There are several strategic-level concepts being discussed across NHS Wales right now – ideas like prudent healthcare, co-production, and shared decision making. These promise to be transformational – not just changing what services NHS Wales delivers, but how they are delivered as well.
The key theme in all these big ideas is closer partnership working between the people delivering healthcare and the people using the services. But how does this work in practice? How can we take abstract ideas and make them a reality?
Recently, I chaired Empowering Communities to Better Health, a fascinating online seminar on how to engage with people to produce healthier communities. This was a truly international occasion – hosted here in Wales with contributors from New Zealand and the USA.
The seminar featured examples of how community engagement has made a difference, often within the context of quite challenging circumstances. Hahrie Han, Associate Professor of Political Science at Wellesley College in Massachusetts, kicked off the seminar. She worked on mobilising support for Barack Obama’s first electoral campaign, and that idea of a groundswell of support for change is hugely relevant to NHS Wales as we change in response to the many pressures on us.
The primary aim of Community Organising is to build up leaders who can enable those without power to work with those that do have power, in order to effect the change they want. Professor Jonathon Gray, Director of Ko Awatea in New Zealand, briefly discussed the specific challenges of the Manakau region, which has a high rate of social deprivation and as a result a community facing poor physical and mental health. He then introduced Alex Nicholas, the leader of the Handle the Jandal campaign in South Auckland.
Alex talked about her battle with anorexia and meeting an unhelpful staff member when arriving for treatment at a mental health clinic. Her bad experience motivated her to set up a campaign around pacific youth mental health. This developed into ‘Handle the Jandal’ and Alex is now part of a ten-strong team.
Margaret Aimer, development and Delivery Lead at Ko Awatea, works with Jonathan and Alex designing and delivering improvement work. In the seminar, she talked about the challenges shaping to community organising. These include:
- Building the capacity in the community to develop and lead campaigns.
- Aligning community–led campaigns with other improvement methodologies.
- Scaling up community organising to reach the entire district.
There are lots of issues raised by the idea of Community Organising. It’s a case of handing over power to people. It takes time for people to develop their skills and start taking advantage of available resources. There can be tension if communities decide they want something that the healthcare organisations haven’t recognised as a priority. (The white paper based on the Nuka System of Care in Alaska, looks at ways of overcoming this tension.)
So, what do you think about this approach? Can we encourage communities to organise and begin addressing health issues? Have a listen and watch the seminar here and tell us what you think by leaving a comment below.
Dr Peter Bradley is the director of Public Health Development in Public Health Wales. Follow Peter on Twitter @pbradley1965.