This report summarises the learning from a development programme which established six communities of practice in different locations across England whose aim was to improve front line collaborative responses to people facing multiple needs and exclusions, such as drug and alcohol dependencies, mental health problems, experiences of homelessness, domestic violence, local authority care and the criminal justice system.

Communities of practice provide a vehicle for brokering knowledge and social relationships between different groups of practitioners thereby opening up the potential for interdisciplinary learning and more collaborative or collegiate ways of working. In setting up a community of practice the aim is to provide a safe venue for people to listen, reflect, receive feedback on processes of care, to tune their competencies collaboratively to new evidence and circumstances, and to try out small changes that encourage innovation. Communities of practice have been used in a wide range of independent and public sector settings and are a close relative of ‘managed clinical networks’ in the NHS.