Category Archives: Realising the Value

What can healthcare commissioners do to get everyone involved with health and care in their own communities?

The need for community-based approaches to give people a real and effective voice in their own health and wellbeing needs has been validated and given greater weight by the NHS Five Year Forward View and its recommendations under Next Steps to utilise those assets as a catalyst for change.

Realising the Value has drilled down to provide the evidence of the validity of these approaches and is a call to action to make it happen.

All well and good, but it’s our contention as authors of Commissioning for Community Development for Health that there are many decision-makers in the health system who want to strengthen community action, but have no model for how to start going about it.

We wanted to produce a research-based publication that addresses this need and provides a framework for action, starting in priority neighbourhoods.

It offers a systematic approach to increasing resident involvement in health-giving activity, mutual aid and community effectiveness across a CCG area, and provides the tools to get it going.

It offers:

  • a down-to-earth explanation of what community development is and does
  • where it fits in to current health policy
  • the kinds of health benefit that these methods can generate
  • a rationale for partnership with other local services to boost community activity
  • mobilising participation through all community groups and networks
  • addressing both health and care and the social determinants of health
  • making services more responsive to communities
  • designing a two to five year community strengthening strategy
  • phasing the work across the CCG, starting with priority neighbourhoods
  • what skills should be sought in recruiting project leader and staff
  • model contract for provision of the community development project
  • model baselines, milestones and key performance indicators
  • reconciling planned outcomes and objective evaluation with scope for flexible fieldwork method.

The Handbook closely reflects C4CC’s own 3Cs. So we are proud to help spread the message to a wider network.

It has also been endorsed by the Royal College of GPs and Think Local Act Personal (TLAP). support we obviously welcome.

But our work does not end with its publication and we are offering introductory seminars and practical workshops to commissioners and others keen to learn more.

As well as explaining the key concepts and instruments and looking at case studies, these can be tailored to particular audiences, priority local issues and participants’ needs.

Contact gabriel.chanan@talktalk.net or brianfisher36@btinternet.com for more details.

 

Realising the Value: four months on

Last November, the Realising the Value programme launched its final reports. The programme aimed to enable people to take an active role in their own health and care, in support of the NHS Five Year Forward View vision to develop a new relationship with people and communities. This was an 18-month programme funded by NHS England and led by Nesta and the Health Foundation, working with Voluntary Voices (made up of National Voices, NAVCA, Regional Voices and Volunteering Matters), the Behavioural Insights Team, PPL and Newcastle University.

Over 18 months we strengthened the case for change and identified evidence-based approaches that engage people in their own health and care. We have:

● Drawn together and consolidated the evidence base
● Developed an economic tool for commissioners
● Created tools to support behaviour and culture change
● Explored the value of individuals and communities in their own health and care
● Pulled together a catalogue of practical lessons from local areas putting this into practice
● Assessed system change levers and drivers
● Set out ten actions to put people and communities at the heart of health and wellbeing.

We also worked with five local voluntary, community and social enterprise sector organisations that are exemplars in the field – Positively UK, Penny Brohn UK, Big Life Group and Being Well Salford, Creative Minds, and Unlimited Potential with Inspiring Communities Together. The understanding brought by our local partner sites has informed all aspects of the Realising the Value programme.

Now is a good opportunity to review the look back on the work we have done. There are some great numbers:
● Over 18 months we engaged more than 600 people directly through a series of programme events at key points, including our two final launch events in London and Manchester.
● We’ve had a lot of interest in our reports and publications. To date there have been more than 15,000 unique downloads of our reports.
● The online reach of our outputs has been significant. The Twitter hashtag #realisingthevalue had more than 4,000 mentions reaching over three million people. There have also been 26,000 views of more than 30 Realising the Value blogs

Behind these high level statistics there are some wonderful stories that have informed the way we think about what good health and care looks like.

Like Mark, who has lived with poor mental health over nearly 40 years and, through getting involved in a local football team, is now driven by an intense drive to make life better, for himself and others.

