Exploring the ‘We’ in Well-being!

Wellbeing

The Kings Fund and National Voices have recently launched an excellent helpful paper ‘People in Control of their own Health’ designed to provide a practical framework to help turn policy rhetoric into a reality.

At the launch event the following question was asked:

What one thing do you think needs to change to support people to take control of their own health?

My simple response to this question is:

To change the lens through which we view and try to improve health from ‘I’ to ‘We’

This response is based on my personal experience of living with type 1 diabetes, supported by experience of working in community development and research around citizenship, peer support and well-being.

A good starting place might be this powerful definition of health I discovered a few months ago through social media in a post written by an Australian GP and writer called Tim Senior

‘Health is not just the physical well-being of an individual but refers to the social, emotional and cultural well-being of the whole community in which an individual is able to achieve their full potential as a human being thereby bringing about the total well-being of their community. It is a whole of life view and includes the cyclical concept of life-death-life.’

It is the Aboriginal definition of Health.

This is about having the opportunity to reach our full health potential no matter what health conditions or disease we may live with. It is also about recognising that our health depends not simply on clinical and medical care but on wider social determinants of health in particular our relationships and our community connections.

To bring this to life in our context, I have had a number of conversations with health care professionals in the last few months often in the context of diabetes around supporting self-management.

We have talked about some of the enabling resources from a more clinical perspective including training and support, equipment and digital technology, but we have also shared a belief that our relationships and networks including the very important human interaction between health care professionals and patients and our wider support network, the social capital in our lives are very important factors in our ability to take control of our health.

We know there is evidence of the impact of isolation and loneliness on our health generally. There is evidence to show that loneliness is worse for our health than smoking 15 cigarettes a day and has an impact on our immune system.

There is increasing evidence that support for self-management needs to be set in the context of social networks. A study published in June 2014 ‘Contribution of social networks to the health and self-management of patients with long term conditions’ showed that greater social involvement was significantly related to better self-management ability, better physical health or ability to cope with health conditions and greater emotional well-being.

Professor Martin Knapp and the PSSRU team at the London School of Economics has also produced a useful report and infographic on the economic case for building community capital.

So the idea of building a sense of community into supporting people to control their own health not only makes common sense but also has a growing evidence based behind it.

Important dimensions of ‘We’ not ‘I’ are the relationships between the health care professional and the individual, and the health system and citizens. As we are all aware this is delicate, tricky and complex because we are human beings. The place to start must be with shared purpose and responsibility, not paternalism and a lopsided power base but the co-production of solutions which are meaningful to us all. If we genuinely wish to support people to feel empowered and in control of their health, we must recognise that the person in the room is a whole person not a condition/set of conditions, e.g. ‘a diabetic’.

So here are some descriptions of people:

  1. A person who lives with Diabetes and Asthma and is a Patient Foundation Trust Governor
  2. A person who is a wife and mother of 2 primary school age children and a volunteer reading buddy at school.
  3. A person who has an MBA and is a CE of a social enterprise

This is not three people but one! When this person walks into the consulting room or surgery they bring all these different facets with them. Each patient or person comes with an individual set of circumstances and resources/assets and so does the health care professional, all of which may be useful but it can take time, trust and listening with intent to understand to effectively utilise all that we bring into the room.

The ‘We’ of community and peer support networks and the ‘We’ of the clinical/patient relationship are important factors of helping us to take control of our health.

Here are a few examples of existing and emerging related approaches and activities which help to build the ‘We’ into Wellbeing:

To complete this post a quote which sums it all up in one sentence…..

Ethos of We Love Life

Postscript:

John Walsh recently wrote a very thought provoking post on his excellent ‘yes to life blog’ which articulates the value of each of us taking responsibility for building collaborative and connected communities.

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Move More Sheffield & the first steps in the Asset Based Community Development Journey

Move More Sheffield has emerged from a history of community, public health and academic interest in increasing physical activity across Sheffield. Enhanced by the Olympic legacy work and the Centre for Sports, Exercise and Medicine and building on what has happened in the past, a growing number of people who share a passionate for this cause are getting together in our city under the banner of ‘Move More Sheffield’.

There is the usual Board but this one is operating in an unusual way. I have spent 20 years managing, supporting and sitting on various Boards and I can honestly say this one is different in culture, approach and actions. The Board, chaired by Dr Ollie Hart, a local GP and guided by Dr Rob Copeland a physical activity psychologist and researcher at Sheffield Hallum University, is an eclectic mix of people who share a commitment personally and professionally to the Move More mission of changing the culture of physical activity in Sheffield.

