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Health Creation Alliance Newsletter Spring 2020

Welcome to your newsletter. This edition focuses on our response to COVID-19,  updates our members on the recent Primary Care Network Workshops and reviews our Power Shifting Tools. In addition, we provide an update on our media and social media activities, including how we have been advancing your on-line movement.

We hope you enjoy reading your newsletter. If you have any feedback, please don’t hesitate to contact us.

Merron Simpson                   Brian Fisher
Chief Executive                    Chair

CALL FOR CONTRIBUTORS

Given NNHSA’s cross sector and multidisciplinary membership and reach, we believe we are well placed to capture our member’s thoughts, views and experiences of dealing with COVID-19 over a period of time, or at a single point of time only.

We will collate and analyse this information to enable us to share our members experience, while identifying the key learnings we can adopt in the coming years.

Whether a one-off, occasional or weekly submission, we would welcome contributions, in any format, that enables you to express your thinking, feelings and learnings e.g. written, photographs, clippings from a paper, a mobile phone video, a telephone message, or a series of tweets.

We very much hope you will be able to support this project.

If you are interested, please drop an e mail to Neil McGregor-Paterson, Director of Communications: neil@realitasconsulting.co.uk

Online platforms supporting our movement 

Health Creation Alliance is a movement that, with our members, has been driving action to address health inequalities through Health Creation. We achieve this by helping to organise the strengths and energy that are already there in a community towards this goal.

In support of this, we recognise the power of digital in enhancing our work, while complementing our more traditional approaches to engagement. The diagramme below, and the reports that follow, provide an overview and update on how we are achieving this.
Please don´t forget to follow us on twitter @NHSAlliance

Health Creation Alliance Digital platforms

 

First Health Creation Forum
Tuesday 7 April | 12:30-13:30

The first Health Creation Digital Forum was held on Tuesday 7 April. Attended by 17 members, the forum provided an opportunity for members to share their experience and learnings on dealing with Coronavirus.

Key discussion points included:

  • Clinical staff have largely been redeployed to the COVID19 response
  • Communities are stepping up and barriers have disappeared, most notably much of the bureaucracy associated with community-led working
  • There are issues about reaching isolated people, especially people who can’t get online or are uncomfortable with digital. Off-line approaches to engagement and targeted support are critical
  • Coronavirus is increasing inequalities
  • The sheer volume of information on Coronavirus can overwhelm people
  • Working with vulnerable communities while people are in social isolation requires new ways of working; do we know who the vulnerable people are?

Finding new ways of working included:

  • ‘A right to contact’ (in public policy) – having someone you people can relate and turn to … a ‘right to the opportunity to have contact’ with someone
  • Contacting all tenants/patients and connecting them with community groups
  • Community strengthening activity – Where communities are strong and people know each other, they are more resilient

Universal broadband, support to get older people online?

Join us on Tuesday 21 April at 12:30 for the next Digital Forum

We will start the Forum by debating: 

What new practice has emerged where mobilised communities are operating in new ways at the boundaries of the formal health and care system, and what can we learn from these?

For example, the community stepped up to look after a patient with an existing heart condition when the clinician was taken away to focus on COVID-19 patients

Look out for the updated invite to this Forum and all other Forums to the end of June.

Coming soon – Health Creation WhatsApp Group
In the coming weeks we will be launching a Health Creation WhatsApp Group. Our aim is to stimulate discussion and debate and to support our members engage with others in the fight against health inequalities through Health Creation.

Watch this space!

A North Yorkshire Health Creation Movement meeting

On Thursday 24 April, the second meeting of the NNHSA North Yorkshire Movement was held. Established by our active member, Lisa Holden, the first meeting was held on 14 February 2020.

The focus of the meeting was COVID-19 and the local community response to supporting vulnerable people in the region. This includes establishing the Ryedale Community Service Organisation to bring together the resources and energy of key community partners who are experienced in the development of volunteer support and management.

