Bromley by Bow Centre and Social Prescribing

1. Bromley by Bow Centre and Social Prescribing The essentials of our model

2. Where are we? Canary Wharf Bromley by Bow Olympic Stadium

3. This is Charles Booth He was a social researcher In 1889 he created a poverty map of east London One of the hotspots of deprivation was Bromley by Bow It still is

4. Charles Booth’s poverty map1898 Lowest class Very poor Poor Mixed Fairly comfortable Middle class. Well-to-do Upper-middle and Upper classes. Wealthy

5. Index of Multiple Deprivation 2010 Dimensions of deprivation: Income deprivation, employment deprivation, health deprivation and disability, education, skills and training deprivation, barriers to housing and services, living environment deprivation, crime. Today 28% of Londoners live in poverty, with 40% of children living in poverty. Tower Hamlets is the 7th most deprived local authority area out of 326 local authority districts in England. 16 out of 17 of its wards are amongst the 20% most deprived in the country with 12 wards in the 10% most deprived wards. almost 50% of children in tower hamlets live in poverty.

6. The Marmot Review 2010 Professor Michael Marmot

7. Social determinants of health Tower Hamlets Reality • At age 5 only 50% of children have a good level of cognitive development • Attainment at Key Stage 5 it is 4th lowest in London • Unemployment: 33% above London average. High proportion of residents work in low paying sectors • 20% of households have income <£15,000. • 50% of Tower Hamlets children are in poverty • Second highest population density in London. 35% of the borough’s households are overcrowded • 10% of the population eat 5 portions of fruit or vegetables a day; 30% exercise to the recommended level ; 42 fast food outlets per secondary school Marmot Review Priorities • Every child needs the best start in life • People to need to be able to maximise their capabilities • People need to feel in control over their lives • Having a good and fair job is vital • Everyone needs a healthy standard of living • People need to live in homes and communities that promote health and are sustainable and stable • There needs to be effective, accessible and sufficient clinical provision in communities

8. the wider determinants of health, including behaviour, have a greater influence on health outcomes than genetics and healthcare combined

9. the effects of the determinants of health are cumulative over the life course, and interventions need to respond to this

10. 70% of our community are amongst the 20% most deprived in England

11. Behaviour: the 4 healthy lifestyle factors in Tower Hamlets Clustering within individuals, aggregation within communities For those living in social housing In Tower Hamlets 40% of residents live in social housing, in Bromley by Bow, almost 60%. • Chance of being a current smoker is 1½ times higher • Chance of having a BMI of 30+ is 1.4 times higher • Chance of being physically active 3 times a week is 20% lower • Chance of drinking 2+ units a day is 40% higher Healthy eating 10% of adults eat 5 portions of vegetables and fruit a day Exercise 30% of adults exercise 5 times a week Smoking 27% of adults smoke, higher than the London average Alcohol 50% of adults drink alcohol, 43% of them excessively

12. The effects of the social determinants of health…..on health Map shows high risk of diabetes, 15-17% (darker shaded areas) 2nd highest rates of premature death in the UK from circulatory disease, cancer and respiratory disease (conditions which constitute 75% of all premature deaths) 10% of adults diagnosed with depression (4th highest in London), 7th highest level of mental health hospital admissions in London 13% of children in reception year are obese (6th highest UK), 25% of 10-11 year olds are obese (9th highest UK) 1 year survival rate for cancer amongst the lowest 10% in the UK

13. where have we landed?

14. Socio-economic status is a major determinant of life expectancy and disability-free life expectancy 70% of the Tower Hamlets population are located in the most deprived quintile of this diagram

15. Welcome to the Bromley by Bow Centre

16. so what’s at the Centre? • Bromley by Bow Centreindependent charity c£4m turnover, c150 staff, operating on 23 sites around 2,000 clients per weeklearning centre – daycare centre – social welfare provider creative arts centre - integrated health programmes – employment programmes – debt advice Plus ‘Beyond Business’ - incubated 57 social businesses in 10 years, 42 still trading. Turnover in excess of £4 million and created over 320 jobs • GP Partnership – Primary Care4 sites with 37,000 patients and turnover c£6m – including a 7 day per week 8am – 8pm Walk-in Centre. 110 staff. • Plus Bow Childcare and Poplar Harca and FoodCycle and Bromley by Bow Church on site

18. Connection Zone A warm welcome with engagement staff, tea and coffee. A place to meet, make friends and build social networks. Group activities, internet café with digital inclusion support, homework club, informal learning and family learning. Time Banking, Community Grants for small projects. Social Care and arts space Social care, inclusive arts space and programmes, including for elders and carers. Artists’ studios. Church / Nursery Childcare provision, community celebration space Café Provides training and volunteering opportunities Welfare, Debt, Legal Advice, Financial Capability Social welfare and legal advice on benefits, housing, debt. Money management and fuel poverty programmes. Promotion of Credit Union. Vocational Learning A range of learning options for young people and adults, including traineeships and apprenticeships Employment Service Careers advice. Extensive employer relationships, work experience placements, and support in applying for jobs. Social Enterprise Supports establishment of new social enterprises, creates service provision and employment. Growing spaces Social and therapeutic horticulture, food growing Health Centre General Practice, Community Health Services Social Prescribing Supports access to all Centre services Health and social care Healthy lifestyles promotion, weight management, mental health projects, social care brokerage, carers support, disability sports. Social Prescribing Receives referrals and supports those referred Children’s Centre activities Activities for parents and children Park and playground Managed by the Centre. Recreational space, children’s playground, sporting events, summer fairs

19. elders’ programme

20. Integrated service model and social prescribing Service provider networks Housingproviders Down to Earth ServiceProviders Partnerships, networks and policy Home Store Public Services Digital Inclusion Literacy numeracy English courses CreditUnion Family Learning Ministries Services to improve the social determinants of health Expert Patients & Self Care Activity groups Health Trainers Traineeships Corporate Partners Carers support Commission-ers Weight Management Apprentice-ships Time Bank Employers Social Care General Practice Health and Wellbeing Boards Mental Health Projects Social Welfare Advice YouthTraining Services that directly support health and social care, often Public Health Programmes SocialEnterprises Care brokerage SocialEnterpriseincubation LocalAuthorities Legal Advice Inclusive Sport Domiciliary Care Food Bank Youth Employment Financial Capability Regeneration agencies Social Prescribing Referral Referral Referral Energy Advice Schools Resident groups Primary care and community health services Employment Children’sCentres Faithorganisations Safer Neighbour-hood Team

21. Social determinants of health also act through the doctor-patient relationship Doctor: ‘Listen……’ ‘your patient…..’ Empathy, attention, time, responsibility, ownership Patient: ‘telling…..’ Education, communication, advocacy, confidence “Listen to your patient, he is telling you the diagnosis”

22. timebank coffee afternoons

23. planet asthma

25. arts and health programme

26. be focusedour mission is to enable people to be well and live life to the full in a vibrant community

27. Dan Hopewell Director of Knowledge and Innovation - Bromley by Bow Centre Website www.bbbc.org.uk Email dan.hopewell@bbbc.org.uk Twitter @HopewellDan @bromley_by_bow