Healthy Stirling Partnership Health Inequalities Subgroup

Detailed Meeting Notes

Healthy Village Approach Initial Service Providers Meeting 2nd November 2011

Present: Tom Houston NHS Forth Valley (Co Chair) Jennifer Kerr Stirlingshire Voluntary Enterprise (Co Chair) Charles Smith CAB Stirling Jacqui Gibson CAB Stirling Mike Seal Home-Start Stirling Rachel Cameron Home-Start Stirling Joe Hamill NHS Forth Valley Oliver Harding NHS Forth Valley Barbara Allan Stirling Council Lesley Gibb Stirling Council Lisa France Stirling Council Lynne McKinley Stirling Council Peter Walker Stirling Council Alasdair Tollemache Stirlingshire Voluntary Enterprise Gail McLaughlin Stirling Council (Note taker)

Presentations

Lisa France, Policy Officer Health & Wellbeing, Stirling Council outlined the summary paper that explains the concept of a healthy village approach.

Aileen Scholfield, Health Promotion Officer, NHS Forth Valley, explained the work that is taking place in Hawkhill, Clackmannanshire using an asset based approach. She explained the model in the context of this project.

Principles

Discussion of the models identified principles from the group of the approach that would later outline discussions to determine a suitable area for a pilot:

1. Focus on prevention and early intervention

2. The approach must be considerate to individual values and culture, learned in both a family environment and a social context.

 There is a role for working with vulnerable families. A base for confidence building, values, morals and work ethics.

3. Asset based approach is about a shared attitude and vision for an area by all stakeholders.

4. Co-Production amongst all stakeholders required- including service providers  Work may arise that is out with traditional organisational boundaries and protection of ‘silos of work’ and red tape might limit responsiveness to potential.  Terminology, branding and language use very important. Some service names or activities have historical negative and/or positive perceptions attached to them. Ex; the word ‘volunteering’ has a very subjective understanding that is not always a positive one with some individuals. In these circumstances, ‘Helping out’ can be way to describe voluntary activity.

5. 5 key rules to asset based approach:  Not talking about something – just do it o knock on doors, draw people out, develop social connections o Essential to get the support of existing networks but also need to make new ones  Organic in nature o develop natural social connections o bottom up  Not prescriptive and flexibility important o Don’t plan too many actions in advance, allow them to develop from within o cut red tape wherever possible  Seize opportunities o quick wins required to sustain motivation o the approach is based on recognising assets and achieving successes o fairly immediate, tangible personal results for individuals develops good word of mouth

 Must be sustainable by the community o Not just another service provided ‘to’ a community

Considerations for planning a pilot:

The following points were raised during the discussions relating to the practical considerations of the areas for consideration.

 Impact o Short and long term gains o On existing community structures and community development work or programmes including community action plans. o Consider possible negative impacts. o While statistics need to be considered to understand a ‘community, deprivation indexes focus on what a community doesn’t have. o We will need to develop ‘asset based’ indices.

 Feasibility o Partners ability to undertake a commitment to the work o Do residents within the local area identify with the chosen ‘community’? o Are there any known hurdles to overcome o Do we have a named leader/coordinator with time to devote ?

 Desire o From the community for the work o From partners to participate in work. . What if partners don’t agree on the cultural changes a community proposes it would like to see? Whose culture and/or vision is ‘correct’? The community? The workers? The management? o From individual workers to work to an asset based approach. . Individual understanding and professional practice in the asset based approach is important . Ability to develop and build relationships of trust key skill

 Dialogue with all stakeholders o Including the community members themselves and non-traditional partners such as local businesses. o Is there time to have dialogue with any of these communities and ensure a Healthy Village approach is desired? o A community is made up of individuals as well as groups. Ex: Volunteers and service users of some community groups deliver services to individuals rather than to a geographic area.

