Co-production approaches to reducing health inequalities

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Co-production approaches to reducing health
inequalities

• Catriona Ness
• NHS Tayside

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Poverty and Health
Stress Lack of Direction Loss of Hope Learned
Helplessness
Health tends to decline in communities where
levels of interaction are low and where people
feel insecure (Smith Institute 2008)
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Changing roles Traditional service delivery
model

• Planners specify what the services will look
  like, procure them and then monitor the services
  using targets
• Practitioners assess need, ration resources and
  deliver services to passive recipients
• Users and communities are defined by what they
  lack and receive care based on how needy they are
  perceived to be

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Changing roles Co-production model

• Planners, Practitioners, Users/Communities
• All three have a role in assessing needs, mapping
  assets, agreeing outcome targets, planning
  allocation of resources, designing and
  delivering services, monitoring and evaluating
  impact
• Professional and experiential knowledge are
  valued and combined, everyones capacity is
  developed.
• Minimises waste by developing solutions with
  users
• Can often reduce costs by focusing on person-led
  community- involved services, relieving pressure
  on expensive specialist services

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Health Equity Strategy Communities in Control
This is primarily a strategy for investing in
community resilience, investing time and effort
in promoting social capital and community
enablement. We will primarily do this by offering
social responses to social problems. In
particular we will support co-production helping
people to plan services and to take back elements
of services which do not need to be delivered by
health professionals so that in total, services
are co-produced by communities and the NHS. This
promotes social capital - the importance of a
connected and caring society - over institutions.
In short we will ensure that our services promote
more patient and community enablement, not more
dependency on the NHS.
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Health Equity Strategy Communities in Control
The challenge is to work with communities, not
to find out what they want and then provide it,
but to enable them to take control and provide
their own solutions. Communities need to be
involved in the delivery of services, behaviour
change initiatives and solutions, as well as in
their design.
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NHS Tayside Health Equity StrategyCommunities
in Control

• Contributing to Health Equity within a
  generation
• NHS will utilise co-production as a means to
  build social capital
• Focus energy and resources on early years
• Focus greater effort on behavioural change
• Improve service access to areas of greatest need
  but ensure that this builds social capital not
  dependency
• Agree, with partners, measures of progress
• Build co-ordinated health intelligence

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Local experience/examples include

• Dundee Healthy Living Initiative
• Healthy Communities Collaborative PK
• - Older People/Teenage Pregnancy
• Healthy Happy Communities Angus
• - Focus on Alcohol
• - Young Families/Healthy Eating
• Time banking - Angus, Perth, Dundee
• Connecting Communities
• Equally Well -Social Prescribing

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Project Example The Family Nurse Partnership
(FNP)

• Changing the World One Baby at a Time

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Remit

• To share talents and skills in a mutually
  beneficial way.
• To make a positive difference in the local area.
• To promote community spirit.
• To establish and strengthen neighbourliness.
• To build bridges across social groups.
• To build trust in the community.

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PK Healthy Communities Collaborative
-Community-led Health
Equal and reciprocal partnership comprising
local people and professionals to effect changes
in communities and improve health care and
well-being
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The Benefits of Co-Production to the Healthy
Communities Initiative

• shares skills and workload
• builds community capacity
• promotes community led development
• reduces costs
• maximises efficiency

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Leading by Example

• Cash4Communities Innovation Fund

• 2 million from Endowment Funds
• Community led initiatives
• Enhanced social capital
• Innovative
• Direct or indirect impact on wellbeing
• 1k to 100k awarded.

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Enablers of Innovation Opportunity

• Top level support, strategic buy in
• but light touch
• Passionate, enthusiastic people good at
  communicating and inspiring
• Start with local people, develop trust respect
• Agility and ability to work around bureaucratic
  obstacles

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Challenges

• Culture Change our biggest challenge for NHS and
  throughout the public sector
• Time to build relationships learn together, plan
  together, deliver together
• Short term funding pilot-itis
• Courage-Public service leadership needs to learn
  to let go and build co-production into
  existing services

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• Chaired jointly by NHS Tayside and Scottish
  Community Development Centre (SCDC), and funded
  by Joint Improvement Team
• Aims to be
• A locus for building on existing co-production
  activity
• A space for learning, debate and development of
  ideas and approaches around co-production
• A forum for practice exchange, and sharing of
  information and resources
• And to supporting dialogue around emerging policy
  on delivering public services differently and
  advancing co-production approaches in Scotland
• Members meetings learning events national
  conference with JIT website with publications,
  resources, networking forum
• Sign up now! www.coproductionscotland.org.uk

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Any Questions