A key output of the meeting was an agreement to explore a new cross-sector collaboration, the aim of which is to capture and learn from North Yorkshire’s community response to COVID-19.

If you are interested in establishing your own regional movement, please let us know.

Primary Care Networks and Health Inequalities – event series

Workshop in Manchester

It was great to see so many people at our events in February looking at the question ‘How can Primary Care Networks succeed in reducing health inequalities?’

Key findings/learnings from our events series include:

  • Primary Care Networks (PCNs) need to include education, housing, probation etc …
  • Actual resources need to be invested in ‘integration’, otherwise it won’t happen
  • Primary Care Networks must focus on healthy relationships; between household and community members
  • ‘Community DJs’ (people with skills in community development) can enable integration between professionals and professionals, communities and professionals, communities and communities.
  • There is enough evidence and guidance to act, but there is also an ‘inverse evidence law’
  • ‘Radical kindness’ is needed to make the transformation happen
  • The DES Contract needs to support culture change, not a tick-box culture
  • New roles in PCNs must include non-clinical roles just as Community Development

Unfortunately, the final event had to be postponed. We are looking with partners at how best to capture and spread the key insights in a post-COVID-19 world.

Thank you to all or sponsors and partners, without whom this series would not have been possible.

NNHSA opinion published in The Times Future of Healthcare Supplement

A joint article by Merron Simpson, CEO and Dr Brian Fisher, Chair published in The Times Healthcare Supplement on 10 March makes a strong case for a properly funded multi-disciplinary Social Health Service with communities as equal partners and Health Creation at its core:

https://www.thehealthcreationalliance.org/wp-content/uploads/2020/03/Times-Supplement-Health-Inequalties.pdf 

And here is our formal response to the Marmot 10 years on report:

https://www.thehealthcreationalliance.org/wp-content/uploads/2020/02/NNHSA-statement-Marmot-Review-10-years-on-response-FINAL.pdf

And a blog from Dr Brian Fisher who considers how the pandemic has demonstrated the power of community action in Health Creation: https://www.thehealthcreationalliance.org/category/blogs/

How to shift power – new resources from NNHSA 

An unhealthy power dynamic between formal services and the people they serve is now understood to be a key factor behind entrenched and enduring health inequalities.

Health Creation Alliance produced a set of ‘power tools’ for Greater Manchester Health and Social Care Partners. We are now making them more widely available as a free resource to help busy leaders throughout the health, care and community sectors to practice ‘power-shifting’ within their day-to-day situations. 

The Power Deck and Power Narrative are now available for you to download and use for free. Please click here: https://www.thehealthcreationalliance.org/power-shifting/ 

If you would like to find out more about our Discovery Learning Programme – that helps organisations and systems both to shift power and to embed Health Creation throughout all aspects of their practice, please email: Peter Hay peter_hay@btinternet.com or Merron Simpson merron@newrealities.co.uk for an informal conversation.

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Community lessons from The Coronavirus Pandemic

Brian Fisher, Chair, Health Creation Alliance

Have you been participating in the online experiences that have mushroomed in response to the pandemic? Have you been clapping for carers? Have you been contacted by a local group, perhaps offering support to collect food and medicines?

The astonishing outpouring of community solidarity, compassion and practical support has brought people together, encouraged confidence, and helped people take more control over their lives and their areas. These initiatives are undoubtedly life-saving in some instances, keeping people in the community when there would otherwise have had to have been an institutional response.

The pandemic has demonstrated the power of community action in health creation.

This insight is not new, but it may not have been so evident before, certainly not so evident to planners and decision-makers in the NHS. The pandemic is also taking us beyond what we knew before. We have long known that bringing people together, strengthening ties within communities, supporting people to collectively identify the issues that matter to them and then supporting them in finding solutions, in collaboration with the statutory sector – all that has a huge benefit to health. In fact, that face to face community action is about as beneficial as stopping smoking. It promotes both physical and mental health at all ages.

