Good health is about much more than clinical interventions. It starts with us listening to our communities.
Shane Devlin shares the learnings from Bristol, North Somerset and South Gloucestershire health and care system in their new community engagement approach.
It’s no secret the NHS and social care face incredible challenges right now. As we work to reset after the global pandemic, address major pressures on services, support and care for an ageing population, tackle increased health inequalities, and challenges within our collective workforce, we need to rethink how we deliver services for our communities.
On 1 July 2022, the way the NHS runs changed. Integrated Care Boards (ICBs) and Integrated Care Partnerships (ICPs) were formed in statute, Integrated Care Systems (ICSs) were enshrined in law, and Clinical Commission Groups (CCGs) were abolished.
Central to these changes is the idea that local services know how best to serve their communities, and local expertise is best placed to determine what local people need to live healthy, long lives.
This local insight comes from health and care organisations, local authorities, the voluntary sector, local charities, clinicians, academics, and local politicians among others. By drawing on this collective wisdom and experience, and by working closely together, health and care services can meet local need while making improvements.
Clearly, this cannot happen without the voice of our communities at the heart of our plans. As also proposed by New Local, meaningful and lasting change – innovation and ideas – can often come from the communities we serve.
Our mission was to really listen to our diverse communities and ask what matters to them.
This is why, during the summer of 2022, we asked people who live across our area what helps make them happy, healthy and well. What we heard will help to shape the future of health and care for everyone who lives in Bristol, North Somerset and South Gloucestershire.
To do this, we visited 57 community events and recorded over 30 video interviews. An online survey attracted over 3,000 responses, providing us with more than 21,000 comments. The survey questions were deliberately open-ended, so what people told us was categorised and coded into common themes.
Our mission was to really listen to our diverse communities and ask what matters to them. We did not go to any event, meetings or community settings with an agenda or pre-determined idea of what we were going to hear.
Lifestyle, relationships, community, and access to services were common themes which came out very strongly from a wide variety of people with different needs, abilities, backgrounds and experiences.
Our local communities said that to stay happy, healthy and well, a healthy and active lifestyle, relationships and social interaction, and access to quality health and care services are all crucial. In terms of what stops people from staying healthy and well, people said a lack of a healthy lifestyle and access to quality care are key factors, with poor work-life balance and poverty also contributing.
People also spoke to us about tackling inequality, greater access to outdoor space, community activities such as volunteering, climate change, the cost of living, better health education, public transport, healthcare staff recruitment, and safer places to live and work. You can see the full range of what we found, and what the next steps are, on our dedicated web page.
local services know how best to serve their communities, and local expertise is best placed to determine what local people need to live healthy, long lives.
How will it shape our strategy going forward?
In the main, the findings perhaps confirm what instinctively know – that a person’s good health is comprised of much more than clinical interventions.
The importance of social connection, community, family, and pets, scored highly in what people told us keeps them well. This may well be a consequence of social distancing and an after-effect of the pandemic; but also suggests community, social contact, and a feeling of belonging greatly help keep people feeling healthy and happy.
As well as providing access to quality health and care services, supporting communities to help themselves, their neighbours, and families, to stay well feels like a direction in which health and care strategy could focus effort. When combined with people telling us they want and need access to open green spaces to stay well, it suggests projects like Green Social Prescribing and other community-based health may be a good place for ICSs to focus their planning.
We also heard that people who live in our area want quality services to be there when they are needed; but equally, understand that their own health is within their own control.
They know a healthy diet, exercise, fresh air and a work-life balance is essential to keeping themselves well. This is really encouraging, as we know that for our area, many health conditions which are prevalent (outlined in our area’s health needs assessment) are preventable by healthier life choices.
This gives us, as systems of health, care, local authority, voluntary, and third sector professionals, an opportunity to work with our communities to design health and care services which will support them to maintain good health, and lead happy, long lives.
This will only be achieved by listening to what our diverse communities need and know, genuinely responding to these needs with people at the heart of our plans and developing their support and trust in the design and shape of services.
Shane Devlin is chief executive officer of Bristol, North Somerset and South Gloucestershire Integrated Care Board.
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