Transforming Services an Assets Based Approach
description
Transcript of Transforming Services an Assets Based Approach
This Presentation:
• Why is Transformation required to tackle inequalities
• Assets v Deficits – why it’s worth trying
• Communities & Services together
• Simple Rules
Why is Transformation Needed?
Used with permission from NHS GG&C
Two boys at a train station. Do they have the right to be equally well in a modern and Fair Scottish Society? Or is it just life? Despite decades of effort, well intentioned policy
and programmes, millions of pounds of investment into deprived communities, Scotland’s health has failed to improve at the same rate as countries elsewhere in the
UK and in Europe.
Health Deficits Approach• We focus on problems, needs and deficiencies in a
community. • We talk of “ deprivation”, illness and health
damaging behaviours. • We design services to fill the gaps and fix the
problems. • We talk of “clients.” As a result, communities can feel disempowered.
People become passive recipients of services rather than active agents in their own lives. We do things to people rather than with them.
Christie Commission Review of Public Services 2011
This suggests that a radical change in the design and delivery of public services is necessary, irrespective of the current economic challenges, to tackle the deep-rooted social problems that persist in communities across the country.
A cycle of deprivation and low aspiration has been allowed to persist because preventative measures have not been prioritised. It is estimated that as much as 40 per cent of all spending on public services is accounted for by interventions that could have been avoided by prioritising a preventative approach.
The priorities identified included: • Recognising that effective services must be
designed with and for people and communities - not delivered 'top down' for administrative convenience
• Maximising scarce resources by utilising all available resources from the public, private and third sectors, individuals, groups and communities
• Working closely with individuals and communities to understand their needs, maximise talents and resources, support self reliance, and build resilience
• Concentrating the efforts of all services on delivering integrated services that deliver results
• Prioritising preventative measures to reduce demand and lessen inequalities
• Identifying and targeting the underlying causes of inter-generational deprivation and low aspiration
WORTHWHILE
MANAGEABLE
COMPREHENSIBLE
healthrelated
behaviours
opportunity, decent housing, socialnetworks, self-esteem,
sense of control
consistent parenting, safe, nurturing early years, supportive
education
Collective Assets
• Build on the personal individual assets and potential
• Multiply that in a family
• And again in a Neighbourhood
• And onwards to larger communities
• People, place, community.
Health Assets
A health asset is any factor or resource which enhances the ability of individuals, communities and populations to *maintain their health and sustain wellbeing. These assets operate as protective and promoting factors to buffer against life’s stresses
* Create Morgan and Ziglio 2009
The Assets ApproachThe Assets Approach
• Begins by building a trusting relationship – Begins by building a trusting relationship – regardless of how long it might take regardless of how long it might take
• Helps individuals rediscover the skills and Helps individuals rediscover the skills and strengths they may have forgotten they havestrengths they may have forgotten they have
• Supports them in putting them into practiceSupports them in putting them into practice
• Builds networks and trusting communities in Builds networks and trusting communities in which people help otherswhich people help others
When people care enough to When people care enough to ACTACT
Institutions have reached the limit of their Institutions have reached the limit of their problem solving potential. They are problem solving potential. They are stretched thin and need more skilful stretched thin and need more skilful engagement with communitiesengagement with communities
They are servants. Ask what people need, They are servants. Ask what people need, offer help, step back, create opportunity for offer help, step back, create opportunity for actionaction
http://www.mike-green.org
When people care enough When people care enough to actto act
There are unrecognised capacities in every There are unrecognised capacities in every community. Find them and provide community. Find them and provide opportunities for people to offer themopportunities for people to offer them
Relationships build a community. See them, Relationships build a community. See them, build them and utilise thembuild them and utilise them
Citizens are at the centre. Engage them as Citizens are at the centre. Engage them as actors, not recipientsactors, not recipients
http://www.mike-green.org
Organisations are People• We are all just people – being a professional or a
public servant shouldn’t separate from this fact. It’s not a them and us… it’s only us!!
• We must transfer power and trust in the community• We must stop hiding behind our systems and
making our job about the system rather than its intended purpose of making life better.
What can help….. Going back to SIMPLE
Organisational Cultures Simple rules
Innovation
Freedom to Act and Freedom to Fail
Permissions and Trust
‘Leadership’
Hunches, Learning Loops
Time, Space, Very small amounts of £
Governance & Accountability
Risk AversionLack of Trust
Hierarchy, over management
Small £ not freed up to frontline
Outputs Outcomes
Guarded partnerships Generative
partnerships
Good Enough Vision andMinimum Specifications
• Hunterdon Medical Center (USA)
• Need: Community health initiatives
• Approach: Nursing committee
• Observation: After 6 months, committee had not yet gotten out of the hospital!
Good Enough Vision andMinimum Specifications
• Instead... Simple rules
– A nurse can schedule up to half-day per week to work on community health initiative
– Don’t do anything illegal
– Remain within the project budget (all expenditures publicly posted)
THANKS!
• http://equallywell.ning.com
• http://www.scotland.gov.uk/Topics/Health/health/Inequalities/inequalitiestaskforce
• http://www.healthscotland.com/documents/5342.aspx
• http://www.gcph.co.uk/publications