What this pandemic has taught us is that this benefit probably extends to non-face-to-face contact as well. The evidence on this point has never been clear. Actually, there has been little research on that at all. We can now see that any kind of benign contact can be health-enhancing.

Health is not just an individual, but also a social process.

We have made so many things happen in the last few weeks, with government’s recognition of the importance of society and the investment needed into the state sector. We must commit to embedding these insights. A healthy society requires a healthy state.

The NHS must now work with Local Authorities to make sure that every layer of out of hospital NHS provision is geared to support building community capital, community solidarity . There are many ways of doing this, but a common route is some form of health creating community development. This approach has a long pedigree.

Community development is an essential part of creating health

Community development is a technique that, at it’s best, helps people, usually in a geographical area, to identify the issues that matter most to them. The approach then supports them, often with the statutory sector, in finding solutions that work locally. It is the building up of control that is the key to health creation.

There are examples of community development in many different sectors across the country over many years. Now we need to recognise this activity as an essential part of creating health to understand what works and why and recognise this activity as an essential part of creating health. We need investment into communities to enable development of a systematic approach that enables each community to make it their own, tailored to their area and their communities. We know that that approach builds relationships and builds trust and also has impacts on health inequalities.

When our physical distancing ends, let’s make sure that our social approach shrinks distancing and builds a more human, community approach to keeping us well.

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Health Creation Alliance statement in response to Marmot Review – 10 years on

The latest Marmot Report “10 years on” makes dismal reading.


It shows that government has not prioritised health despite the concerning trends during the austerity years. Increases in life expectancy and years in good health have stalled for many. These trends show sharp inequalities: the more deprived the area the bigger the drop in life expectancy and years in good health.

Healthcare provided by the NHS only accounts for approximately 10% of a population’s health: https://www.health.org.uk/blogs/health-care-only-accounts-for-10-of-a-population’s-health. The other 90% of health is created through a social process that happens in people’s homes, neighbourhoods, workplaces and wider networks. The solutions lie outside the NHS even more than they do within it and it’s time public policy and fiscal management recognised this.


Health Creation Alliance agrees with all of Sir Marmot and his team’s recommendations, but we would go further.

The Review emphasises that, to tackle inequality, our society needs to enable all children, young people and adults to maximise their capabilities and have control over their lives. At the same time, we must create and develop healthy and sustainable places and communities.
Now is the time to develop of a properly funded, cross-sector ‘Social Model of Health’ to improve health and reduce health inequalities in the community. This needs to be everyone’s job – all sectors and communities themselves – and it needs to have Health Creation at its core.

About Health Creation and the 3Cs
• To be well, people need sufficient Control over the circumstances of their lives, meaningful and constructive Contact with other people, Confidence to take action with others to make improvements. People who fall below the required threshold will struggle in life and experience worse health outcomes. Enabling people to increase our levels of control and confidence, through meaningful and constructive contact with others, keeps us as healthy and productive as possible.

It also helps tackle health inequalities. Control, Contact and Confidence are the 3Cs of Health Creation.

• See our Manifesto for Health Creation here: https://www.thehealthcreationalliance.org/wp-content/uploads/2018/11/A-Manifesto-For-Health-Creation.pdf

• This ‘Manifesto for a Health Creating Society’ to which Health Creation Alliance is a signatory takes a broader approach that also makes a case for a ‘social model of health’: See https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31801-3.pdf and


Other recent Health Creation Alliance documents setting out our position

• Manifesto for a New Government: https://www.thehealthcreationalliance.org/wp-content/uploads/2019/11/Get-Health-Creation-Done-a-New-NHS-Alliance-Manifesto.pdf

• Submission to the Prevention Green Paper which provides many examples of Health Creation in action: https://www.thehealthcreationalliance.org/wp-content/uploads/2019/12/NNHSA-submission-Prevention-GP-FINAL-for-website.pdf