And Alex, a 41-year-old father of three, for whom a local project to promote the importance of fathers’ wellbeing and the impact it has on their kids has has brought clarity to his life.

We want these stories, and our work, to continue to inform and shape debate and action. And we are already seeing early signs that the tools developed through the programme are being picked up and used on the ground. We have spoken to a number of CCGs who are using the economic tool to inform their business planning, as well as voluntary organisations using it to inform their conversations with commissioners. And there have been more than 5,000 downloads of the two behavioural insight guides to date.

And we are seeing signs of Realising the Value informing broader policy-making. For example, the Director of Patient and Public Involvement and Insight at NHS England, Anu Singh, has said that,

“Realising the Value has formed the blueprint for NHS England’s new Supported Self Care programme”.

Dr. Alf Collins, clinical lead, person centred care, NHS England, has said,

“Thanks to the work of the Realising the Value programme, we can now see a structured approach to supported self-care that is based on evidence and practical examples. Given this evidence, NHS England is committed to providing leadership for the NHS to engineer Realising the Value principles and practice into the way it works. In short, putting in place Realising the Value will go a long way towards delivering the vision of Chapter 2 of the Five Year Forward View.”

Jon Rouse, Chief Officer at the Greater Manchester Health & Social Care Partnership, has said that he has, “taken learning from the programme directly into the development of our Population Health Plan and our work on integration of health and care services.”

A huge amount of work has gone into the programme, and it’s fantastic to see the impact the work is already having across the system. We hope this provides a solid foundation on which we all need to build. We are now in a much better place to understand what should be done and how people need to work differently to put people and communities at the heart of health and wellbeing.

C4CC’s Reflections on Realising the Value

When it comes to transforming health and care, there are countless toolkits, guidance documents, and resources that provide information about what should be done and what could be done. There are numerous legal duties that set out what must be done. There is a growing abundance of evidence generated from what has been done. And there are plans about what will be done.

This can be overwhelming at times, but the wealth of information and conversation over recent years has led to a level of consensus about the fundamental shifts we need to achieve, that suggests that now might just be the right time to pursue and realise the ambition.

“More stars are aligned to this agenda this time, let’s make it happen,” RtV presenter at regional event.

The Realising the Value (RtV) programme has made a significant contribution to this sense of alignment and possibility. In bringing together much of the outspread evidence, strengthening the case for change and pointing to the breadth of behavioural, cultural and systemic change that would be needed to achieve the transformation, the programme marks a watershed in our approach to health and wellbeing, validating the community and person-centred approaches that are being championed by C4CC and its partners.

C4CC is committed to working with its partners and other key stakeholders to ‘become clearer about the difference that these approaches make to people’s own health and wellbeing and to the wider system (page18 ten key actions doc)’ and bring about the fundamental changes that are needed to enshrine these ideas into the mainstream.

We know that it’s not about re-inventing the wheel, but making the best of assets that are already in place and utilising them in coherent and sustainable plans. Our coalition is a diverse and vibrant partnership that spans disciplines and sectors and reaches into the complex networks of changemakers at local, regional and national levels.

Together we have articulated the enablers to change as the ‘three Cs’; better conversations, coproduction and community development. Through collaboration at a local, regional and national level we will:

  • Support the ‘do-ers’: increasing their awareness and understanding of the ‘three Cs’; building consensus about what the ‘three Cs’ mean in a particular place and to different groups; and, improving the knowledge, skills and capacity to do or deliver the ‘three Cs’.
  • Create the conditions: supporting the development of behaviours, practices, systems and cultures that will sustain the transformation being sought.

Change can happen in many different ways. The implementation of person and community centred approaches will be configured differently, will be experienced differently and will produce different results in different areas and for different people. Our challenge will be in developing the adaptive capacity of people, communities and systems to ensure that the changes can be sustained long term and become the norm.

All the evidence and resources produced as part of the Realising the Value programme can be found here. If you would like to get in touch with the team, you can email health@nesta.org.uk

To follow the work of the Coalition for Collaborative Care, you can join us, free of charge, as a member here, subscribe to our newsletter here and follow us on Twitter here.