In the first of an occasional series of guest blogs Steve Tathata (currently working with the West Wakefield GP consortium) provides a compelling account of why neighbourhood-based community organisations are vital to the health and wellbeing of our district.
A thread running through the NHS Five Year Forward View is the need for the health service to adapt and evolve in order to meet the needs of the ‘demographic time bomb’. That means people living longer with complex and often multiple health issues, many of which are lifestyle related and preventable. A danger though is that the emphasis, energy and resources only go into providing health service responses to meet the anticipated demand. Of equal importance is the need to take prevention and self-care seriously with the aim of promoting health and reducing demand. People, even those who are estimated to place the heaviest demands on services, already self-care 99% of the time. They just don’t do it as well as they could. That’s why we’re going to be in a bit of a pickle. What can we do?
The Forward View presents an exciting opportunity for primary care to build and develop new models of care which are not only better able to comprehensively respond to the demands arising from ill-health but to also build health and wellbeing in communities. How might that be done? There is no single, simple answer and nor should there be if creativity and innovation is to be encouraged. But why not tap into a credible and established resource that already exists? Community Anchors.
Community anchors have been defined as “ independent community-led organisations. They are multi-purpose and provide holistic solutions to local problems and challenges, bringing out the best in people and agencies.They are there for the long term, not just the quick fix. Community anchors are often the driving force in community renewal” .
They’re about people.
If people are the heart of the community then community anchors are the lungs – breathing life, energy and opportunity into the lives of so many and often into the so many that need it most. Provided by the community for the community they are exemplars of community engagement and the doorway to the communities they serve.
Take, for instance, St George’s in Lupset, Wakefield www.stgeorgeslupset.org.uk where, if you were to make the time to visit, you would witness first-hand an example of a ‘cradle to grave’ Community Anchor that makes a positive difference to a great many people. Whether it be the Youth Cafe on a Wednesday, the Friday Lunch Club, the daily nursery or the variety of educational opportunities on offer you’ll find care, compassion and co-production in abundance. People from every generation working together and making a difference. Simple initiatives that provide opportunities for ‘togetherness’, reducing social isolation and building community capital. Structured courses providing education and growth and informal learning opportunities that build self-esteem, self-confidence and resilience, providing people with essential skills for life and living.
Places such as St George’s already draw on the ‘renewable energy’ of carers, volunteers and patients that the Forward View readily recognises as an untapped resource.
For example, just last weekend over 20 young people gave up their weekend to the give the nursery a makeover, with all of the materials and project support provided free of charge by Hybrid Training and VIY.
The difference the redecoration made to the building was instantly apparent but what was also evident was the difference the activity made to the people who did the hard work. The people who volunteered their time and energy. They felt good about doing it and wanted to do more. They felt good about themselves and the skills they didn’t realise they had and wanted to learn more. They felt good about the contribution they’d made and wanted to give more. It was a wonderful lesson on the power of investing in people and in a community.
When they took a break and a question was asked about what kept them well they didn’t say “ the health service“, this is what they said:
And when asked if they wanted to play a part in making more of that happen, without exception every person asked said they did. These are the very people who will defuse the potential demographic time bombs of tomorrow…if we invest in them now.
So much more could be done, together, to build sustainable health and wellbeing in and across our communities and Community Anchors and the people within them could have a valuable role to play in making that happen. But only if they’re supported to do that.
They don’t need lots of fancy words and ‘blue sky’ thinking, nor do they need nonsensical strategic papers or endless policies, procedures and consultation exercises. Most of all, what communities really don’t need is someone on the outside coming in and telling them what their vision for health and wellbeing should be and how to go about achieving it. Because they’re already doing it.
Hopefully, what the Forward View provides is the impetus for new partnerships to develop, built around the needs of the communities and provided by the communities. If we can start exploring, together, how we can build sustainable services, co-productive relationships and healthier communities then examples such as St George’s suggest there’s no shortage of people who want to play a part in that. What there’s often a shortage of is equitable opportunity to the financial resources to make things happen and on a long-term, sustainable basis. The greatest contribution the health service could make to the communities they serve then is to provide Community Anchors with the resources they need to do more of that which they’re already doing and doing very well. Help to create the environments for people and communities to flourish.
And as a bonus the Community Anchors provide an open door to working on at least two other topics of significance. A topic touched on in a previous blog – the enormous prevention agenda and also the workforce agenda. We need to work on prevention at the level that will make a difference. The personal level. Prevention needs to get personal because self-care is about individuals and about personal responsibility. People won’t come into services to be told about prevention. But they’ll talk about and explore the topic with their peers. The ability of peers to get personal is unparalleled because peers are usually speaking, and acting, from experience. They’re also in a position of trust, credibility and respect. Peer delivered opportunities allow people to learn with people who understand the position they are in and the path they are potentially heading down. Peer led initiatives open up exciting opportunities for addressing the need to develop ways of doing things differently, together with the roles to do that, because another time bomb on the horizon is the dwindling health and care workforce.
“So this Forward View sets out how the health service needs to change, arguing for a more engaged relationship with patients, carers and citizens so that we can promote wellbeing and prevent ill-health.”
Let’s not talk about it, let’s make it happen.