Event by the King’s Fund: Community is the best Medicine
Sophie Chester-Glyn • 9 October 2019
Making a reality of community-based health
The King’s Fund
is a leading think-tank and independent charity which holds regular health and social care events, shares research and commentary. Whilst the King’s Fund has traditionally focused on health-related topics, it is increasingly shining the light on leadership and community developments in social care. This latest event on community-led care and support is an example of this. We were lucky to attend. See our blog summary below.
The aim of this event was to share good examples of how communities were created and supported to maintain sustainable healthcare improvement to their citizens and to share the resulting outcomes achieved and capacity building.
After an introductory session, events at The King’s Fund are typically split up into break-out sessions. Whilst we weren’t able to attend all of these, here are our main take-aways.
The plenary session was chaired by The Kings Fund’s David Buck
(senior fellow specialising in public health and health inequalities). David pointed out that as a country we are living longer yet are less healthy. Whilst this is nothing new, the concept of population health is possibly a less familiar concept to non-health professionals. David reminded us that population health
is one of the key focuses of The King’s Fund’s work and concerns the intersection (see the purple section below) between health behaviours, systems, the wider determinants of health and communities. Today’s event was focusing on the latter.
Next, Professor Jane South, National Adviser on Communities from Public Health England, started us off with a look back at the reviews considering the benefits of assets within our communities. She reminded us of the literature over recent years, which builds up the academic and policy case for better community-centred approaches to improve health and reduce inequalities, such as:
- The Marmot Review – ‘Fair Society, Healthy Lives’
- Public Health England – ‘From evidence into action: opportunities to protect and improve the nation’s health’
- NHS – ‘Five Year Forward View’
- HM Government – Civil Society Strategy: Building A Future that Works for Everyone.
- National Voices – ‘New Model Partnership people and communities’
Her message was to consider how health benefits and services can be delivered ‘with’ rather than simply ‘to’ people.
Hot off the press! (well almost) is Jane’s announcement that Public Health England’s new publication for November 2019 on taking a whole system approach to community-centred public health.
For more detail on the topics covered in Jane’s talk visit:
Next up was Tony Cooke, Chief Officer at Leeds Health Partnership Team.
Tony was a talking point for much of the event as he married the theory and research of community work with the reality and outcomes for people in communities. With a focus on how socioeconomic and structural issues adversely impact the health of children and adults living in poverty, Tony introduced us to some interesting stats. These included the statistic that, in the area he covers, 1 in 5 children live in poverty and 76,000 households claim at least one welfare benefit. Therefore, the focus needed to be in improving the health of the poorest the fastest. Therefore, Leeds started to look at those in ‘isolated areas’ moving these areas out of adverse inequalities.
Fiona Flowers at Macmillan Local Area Partnership Programme (MLAPP)
Fiona introduced us to the way the MLAPP had driven coproduction in linking health and Clinical Commissioning Groups (CCGs). There were some fantastic examples here of coproduction and how to start, continue and complete coproductive ways of working such as:
- Coproduction working groups where all the professionals involved had to report to a coproduction governing group with experts by experience.
- Job specification and agreed ways of working coproductively within the group including terms of reference
- Mentoring facilitators
Zereen Rahman-Jennings continued this theme with a presentation on the work carried out by Tower Hamlet's Living with Cancer Programme with examples of how services were changed. See a YouTube video of a previous talk she did here. Zereen valued the benefits of mapping which assets there are within the community and how they interact. She surmised that coproduction can be messy. Her attempts to create a coproduction group initially resulted in an inability to get the same people in the same room on a regular basis to coproduce the project. She revealed that there is more success to be had with more informal processes of gathering interested individuals to develop.
One of the most interesting talks was by Ken Kanu. Ken is the Director of Help On Your Doorstep, an organisation aiming to improve the health and well-being of isolated people in Islington. For Ken, ‘the community is in a better situation to deliver services’. Through their ‘Good Neighbour Scheme’ (GNS) which was ‘hyperlocal’, co-ordinated by paid community workers and included resident involvement produced outcomes such as:
- 82% of people feeling happier, people feeling more connected and closer to others
- 79% felt their health had improved and
- 74% felt more connected with their neighbours.
During the afternoon workshop, we heard from Alex Fox from Shared Lives Plus, an organisation which supports people to care for people with care needs in their own homes. Alex revealed the important work TLAP
was doing around promoting coproduction, something they describe as shared living. He also posited a new way of empowering communities by switching the way power dynamics in service delivery are funded and provided to the community that needs support, rather than the top-down external services. He signalled to the work carried out by TLAP (Think Local Act Personal) in their rainbow diagram. Access this dynamic tool and understand who has signed up to and is using it here.
Alex shared that his new book ‘A New Health and Care System’ sets out an original alternative to the current care and health services systems with examples of how the Shared Lives model provides both humanity and care on a sustainable and scalable level.
Later, Kathy Martin, Strategic Impact Manager from Northern Ireland Community Development and Health Network, shared the importance of taking action on the social determinants of health.
Her work included supporting people across all of the determinants below, with a focus on pharmacy. Her work recognised the community standing of pharmacists and the network’s funding supported pharmacists to come away from the shop floor and into the community to work.
One of the final talks included messages from Ingrid Abreu Sherer, a Well-being and Civil Society Lead on, of course, well-being and Dr Tim Chadborn (head of behavioural insights at Public Health England) on the benefits of considering behaviours in health and social care.
Ingrid shared some insights, including some well-recognised information that childhood experiences, health and financial security are key determinants of well-being. She also enlightened the room with her take on how well-being changes over time, with middle age showing a key dip in life satisfaction.
Dr Tim Chadborn encouraged us to consider the myriad of actors within health and social care relationships and how their behaviours will be different across the system, such as volunteers, organisations and systems and how these may or may not contribute to improved social support. He introduced the idea of doing systems thinking from a behavioural perspective.
Snooping
We couldn’t help ourselves but to snoop around The King’s Fund library during our break. It turns out it’s pretty extensive – as you’d expect from a think-tank. Interestingly, we stumbled upon a book on patient involvement from back in 2003. It turns out coproduction and involvement really isn’t that new after all!
Overall, a fantastically informative day and as always, a wealth of information. Check out their website for more on The King’s Fund events, blogs
and publications. Their events come at a cost, but any which we attend, we will blog / tweet as always, for knowledge share and (of course) to open up the care debate!
Comment below in anything you found interesting in this conference summary and as usual feel free to share.
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