Community Development and Health Network (CDHN) and Antrim and Newtownabbey Borough Council together with people from the Toomebridge area have been involved in a socially innovative co-production project.
Since October 2015 Antrim and Newtownabbey Borough Council through its Joint Working Arrangements Steering Group (JWA) with the Public Health Agency (PHA) and Northern Health and Social Care Trust (NHSCT) and the Northern Health and Social Care Board (NHSCB) have been investing in a co-production pilot in Toomebridge. This project has been developed over a period of 2 years it has a co-production focus and has relied on 6 principles of co-production throughout its development.
- Recognising people as assets
- Building on people’s existing capabilities
- Promoting mutuality and reciprocity
- Developing peer networks
- Breaking down barriers between professionals and recipients
- Facilitating rather than delivering
The project has engaged with 29 people some of whom had little or no previous involvement within their community. Through CDHN’s Community Health Champion programme the group have gone on to establish themselves as the Duneane Collective. This training programme was the catalyst that brought the community and statutory partners together. They built trust and relationships began to develop which has enabled the community to view The Council differently but also how they see their role within the community and their relationships to each other. It has demonstrated to the The Council and other statutory partners that there is great merit in engaging with communities differently.
The Duneane Collective have developed an asset map of their area, a health and wellbeing catalogue, established a Timebanking working group, organised a community spirit day, managed their own budget and designed their own logo and vision statement. They are currently planning ways in which they can address health and wellbeing issues that they as a group have identified as important for their community.
Collective member comment on their involvement in co-production pilot.
“You can be part of the solution to some of the problems in your area as opposed to accepting the status quo…….it has given me hope…..”
What would social care for people with learning disabilities look like if the people who used services designed, developed and decided what was needed?
In Torfaen and across the counties of Gwent we are on the brink of finding out.
As a former manager of provider services, I am personally challenged but ultimately excited by the prospect. I am convinced that the people who have experience of receiving services are a beacon of good sense and that many of the best ideas in social care come from the grassroots.
In October this year, I began the journey as innovation and development manager in Torfaen County Borough Council. The post, funded by the intermediate care fund, has the brief to coproduce a plan for new ways of working and delivering services for people with learning disabilities.
I have been lucky enough to enlist the excellent support of Barod (a training and information company whose owners are a mix of disabled and non-disabled people), Torfaen People First and other People First groups across Gwent as advisors and co-producers respectively.
Together we have developed some principles for our work:
- People with experience of using services will decide upon the final recommendations
- We will make sure that the voices of people with learning disabilities are put first
- All the documents we produce will be as accessible as possible
- We will work with other people and organisations involved with people with learning disabilities to include their ideas
- We will find out about the best ideas and make them accessible
- We will involve people using their strengths
- People will be reimbursed for their time and expenses
- We will use person centred communication
The final report will be published in April 2017, concluding a series of workshops and network events across Gwent. It will be easy read and will include business cases for new services and enterprises.
We have found many examples of good practice but would be interested to hear from anyone who has good ideas, knows of something that works well or wants to help in other ways.
Jim Wright – Innovation and Development Manager Torfaen County Borough Council
How can mindfulness support people working to promote sustainability, social justice and wellbeing in society? How can mindfulness training and practice in mainstream settings help or hinder efforts to address the systemic causes of social, economic and environmental problems? And what is the relationship between individual and social change?
These are some of the questions being explored by the Mindfulness and Social Change Network, a group of people working on issues such as equality, international development and climate change, whose mindfulness practice is at the core of their personal and professional lives. The Network now has over 70 members, and has run a workshop and a retreat, and is planning further events next year.
There are serious debates to be had in this area. Given the size and scale of many of the social, environmental and economic problems that we face, collaborating with others, through networking or forming coalitions, is a crucial strategy for making significant systemic change. People working for NGOs, charities and community organisations face significant pressure over funding, demonstrating impact and responding to complex, interwoven challenges. Many risk burn out, which affects the quality and longevity of their engagement in social change. Mindfulness training, particularly focusing on stress reduction, can promote resilience and mobilise people’s inner resources to support them through challenging situations. However, can mindfulness training be tailored to address deeper structural and systemic social and environmental issues?
The Mindfulness and Social Change Network aims to work together to explore these and other related questions. Members of the network include mindfulness practitioners from various European countries who have/are working for Oxfam GB, WWF, Amnesty International, UN bodies and a range of universities including Aberystwyth, Cardiff and the Open University. Please get in touch with Paula Haddock and Luke Wreford for further information about the network.
Communities Together is a community development project in north Pembrokeshire. It’s a project about facing up to alcohol issues in our communities – but one that didn’t begin with questions about alcohol at all.
Here in Wales, much like our neighbours across the British Isles, we don’t always have the healthiest relationship with alcohol. Doctors and public health workers have been telling us for decades to cut back. It’s a simple message, but in our complicated lives it’s not always an easy one to follow.
