Our Health Partnerships Strategic Manager, Richard Boggie attended the Boost Neighbourhood Health Learning Conference in June and shares his reflections on the key themes and concepts emerging from the day.
There was lots of ideas, learning, opinions and challenges shared at this event. In this reflection, I will try to draw out some of the key themes/concepts that seemed to emerge. The day ended with workshops aimed at identifying key actions to take forward, reflecting on what we had heard from the excellent speakers. Thankfully, there was good representation from the VCSE sector in the room, as well as colleagues from the Integrated Care Board (ICB) and NHS.
Leadership Insights
Andy Brooks, a GP and leader at the National Association of Primary Care (NAPC), a national not for profit organisation leading the development of primary care and integrated care models across the UK, reflected on the type of leadership that is needed for successful neighbourhood systems working. He emphasised the need for curiosity and listening – acknowledging that the professionals and leaders do not have all the answers, and that collaboration and humility are key. He spoke about leaders listening more to people about their needs and priorities, and persevering through the chaos that inevitably comes with changing complex systems.
Using data to target work
We then heard from Ben Anderson, Director of Population Health at the North East and North Cumbria (NENC) ICB, on the topic of Population Health Approaches to Neighbourhood Health.
He shared some of the data and methodologies being used to inform ICB thinking and planning. He emphasised the power of the available data to get a rich understanding at a hyper-local level, understanding what types of disease neighbourhoods are living with and dying from, and how these vary across different communities sharing certain characteristics such as age, ethnicity, disability.
This approach is enabling the ICB to gain a very granular picture at neighbourhood level, identifying the key risk factors and designing services and interventions to address these. He also emphasised the need to look at who was not in the data – which groups are missing from records , or who have incomplete health information. What practical changes can we make through the neighbourhood health model to better reach and support these groups?
Neighbourhood Health in Action
Delegates then heard from the two Neighbourhood Health pilots in the NENC region – Stockton and Sunderland – about how they are using new approaches to radically change delivery models to better meet the needs of communities. In Sunderland, they have been applying new, multi-disciplinary, GP-led acute frailty services to encourage prevention and reduce admissions.
Their pilot offers useful learning for others:
- Be honest about the shift you’re trying to make
- Ensure resources match the ambition
- Start with one cohort and prove it works
- Form follows function
- Align money early
- Invest in local Business Information and analytical capabilities
- Focus on integration
- Expect non-linear progress
See me, not my labels
Following this, there was a much-needed shift of tone, as we heard from Glyn Butcher, an expert by experience and a Director at the charity, People Focused. Glyn reminded the room of the importance of understanding people on their terms, and treating people as people, not a list of diagnoses or conditions. I think he summed it up beautifully when talking about neighbourhood care as helping people to do the things they love, with the people they love, in the places they love.
Power to the people!
Dr Simon Duffy, Citizen Network, then shared his experiences and reflections from his work in Sheffield. There, citizens were involved in mapping their own neighbourhoods and came up with 147 – a pleasing outcome for the home of the world snooker championship. The average size of these neighbourhoods was 4,200 – much smaller than the 30-50,000 people suggested in neighbourhood health plans.
He encouraged us to look at this as an opportunity to involve and empower communities, who hold the real power to improve socio-economic determinants of health. He also suggested that most money spent on health and care does not land in the communities it is for, but passes through, and neighbourhood health is an opportunity to redesign services so that more resources and investment stays within the neighbourhoods, strengthening community assets and resilience.
In Summary
The ICB’s Boost team hosted a very stimulating event with lots of food for thought. Clearly, moving to neighbourhood health working presents a lot of challenges – starting with what we mean by neighbourhoods, and how we achieve real integration of services. But there does seem to be acknowledgement that a more people-centred approach is required, doing with people rather than to them. This is evident from the pilots and case studies presented and there is good evidence that it works. The VCSE sector is therefore a critical partner in delivering this new way of working – it is essentially what many organisations have always done, working closely with people in their communities, to improve their lives.
Hopefully, this will be one of many regional and local events and conversations involving system partners so that new models of neighbourhood health are shaped with the insight and expertise that the VCSE sector has to offer.