Change in Inequalities Gap in Spearhead Areas - Women. Bradford. . . Change in Inequalities Gap in Spearhead Areas - Men. Bradford. . Improving the Patient Experience Strategy. This tPCT Strategy looks at improving the quality and range of NHS services from four perspectives:Learning from patients' actual experiences and responding to those through the commissioning, service redesign and contracting processes.Providing information to patients and the wider public to enable them to make23
1. A strategic approach to
2. Change in Inequalities Gap in Spearhead Areas - Women Bradford
3. Change in Inequalities Gap in Spearhead Areas - Men
4. Improving the Patient Experience Strategy This tPCT Strategy looks at improving the quality and range of NHS services from four perspectives:
Learning from patients’ actual experiences and responding to those through the commissioning, service redesign and contracting processes.
Providing information to patients and the wider public to enable them to make choices about their healthcare and give them assurance that their local healthcare commissioner and its providers are responding to their needs as patients.
Engaging patients and the public appropriately in the development of strategy and service changes.
Through a programme of community development work, identifying and addressing the needs of local communities, opportunities for developing sustainable social capital, and the needs of those in the community who do not access services.
5. Population Health Measures
6. What do we mean by community engagement? improving the health of individuals and communities
increasing social capital by developing social networks
improving the economic viability of communities
communities shaping services and increasing accountability– PPI
improving the community’s capability to take responsibility for their own health
Dr Brian Fisher: NHS Alliance
7. CD Definition (NICE 2008) “Community development is about building active and sustainable communities based on social justice, mutual respect, participation, equality, learning and cooperation. It involves changing power structures to remove the barriers that prevent people from participating in the issues that affect their lives.”
8. Community Development and the NHS Skilled staff, resources and infrastructures at community levels to empower people take more control over their own health & that of their communities.
Targeting relevant skills, appropriate services and additional resources to communities experiencing highest levels of health inequalities, and on the health issues and concerns that are most pressing.
Ensuring a coherent link is made between equalities issues (including Equality Impact Assessments) and the strategic and operational changes needed to tackle health inequalities in communities.
Breaking down barriers to existing services including identifying more appropriate ways of delivering services to specific communities and individuals.
Building bridges to ensure more coordinated joint working between all organisations, services and groups who can promote health and well-being within communities.
Identifying unmet needs and gaps and working with commissioners and with communities and other partners to meet these.
9. CD Strategy Manager roles
10. B&A tPCT CD Team May 2008 CD Strategy Manager
2 CD Managers
1 Team administrator
15 (12.5 wte) Community Health Development Worker’s
All 15 CDWs are currently BME staff
(Pakistani, Bangladeshi, Indian, African Caribbean heritage)
11. Healthy Living Projects The current projects are:
BD5 Trident (Little Horton, Highfields and West Bowling)
Café West (Allerton area)
Grange Interlink (Horton Grange and Great Horton areas)
Highfield (Holmewood and Bierley areas)
12. Wider CD commissioning 07/08 underspend
Community Centres & health conference
Social enterprise and health inequalities
Communities of Interest Working Group
Accredited CD training
Revitalise CD Workers Network
Mapping CD & health work
13. Strategic level Community Development in B&A tPCT A rigorous, equalities focused approach to managing the change needed to refocus an organisation and its workforce to effectively tackle health inequalities.
14. DH NST Health Inequalities “All interventions should be systematically applied and industrially scaled …. Implementation plans should use tPCT and BMDC (Bradford Metropolitan District Council) commissioning to strengthen the systematic and effective application of interventions … The NST would recommend that the community development Strategy is given the backing of the full tPCT to ensure effective system and scale rather than tokenism.” Department of Health National Support Team Health Inequalities: Bradford Feedback: February 08
15. Strategic Framework for CD Grass-roots
16. STRATEGIC FRAMEWORK FOR CD: Partner’s in Bfd Council’s Community Action Days Grass-roots Community Work
50 days direct door-to-door work
Advice, 2 way info, health checks
17. Four main types of interventions at grassroots level Community Empowerment: development of strong and independent community groups and networks, principally in priority areas of deprivation and inequalities and communities of interest and identity
Community Engagement: to listen to, consult and empower communities so that community needs can be better met by service deliverers and decision-makers.
Community Resources: provision of sign-posting to information, guidance, training, grants, buildings and governance and other support to community groups.
Client-based support work in a community setting: activities initiated by agencies within community settings, and support to vulnerable individuals, or groups of people from target priority neighbourhoods and communities of interest. Initiated from professional rather than community agendas.
Achieving Better Community Development (ABCD) framework
18. World Class Commissioning Competency 8 PROMOTION OF IMPROVEMENT AND INNOVATION A tPCT who:
Catalyses change and helps to overcome barriers, including recognising and challenging traditions and ways of thinking (for example in service design and workforce development) that have outlived their usefulness – and supports providers that constructively break with these
Understands the potential of local community and third sector providers to deliver innovative services and increase local social capital
Develops relationships with current and potential providers, stimulating whole-system solutions for the greatest health and well-being gain
19. ‘Health Apprentices’ Win in relation to getting unemployed people into work (especially from communities such as BME, single parents, young and older unemployed people, people with mental health problems and homeless people)
Win by widening the diversity of the health and well-being workforce
Win by bridging between communities and services to ensure better take up and
Win by freeing up health professionals to use their expertise where most needed
20. Challenges ? Not everyone gets it “can they deliver leaflets door to door?”
Not everyone agrees with it “where’s the evidence?”
Too many people see CD as their delivery route without additional resources “ah yes, the CD workers can do this for us”
Not everyone sees they have to come on board ‘great idea – good luck!’
Scale of change vs capacity – ‘so it’s a 24/7 job then?’
Access to resources and key decision making ‘ CD who?what? £?’
LSP not functioning yet - ‘Some day my prince will come’
tPCT Commissioning budget already allocated ‘back to the shoe string?’
Lack of risk taking culture in the public sector ‘not sure about that: let me get back to you sometime’