 

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Health Creation Alliance Newsletter December 2019

Season’s Greetings to all, from Health Creation Alliance

 

The last year has seen big changes in Alliance’s work and the landscape in which we develop. It has been exciting and satisfying to see that the ideas of Health Creation have become more accepted across both the NHS and LAs. The concepts of Contact, Confidence and Control appear in documents across many sectors and there are now many debates around power. Our contacts with organisations demonstrate that they are open to help tackle health inequalities which continue to blight our country. This aspect of our work will be expanded and focused over the next year. We hope to work with PCNs, STPs/ICSs, local authorities, housing and others to understand local and national understanding change through these eyes. That is a tribute to our members’ work and to the power of the truths we are promoting.

At the same time, there is much more work to do. Translating these ideas into grassroots change is yet to happen in many places. Our collaboration with NHS England and NHS Improvement may well help that spread and we look forward to that continuing.

We know that work with communities in a health creative way cannal issues, how they combine in a place, and how they may be tackled through multi-sectoral interventions.

There is all to play for – we are at a time of great change post-election. Health Creation Alliance is well-placed
with our new Patron, Lord Victor Adebowale, to help with delivering positive change for people and
communities across the nation.

 

The 12 Days of a Health Creating Christmas and New Year

As the dust settles on the 2019 general election the focus shifts to a new government that has ensured
that the electorate is conscious of the need for investment into health and care. We all know that the
issues are more than additional investment.

So here’s ‘Twelve Christmas actions for a health creating New Year’ by Peter Hay, enjoy!


Three events: How can Primary Care Networks succeed in reducing health
inequalities?


Emerging Primary Care Networks (PCNs) will be expected to deliver ‘locally agreed action to tackle health
inequalities’ by 2021. The good news is they don’t have to do it alone. There are many opportunities to
develop a new dynamic in the relationship between primary care, the communities they serve and other
local partners to improve population health.
Health Creation Alliance and RCGP Health Inequalities Standing Group are hosting a series of events to explore
in some depth how PCNs can best lead and support these changes. The events are supported by NHS
England and NHS Improvement and a range of partner organisations.
To find out more about each event and reserve your ticket, please click on your preferred event and complete the details on eventbrite:


• Manchester, 11th February
• Birmingham, 26th February
• Bristol, 31st March


Read Merron Simpson’s blog here (you will need to scroll down): Get to know your neighbours (or
you face a lonely struggle)

 

North Yorkshire Health Creation Group – 14th February 2020

We’re delighted to tell you that one of our active members, Lisa Holden, is holding a meeting in February
to gauge the appetite for a Health Creation group in North Yorkshire.


If you want to learn more about Health Creation, asset-based and community-centred approaches, how
‘experts by experience’ can be valuable partners in creating community health and about the national
Movement for Health Creation, then come and meet like-minded people on 1-3pm on Friday 14th February.
The meeting will be led by Lisa with contributions from Merron Simpson, CEO and Brian Fisher, Chair of
the Health Creation Alliance.
The meeting will take place in Malton, North Yorkshire, and the venue details will be available shortly.
Please let Lisa know you will attend by emailing her on lisaholden48@outlook.com
If you would like to explore starting a Health Creation group in your area we’d love to hear from you and
support you. Please contact Lynne Bowers on lynne.bowers@outlook.com

 


Get Health Creation Done – our Manifesto for a new government

Following our Annual Member Day on 16th October, at which members considered what our ‘ask’ might be for a new government, we have published this Manifesto.
Please feel free to tweet about it using http://bit.ly/NNHSA

 


Prevention Green Paper – Health Creation Alliance response


Click here to view the: Health Creation Alliance submission to Dept of Health and Social Care on the
Prevention Green Paper

This was based on many examples and findings that our members have provided over the years. Thanks
too, to Birmingham Mind Experts Group for providing input to the questions on mental health.
We have been invited to attend a meeting with DH&SC about this submission to the Prevention Green
Paper once things have settled following the election.