The Board does things differently, we move more in meetings, there is a genuine sense of shared purpose and equality of respect across the different roles and  it acts as a facilitation board rather than being directive. It is also acting as a central point for building bridges across many different networks. NHS Improving Quality Chief Transformation Officer  Helen Bevan champions this approach as a means for transformational change lending from Batillana and Casciaro’s The Network Secrets of Great Change Agents.

Last year, as the Board was forming it reached out to the wider community by hosting a large 300 people strong event and through media and social media means. It asked what assets do we already have, what ideas do we have and what gets in the way. The results of this ‘consultation’ were combined with research and evidence to develop the Move More Plan, a framework for action. At the heart of this plan was the recognition that cultural change will only happen if genuinely owned by the citizens and communities of Sheffield and that this cannot be imposed. The Board learnt about the potential of ‘asset based community development’ as a means to transform the power base and culture of creating thriving healthy communities. It recognised the incredible experience of community led activities in this city, in particular community health champions, and the potential tool of digital technology and set off on a journey of discovery about how we could bring these three aspects together to make a transformational and sustainable difference to the quality of life of citizens and communities in Sheffield.

The first step was to bring some outside expertise to the city to help those who feel a connection to the ambitions of the Move More Sheffield Network to come together, learn more about asset based community development and consider how we might take action collectively and in our communities. So we invited Cormac Russell of Nurture Development, Europe’s leading light in asset based community development to come to Sheffield and host three development days. In early May, 90 people from many different backgrounds united by a passion for changing the culture of physical activity in Sheffield came together to learn about the approach, the principles, to experience some of the tools and techniques of community building, to listen to the experience of Croyden from the fantastic community builder Jennine Bailey and to reflect on how we can apply this approach in the context of what we have in Sheffield. A follow up survey showed that most people felt we should continue our asset based community development journey.

 

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Around one-third of the participants of the development sessions came together one rainy evening two weeks later to reflect on what they had learnt and what our next steps should be both collectively and in our communities.

At this point I noticed a change in the conversations. From the usual desire for a strategy with targets and actions linked to a hierarchy of responsibilities, a business case and allocated budget, the talk was of informal networks, celebration of our amazing existing assets, recognising the value of the connections we could make, talk of citizenship not volunteering. In true ABCD style it felt like the Sheffield glass was brimming with ‘assets’ and ideas and that the biggest problem that we need to tackle was not lack of resources but the need to build bridges, communication channels, information sharing and connections and relationships between people, organisations and networks.

Two examples stood out for me:

Rachel has a field with three horses in a beautiful part of the city, she is skilled in horse whispering, knowledgable and committed to environmental sustainability and willing to share her knowledge and skills and space, a fantastic offer! Through this experience she is now talking to people in community organisations about bringing young people from another part of the city to camp in her field and learn about horses and the environment.

Stuart has a role with Sport England to help secondary schools in Sheffield to maximise the potential of their facilities and open them up for community use. He has built relationships and understanding with all the schools in Sheffield and now wishes to build bridges between schools and people, networks and organisations in communities who could benefit from the facilities the schools offer. The roomful of well networked people the Move More Network offered their support to help make those connections.

stop start keep

As the dust settles on this exciting turning point in our collective approach to changing the culture of physical activity, we may not yet be able to see the whole staircase but iterative steps are being taken, bridges are being built, personal and organisational connections are being made and action is being taken in small groups and at a city-wide level.

The cultural change is running deeper (excuse the pun) than physical activity, it is building on a people power approach which already existed in the ‘People’s Republic of South Yorkshire’, unleashing our potential and helping us all to feel more empowered to act on what we feel passionate about changing without permission or direction from a hierarchy of power but supported by connections in communities. As an integral part of the city, More More Sheffield is becoming  a catalyst for a cultural change which is fundamentally about citizenship and building thriving communities.

If you are interested in getting involved contact Move More Sheffield  or connect via twitter @movemoresheff

If you have a long-term condition and are interested in specialized support to move more check out Miracle Cure

And I would also love to read your  reflections, views and ideas below …

 

(N.B. Roz Davies, We Love Life is a member of the Move More Board/Network)

 

PostScript:

I recently read two enlightening pieces about the power of communities, the first about the Aboriginal definition of health and the second about the power of asset based community development, here they are for those who are interested..

What can we learn from Indigenous understandings of health from Tim Senior with a HT to John Cosgrove

The power of asset based community development from Cormac Russell, Nurture Development

 

Health and Well-being Citizenship Resources:

A mixture of research and information articles, publications and websites which showcase principles, approaches and stories of community development and citizenship in health and well-being NESTA co-production catalogue  NESTA the business case for people power health  SCIE Co-production and participation:older … Continue reading