Stage 1 submission - September 2020
Please describe specifically which groups or communities your partnership seeks to benefit and how you will involve them in developing a plan over the first 6-9 months. How will your approach promote diversity and inclusion?
The partnership seeks to benefit the citizens and communities with the poorest health outcomes from the most disadvantaged communities and specific cohorts who often face higher levels of disadvantage and social exclusion, e.g., people from BAME individuals/groups, and people experiencing poor mental health. We are placing specific focus on the intersection between these groups and bringing in a greater breadth of voices, especially now that the impact of COVID on wider health determinants (e.g., unemployment) becomes clearer.
The process is designed to give a voice and catalyze leadership in the groups we seek to benefit. They, in turn, will take a lead role in the design process through sharing their experiences of social connection, community, and related challenges. The early stages of the project will comprise dedicated first-person engagement. We will recruit community members and provide training to support them in conducting conversations across their communities to build a deeper understanding of challenges/opportunities.
The resultant evidence base will deliver maps of experience (‘fuzzy’ cognitive maps) to create real-world testbeds. Starting at a small scale using the infrastructure of relationships and participation, the project will enable individuals and VCSE groups to generate a collaborative vision with the statutory sector to enhance the health and care system. The concurrent prototypes and real-world tests, wherever possible, will be led by people from the groups we seek to benefit, thus enhancing our approach for the subsequent months and years by:
- Building on validated layers of learning
- Meeting the identified leadership challenge with inclusive participation
In what specific ways do you want your partnership to transform the way the local health and care system works together? What will your plan be to achieve this?
Whilst we know connections and relationships play a central role in individual and community wellbeing, the partnership will focus on discovering exactly how and will show learning on two levels. Firstly, by exploring how connections and relationships play a central role in individual and community wellbeing. Secondly, by exploring how a co-design process enables a local health and care system to navigate the inherent complexity in responding.
By increasing the diversity of participation, we aim to gain a deeper understanding of issues to assist in building a platform for better collaboration and stimulating innovation in potential solutions. Whilst the maps of experience will be important, we are seeking to identify genuine sustained impact and how it can be translated into action.
Within Plymouth, a co-design approach is becoming embedded as 'business as usual'. Strong foundations exist for shaping and furthering the partnership’s objectives, e.g.:
- The Plymouth Complex Lives Alliance used the voices of people using drug, alcohol, and homelessness services to lead the redesign of health & care services, resulting in systemic change and new forms of contracting and commissioning.
- Use of Appreciative Inquiry is a strategic aim within Plymouth City Council’s approach to engaging communities.
- Cooperative commissioning methods and approaches.
- SW AHSN led system collaborative that utilizes data from General Practice to support the design of person-centered, non-medical approaches to improve ‘whole person’ healthcare and more resilient communities.
Plymouth is ready to take the next steps promoted within this bid:
- Tackling an issue an order of magnitude more complex – linking health outcomes to community connectedness and resilience.
- Approaching the issue through people’s experiences, not services.
- Bringing different forms of finance (not just commissioning) to play in the solutions, e.g., social investment.
Transformation will be driven through:
- Increased participation, voice, and leadership from those directly affected.
- New relationships and increased focus on collaborative leadership.
- Prototyping change – using learning from approaches such as Nesta’s 100-day challenge work.
- Agreement on indicators of success/forward momentum.
- Building a long-term business case that recognizes complexity and opportunity, supported by Kings Fund to help link existing evidence and health impact to the maps of experience.