A big thank you to all our contributors and sponsors


From everyone at Health Creation Alliance we want to thank them for their
outstanding support.

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The twelve health creating days of Christmas

As the dust settles on the 2019 general election the focus shifts to a new government that has ensured the electorate is conscious of the need for investment into health and care. We all know that the issues are more than additional investment, so here’s twelve Christmas actions for a health creating New Year.

Peter Hay, Treasurer, Health Creation Alliance

@peter_hay

Action 1: think about how the 3 C’s help create value 

The election debate has been about traditional big levers of government, particularly taxation and spend. It’s seen little about ways in which citizens can engage as participants in health and care. The Health Creation Alliance commitment to health and care systems pivots on the capability to have confidence and control as well as being able to connect, supporting the big levers from the bottom up.

Action 2: let’s get people involved

Being invited into the process and finding ways in which people can participate takes time. But it does build a better approach which doesn’t sound so long term when contrasted with watching for money to show up in your locality.

Action 3: well, it’s Christmas, so we could commit to a journey

Participating and making our own health and well-being does not come ready made.

We could lead with a question about what it might take to meet the needs of people today in the best ways? (If you know all the answers already then proceed directly to a top down plan. If you know some of the shape but still need to find some answers then going on a question-led journey may work for you!) As we have never had today’s demographics be wary of the former!

Action 4: what would new hospitals look like?

40 new hospitals will be new capacity. Let’s try and avoid this meaning 40 more A&E’s that are full of older people for the want of something more imaginative or those in heightened mental distress as there is nowhere else. What do hospitals look like that are designed for the needs of people now rather than being more of what we have?

Action 5: can we find the younger adults (please?)

Social care is important to older people and is equally important to adults with needs arising from their mental health, learning disability, substance use or a whole range of needs which require support in day to day living. We need to ensure that the debate about social care is inclusive for all people whose needs require support.

Action 6:  think broadly about assets

A debate framed around not using your home to pay for the costs of care starts from the wrong perspective. Where we live and the houses we live in can change the way we age. We know from the research of Extra Care Charitable Trust and Aston University that extra care is life improving and creates better health. And we also know that 80% of older people want to stay living in their existing home. We need to think about using our housing choices and our community connections to change our life experiences. (If defending the financial asset is important, let’s not attack the best from of defence?)

Action 7: profitability does not guarantee quality

It’s uncomfortable but quality does not automatically follow money. There are profitable businesses that should not be allowed to hide behind the cloak of severe cuts of recent years.

Last year the Guardian reported how inadequate care homes were being run by very profitable companies. This is also an issue in children’s care: look at  action taken by Ofsted against a profitable company where children had to share a single toilet roll across six bathrooms and one child had a weekly ‘diet’ of approximately 122 chicken nuggets and 14 litres of fizzy drink.

We have to challenge the use of money as much as the allocation.

Action 8: well, it’s Christmas, so what about thinking about morality?

We need to find a language about ethics and morality that is entwined with the regard that we show people. The era of spin, fake news and a casual approach to evidence presents a challenge to how people trust, engage and think about organisations. How are the organisations in health and care different?

Action 9: bring in public health

There were some election commitments about broader thinking on wellbeing and how regulation and wider levers for change might be used. We need to think how we plan to make public heath the centre of population and place-based approaches.

Action 10: well, it’s Christmas, so let’s bring in the Tiny Tim’s (and Timina’s …)

Children are 25% of the use of the NHS – but you wouldn’t think it. There are serious issues to be faced from mental health to lifelong  approaches to disability and more. These issues need some considerable attention and children need more visibility.

Action 11: have a Christmas wish …

What one thing would make the biggest difference for you? For me, perhaps the end of the use of seclusion for people with learning disabilities and mental health?

Action 12: Enjoy! Have a Happy Christmas and a health creating New Year.