Telling people to live healthier lives doesn’t work. But what happens if we ask people what good health would look like for them? The pioneering American alcohol researcher Dr Harold Holder has urged “the well-intentioned people who introduce programmes into communities”, to engage with the community, relinquish control, and be prepared for things to happen in “unexpected ways”. That’s exactly what we did. Poetry, football, and ballroom dancing have been just some of the “unexpected” outcomes.
We believe that we’ve created a new paradigm for getting to grips alcohol issues in our communities. To find out more, contact the Project Manager,
Our Associate Director Andy Phillips is also Director of Therapies and Health Sciences in ABMU, he’s just about to finish his PhD, he’s in the middle of packing for a move to New Zealand, AND he has found time to pilot a ‘Co-creating Health Framework’ which is based on co-pro principles of equality and assets.
The Framework consists of nine elements that can be used by clinicians in establishing a co-creating health interaction with patients. The framework supports clinicians to use all or few of the elements within the interaction and is intended to be iterative rather than prescriptive. Here’s the poster that goes with the Framework, which outlines a very specific role for the clinician:
Within the co-creating health framework, the role of the clinician is to:
- Prepare self and patient for interaction
- Assess the ability of the patient to manage their own health and well being
- Acknowledge patient expertise
- Work collaboratively with both the patient and clinician agenda
- Understand potential outcomes for patient according a number of ‘care aims’
- Ensure patient understands their condition
- Ensure patient understands benefit and dis-benefit of potential options
- Support patient to make decisions about options available to them
- Support the patient in managing their condition
- Provide effective treatment or ensure these are put in place
- Support patient to change their health behaviours where appropriate
- Review patient outcomes and discuss further options as necessary
- Ensure that the patient understands when no further progress towards goals is possible and then discharge or refer on as appropriate
- Understand the likely outcomes for patients by undertaking routine clinical audit and review of the evidence base and findings of clinical research.
- Continuous engagement in service improvement to offer new interactions
- Report outcomes of clinical audit to service designers, engage in service redesign activities-particularly to prioritise prevention
So how on earth do we measure it?…
Evaluating co-production: pragmatic approaches to building the evidence base
Catherine Durose, Catherine Mangan, Catherine Needham, James Rees, University of Birmingham
The authors of this 2014 paper suggest that co-production is ‘one of the few positive storylines in the public service narrative of long-term austerity’. They also acknowledge that we still lack compelling evidence base and suggest two reasons: ‘first, the breadth of the term, its lack of programmatic consistency and its focus on relational aspects of process in an era when performance measures focus on outcomes and impact; and second, the shifting parameters of what constitutes evidence-based policy within government, with conflicting messages about the value of qualitative and case study approaches making it hard for people working in co-productive ways to understand what kinds of evidence are required.’ The authors go on to discuss three potential responses to these limitations, with major implications for traditional approaches to the meaning and purpose of ‘evidence’.
Adrian Roper is one of our Associate Directors – and a thorough-going champion of co-production, co-operatives and mutuals. He’s also the CEO of Cartrefi Cymru, a not-for-profit organisation that supports people to lead fulfilled lives – people with disabilities, autism, challenging behaviour, older people – and provides breaks for carers.
Cartrefi are taking a lead on citizen-led approaches in a whole range of ways.
- They are providing a Floating Support Service in Brecon using systems thinking which focuses on identifying what the service user actually wants and needs, with a strong emphasis on articulating this in their own words, rather than following professional prescriptions and pathways.
- They’re facilitating the development of a multi-stakeholder co-operative in Llandrindod, bringing together people with learning disabilities, families and support staff in the town to raise their confidence and expectations and capacity to make their lives better through mutual self help.
- They co-founded the Mid Wales Social Co-operative Consortium as a registered body with the primary purpose of bringing agencies and citizens together to develop new, inclusive ways of achieving well-being for people with social care needs.
- They’re pioneering a highly effective new approach to ‘Active Support’ for people with learning disabilities. This is based on principles of ‘doing with’, not ‘doing for’, and a strong focus on enabling individuals to have more choice and control over their lives through confidence building, skills development, experiential learning,starting from their strengths and interests.
- Cartrefi have made an organisational promise to respect service users’ rights and responsibilities as tenants, citizens and ‘co-workers’, and to enable them to enjoy these actively rather than passively.
- And they are kindly sharing their offices and resources with us in Co-pro Wales. How lovely is that!
For more information about their wondrousness, visit their website: cartrefi.org
David Jones knows a thing or two about the relationship between well-being, inclusion and the arts – and he’s a co-pro fan. This glorious combination has produced the Cor Cwmni Teg Choir – The Good Company Choir – set up with residents of Tegfan Care Home in Aberdare and visitors to the neighbouring day centre. It’s proving to be an inspirational route to health, happiness and wellbeing… (Read all about it in this article.)
Their next (free) concert will be at Ysbyty Cwm Cynon in May, in the foyer. If you’d like to come along, get in touch with David at firstname.lastname@example.org