Where we started out wasn’t where we ended up

We’ve recently completed  a commission in the North of England, which in common with the way in which strategy development can take place, where we started out wasn’t where we ended up. Initially focussed on ‘preventing mental ill-health’ we ended up proposing some far reaching wellbeing measures within strategic planning for housing, jobs, green spaces and recommending a ‘place-making’ approach. We moved from health is healthcare to health is anything but the work of the NHS and care providers. We will post a link once the strategy is signed off.

Now this isn’t new, indeed we took our lead from the https://thrivenyc.cityofnewyork.us/ and the work of the West Midlands Combined Authority https://www.wmca.org.uk/what-we-do/thrive/thrive-at-work/ and the Liverpool City Region https://liverpoollep.org/wp-content/uploads/2018/11/Alan-Higgins-Public-Health-England.pdf whom are all on the same page, although its interesting to note how easy it is to retreat into what we know when you start to examine the transformation work outlined…….many of the actions relate to health and care service redesign, missing the opportunity to focus on place making as set out in their vision documents.

So what is place making: Research by the University of Wisconsin Population Health Institute (2016) has found that only 10 to 20 percent of a person’s health is related to access to care and the quality of services received. In comparison, over 40 percent of the factors that contribute to the length and quality of a person’s life are social and economic, while another 30 percent are health-related behaviours directly shaped by socio-economic factors, and an additional 10 percent are related to the physical environment. Over the last several decades, a growing body of literature has emphasised the importance of “place” to people’s health, with a frequently cited finding suggesting that a person’s postcode can be a larger determinant of his or her health than any other factor, including genetics.

We certainly found this in our work where there was real appetite to understand the funding flowing into the area from public sector, residents, the community, and local business and to consider how best this could be invested in the wellbeing of residents. We didn’t get as far as https://en.wikipedia.org/wiki/Zero-based_budgeting to model if the area was receiving the funding that its needs demonstrate and/or indeed to recommend a % of the area budget to go into something like Participative. Budgeting (PB) https://pbscotland.scot/blog/2020/1/6/exploring-local-authority-activity-towards-mainstream-participatory-budgetingnbsp as they do in parts of Scotland,…….here’s where we would need the support of someone like C.Co. to help us with http://www.socialauditnetwork.org.uk/getting-started/what-is-social-accounting-and-audit/ and the sums behind PB

So lots of people are interested in place based working and indeed some LAs have appointed Place Directors but usually this is to differentiate their work from a bunch of folk called People Directors who largely focus on children’s and adult social care services but actually they both have resources at their disposal which will provide wellbeing outcomes. In our work we spent some time talking to Place colleagues working on town centre masterplanning or large regeneration schemes to look at the flexibilities they have to do things differently. From this small sample of folk it would seem the issue is more about Place people seeing the potential to link with People people rather than prescribed process and do’s and don’ts .

So why blog, well because this is interesting and because it feels like the right thing to do and therefore we should recommend this approach. We would however, want to pursue this approach in partnership with providers such as C.Co who ‘get-it’ and who can add value to the process. We can offer a review, policy development inc financial modelling (via C.Co) participative budgeting and all the documentation to put in front of decision-makers.

 

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