We are accustomed to reading reports on the unprecedented challenges facing the NHS and social services, along with the ever present caveat, ‘the increasing ageing population’. Framed in this way the future of health and social care is grim – conjuring images of a dystopia where many of the most vulnerable are forgotten and neglected.
Yet we can absolutely change this. I have had an incredible personal experience of working alongside a community which collaborated with organisations to effectively combat crime, improve the local environment and support each other to learn and build education, careers, health and wellbeing. If this is possible in one disadvantaged community over a few years, surely a healthier, more socially just society with vibrant, caring communities can be built?
The research project I developed as part of my Clore Social Leadership Fellowship has provided me with a golden opportunity to delve more into this question. The main findings were as follows:
Projects carried out in isolation will have limited impact
Firstly the paper explores the concept of wellbeing and how wellbeing is achieved. It then goes on to explore some of the practical ways in which individuals, families and communities can be supported. It argues that projects carried out in isolation will always have limited impact and will not lead to systemic change nor the building of resilience in individuals, families or communities. In other words, doing sophisticated, cutting edge person centred planning with individuals will have limited impact if the family and community with which they live are not able to be inclusive, supportive and enabling. Equally, great community projects are not enough if very vulnerable individuals are not supported. This diagram aims to demonstrate the interdependence of individuals, families, communities and services as well as local and national government.
Bespoke solutions with individuals, families and communities mean getting it right first time thereby reducing waste and costs
Systemic change is rarely achieved because working in silos can be perceived to be easier to comprehend, organise and deliver. This paper aims to show how systemic change can be implemented and shows that it is not a daunting utopian ideal. It also emphasises that rolling out large scale programmes with no regard to local context is an expensive mistake.
We need a greater focus on coproducing social outcomes, based on what matters to people rather than coproducing services
Organisations and institutions focus time and energy on consulting about their strategies and services; in more recent years they have been looking at way to coproduce services. However, this paper argues that more systemic change will be achieved if the focus is on the wellbeing of people and communities rather than services. Services can then be shaped around people and communities in a way that is supportive rather than undermining.
Aneurin Bevan said that the ‘purpose of getting power is giving it away’. Supporting people to take a lead in their own lives, their own families and communities is our biggest challenge as we have built a culture of centralised leadership. We have to consciously learn to give power away as leaders of organisations as well as to take more control of our own lives, as citizens.
Taking more placed-based, relational approaches are of fundamental importance if we are to achieve sustainable wellbeing
Finally, the paper sets out the challenge to both the public and voluntary sectors to invest in people and communities whilst reducing unnecessary costs. The recommendations show how:
- The voluntary sector, local and national government can move towards empowering individuals, families and communities simultaneously in a more skilful and adaptable way than ever before.
- Governments can develop a new approach to accountability that enables leadership and innovation at all levels rather than stifling it.