During the pandemic, many health professionals witnessed first-hand what communities are capable of; people’s desire to help during the lockdown periods; the deft way that communities organised to keep everyone connected, fed, occupied and receiving the health management and medicines they needed; and the willing volunteers staffing testing sites and vaccination centres.
Practices and PCNs have worked together with community groups and voluntary organisations to deliver huge programmes of care and relationships have been forged in the heat of an emergency. How do we hold on to and build on those effective relationships now as we look to transform healthcare and tackle the health inequalities that have been highlighted for all to see?
Shifting the focus from ‘making people better’ to creating the conditions for everyone in communities to be ‘well’ is one way of thinking about the change that needs to happen across the system. There is now widespread acknowledgement that both individuals and communities need to become active participants in their health (and not just passive recipients of services) and Health Creation provides a framework and practical resources for making that shift.
Health Creation involves working with people and communities; connecting with and supporting local partners who already have credibility with local people; and enabling the health workforce to embed and mainstream new ways of working so that Health Creation becomes business as usual.
In the wake of the COVID-19 pandemic, our Call to Action is to ‘Build Back Together’ because experience tells us that when the people who live in a place and the people who work in a place are working together, on equal terms, and playing to everyone’s strengths, these are the optimal conditions for lasting Health Creation to take place. Our 10 key messages associated with this call to action align well with the 10 principles for working with people and communities recently published by NHS England and NHS Improvement as part of the ICS Implementation Guidance (see below).
More fundamentally, the five features of health creating practices, which reflect people’s and communities’ lived experience on the ground, provides a very effective and concise steer when you are working out how to redesign your services to be more health creating. The five are:
- Listening and responding: Effective, genuine listening to the reality of people’s and communities’ lives is essential, followed by responsive action, acting differently and not just reverting to the established systems. Listening can also help to build trust that enables truth-telling if people feel safe to open up about matters that concern them.
- Truth-telling: When people and practitioners identify and acknowledge what holds them back from creating health, rather than focusing on treating symptoms, they can start to get to the root causes of problems and find solutions. This can be a challenge at first but the benefits are life-changing.
- Strengths-focus: Health creation happens when attention is paid to what people can do for themselves or others. Enabling people to recognise their strengths, and finding opportunities for them to use them, unlocks their potential and builds confidence for creating health.
- Self-organising: Helping people to connect meaningfully with others makes it possible for them to find solutions and take actions together. They are more likely to find purpose in their lives and this drives wellness. Over time, people become less reliant on health and care services.
- Power-shifting: People are conditioned to depend upon the NHS and practitioners are accustomed to give direction and advice. It will take time to blur those edges and the introduction of shared decision-making is a big step in that direction. Helping people feel confident to take control of their self-care, digital solutions and personalised care roles working in communities will all help to shift the power balance and give people more autonomy over their own wellbeing.
Whatever your role within the wider health system, you can play your part. You can maintain and build on the community contacts and relationships you made during the pandemic. You can introduce your colleagues to the five features of health creating practices and discuss how you will implement them in your workplace. And you can challenge your system when it reverts to more traditional ways of working.
Let’s stop looking to government for all the answers and work together, with our communities and local partners, to move beyond delivering services to a model that is principally focused on how the NHS, communities and other local partners create health together.
The ten key messages can be found here: Building Back Together: 10 Key Messages. They are drawn from the following The Health Creation Alliance reports:
- Health Creation: How can Primary Care Networks succeed in reducing health inequalities?
- Primary Care Networks and place-based working: addressing health inequalities in a COVID-19 world. A partners’ perspective
- Learning from the community response to COVID-19; how the NHS can support communities to keep people well
- Digging Deeper, Going Further: creating health in communities. What works in community development?
For more information and how to join the Movement for Health Creation: Members | The Health Creation Alliance.
Last Updated on 26 November 2021
