid to foreign nationals, older people, those with digital difficulties and vulnerable groups. The new local support service risks being ineffective if citizens do not know what the centre has to offer and how to use it.

Citizens do not merely receive information; they are listened to. Agenas organises questionnaires, ‘suggestion boards’, permanent round-table discussions, citizens’ juries, town meetings and health forums. The organisation should explain in advance the weight that will be given to the feedback gathered and then report on how opinions and proposals have influenced decisions. This is a step towards ensuring that participation is not reduced to a mere bureaucratic formality.

Patients, carers, organisations and communities can be involved in jointly setting priorities, jointly designing services and care pathways, jointly delivering certain activities, and jointly evaluating outcomes. The document suggests that citizens and organisations should be involved from the very outset of the Community Centre’s establishment in identifying local needs and designing services. The patient’s ‘experiential’ knowledge is thus combined with the technical expertise of professionals. This collaboration can also extend to the management of certain activities: reception and guidance desks run in partnership with organisations, transport to healthcare facilities, therapeutic education groups and support for adherence to treatment, as well as initiatives involving patient experts and community support workers. Agenas also highlights ‘social prescription’, that is, connecting individuals with social and community resources that contribute to their wellbeing.