Rennes May Dr Jonathan Stead Health Complexity Group Exeter University Medical School

Transcription

1 Rennes May 2015 Dr Jonathan Stead Health Complexity Group Exeter University Medical School

2 Connecting Communities (C2) Complexity Enabling Conditions New relationships Co-learning Self-organisation * Emergent leaders *

3 FROM ISOLATION TO TRANSFORMATION Bringing back compassion to our communities by enabling, connecting and listening.

4 So what s the link between strong, self-managing communities and health inequalities? Compelling evidence that: Failing to manage your environment causes chronic stress leading to poor health behaviours Anti-social behaviour causes ill- health Chaotic early life changes way the body functions and the brain develops Having no sense of influence or control in decision making about where you live, harms health FACT residents, supported by service providers, can lead and sustain transformative community change & improve their own health This is also highly cost-effective for all organisations

5 SMOKING ALCOHOL INACTIVITY OBESITY POWERLESSNESS HOPELESSNESS DISCONNECTEDNESS PASSIVITY

6 1995/1999 Beacon Project, Falmouth

7 *teenage pregnancy zero The Beacon Community Regeneration Partnership, improving the quality of life for all who live on the Beacon estate 'We thought we were doing up houses but we were doing up lives Grenville Chappell Co-ordinator of Beacon Partnership * Overall crime rate down 50% *Unemployment down 71% *improvement to 1000 homes * Educational attainment up 100% * Child protection rates down 42% * Post natal depression down 70% * Childhood asthma down 50%

8 Health Deficits approach Focuses on problems, needs and deficiencies in a community such as deprivation, illness and health damaging behaviours. It designs services to fill the gaps and fix the problems. As a result, communities can feel disempowered. People become passive recipients of services rather than active agents in their own lives

9 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. The assets can operate as protective and promoting factors to buffer against life s stresses Morgan 2009

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12 The method connects communities in three ways: 1. Within themselves networks and cooperation amongst local residents. 2. With local service providers and public agencies building a parallel community of interest amongst the front-line workers and others. 3. With other communities getting and giving inspiration directly from one place to another.

13 Hawkhill WDi40 Timmergreens UNITED KINGDOM Bell Park, Shelton Etruria, Blurton Estate and Holly Bush Foleshill Moving Forward Beacon Community Regeneration Partnership Redruth North Partnership Smiths Wood and Chelmsley Wood TR14ers Hand in Hand Beacon Heath Winthorpe Wainfleet Putney Vale Partnership Newington Community Unity Cliftonville Townstal Community Partnership

14 The C2 Seven Step Framework STEP 2 Hold workshop to consolidate connections within steering group and embed skills and mindset needed to support residents to lead change and become self-managing. Jointly plan listening to community event to identify and prioritise neighbourhood health and well-being issues. STEP 1 Identify and nurture key residents. Establish partnership steering group of front line local service providers, key residents and other stakeholders who share common interest in bringing about change and improvement within a targeted neighbourhood to jointly undertake the 7 step process towards a resident-led partnership. 14

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17 STEP 5 Monthly partnership meetings, providing continuous positive feedback to residents. Celebration of visible wins e.g. successful application to funding streams which support community priorities, and promote positive media coverage, leading to improved community confidence, more volunteering and increasing momentum towards change. STEP 4 Constitute partnership which operates out of easily accessed hub within community setting, opening clear communication channels to wider community e.g. regular newsletter, estate walkabouts, links with other community groups and interface with strategic organisations. STEP 3 Steering group hosts listening event and produces report on identified issues, fed back to residents within 10 days. Commitment established for resident led, multi-agency partnership to tackle issues. Exchange visits undertaken to meet communities who successfully self-manage. 17

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19 Wandsworth Council subsequently invested 140k to restore Community Centre to be managed by residents, offering wide range of health enhancing activities for all ages.

20 STEP 7 Partnership firmly established and on forward trajectory of improvement. Two or three key residents employed and funded to coordinate activities. Measurable outcomes from community action plan and evidence of visible transformational change, e.g. new play spaces, improved residents gardens, reduction in ASB, all leading to measurable health improvement and parallel gains for other public services STEP 6 Evidence of community strengthening and self organization characterized by setting up of new groups and activities increasing social capital, catering for wide spectrum of age groups and targeting health priorities. Accelerated responses in service delivery from partnership agencies, leading to increased community trust, cooperation and reciprocal uptake. 20

21 C2 from a Complexity Theory Perspective C2 creates an enabling environment that facilitates: Connectivity based on active feedback Outcomes are emergent Residents self-organise and explore their space of possibilities, while co-evolving to create a new community Agencies & professional bodies also co-evolve with the community Co-evolution of trust & compassion within the community and between the community and its environment Specific, local needs of the community are responded to 21

22 Conditions needed to create an enabling environment for community leadership & transformation: New relationships Emergent Results Trust, respect & compassion Interdependence Capacity release Listening Working/thinking differently Enabling mind-set Connectivity Co-learning Visibility Community selforganisation Increased social networks Health giving costeffective solutions Dispersed leadership New order New healthseeking behaviours Long term culture & mind-set shift

23 Birds flocking :example of self-organisation in nature 23

24 Self-organisation Not directed or designed by someone outside the group The group decides what needs to be done, how, when Can be a source of innovation (Kauffman, 1993, Mitleton-Kelly 2003) Spontaneous coming together 24

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29 Onthank s Children s Breakfast Club June 2012

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33 Trojan Mouse