 Management Structures o Careful consideration to the role and purpose of each level of management structures for an organic process. o Coordination and leadership . The group discussed the pros and cons of having a high level strategic management structure in place for a bottom up approach . There was general consensus that sometimes it was necessary to ensure red tape could be cut between partners and within services . All services need to buy into shared vision . There could be a large onus of leadership and coordination required on behalf of one or few partners.  Ex: Healthy village model includes a coordination role. This could be undertaken by a lead partner or the Healthy Stirling Partnership or from within community.

 Avoiding duplication o The discussion is taking place within the context of Community Planning processes and structures. We need to ensure that we maximise links between critical partnerships, but avoid duplication of effort or accountability. Individual Area presentations and discussion

Cultenhove

 Cultenhove as an area has now extended to include Borestone area. The area is working to join up multiple senses of identity into one area.  But in general, this approach is already happening in Cultenhove, it started from a different place, the masterplanning process to address an area with comparatively high levels of deprivation. However, the master planning process has been undertaken for place making. Funding has changed for re-building and a new 5 year plan agreed; Physical regeneration, greenspace, housing, ‘space making’  People Plan more recently completed  Health outcomes are an important theme in the communities action plan. More health service input would benefit the area’s outcomes.  A seminar was held in September with partners and residents, including Cultenhove Opportunities (COP) and the Community Council.  Data profile on the area available and research undertaken with residents and partners to identify if we know the reality and if the anecdotal evidence matches up.  Services impressions were different from local people’s impressions  A workers network has been in place for many years. May areas of collective work:  Health Improvement  Many vulnerable people with chaotic lifestyles, due to housing policy, want people to feel part of the community.  Young people – not huge numbers but significant  Poverty and disadvantage – unemployment, training and skills needed  Community Involvement and cohesion o Range of partner providers to link with o Link the physical with people ie community park ‘space’ food work and healthy eating.

 At this point in Cultenhove’s development, a healthy village model of work might complicate existing CLD work or it might get minimised by the ongoing development and progress.  Partner’s are already working together in different ways to align with the needs of others in the community  Coordination of services – COP is also a service provider as well as a residents group.  This area’s development planning work currently feeds into the ‘Tackling Poverty’ Partnership group.  It is expected that reform of the benefit system will have a high impact in this community due to the high rate of persons claiming disability related benefits.  A more efficient way of monitoring health outcomes may be a link into the HSP and more health services input into the anti-poverty work. Perhaps some joined up monitoring City Centre North

 Starting point for this Community is core statutory services, including the Police and Stirling Council, coming together to deal with recurring crime issues in a small enclosed geographic area.  Police Services felt they were offering a sticky plaster over some fundamental issues in the area. A partnership approach was used to understand the issues and create a plan for dealing with them.  An outcomes based logic model was undertaken and a action plan produced. Actions were prioritised into Urgent and essential work that could be undertaken within existing current budgets immediately to make a difference. Ex: lighting, graffiti, street sightlines  The community does not identify itself as a ‘community’ which is a key part of the problem.  It has a transient population and more than 20% of housing in the area is HMO. This is above the Stirling Council planning policy for an area. The standard of housing is not always top quality as is rental accommodation. Family life is difficult due to busy roads and a lack of green space.  Are working with planning department to reduce this in the future and also there is a lot of work to be done with Landlords who could improve the sense of community.  500/ 1200 residents are students, with a large concentration of foreign students, Chinese, and Polish. It is difficult to make students feel engaged in a community. Temporary residents do not want to engage and invest in a community.  Students are both the victims of crime and cause crime: nuisance, noise, litter, trollies.  Community Engagement Events are planned for next week. While the community council for the area isn’t entirely representative of the ‘community’ it is taking part.  In terms of stage and readiness of the community, this area is not a community yet and fitting a health element alongside the existing process aimed a reducing crime and improving a community is not a good fit.  The action plan and work of this partnership sits within the Community Safety Partnership. Fallin

 Fallin as an asset rich community: Alpha Centre, Library with a great librarian, volunteering, mothers and toddlers, pensioners group, sporty, youth programmes, craft groups, social enterprise. Primary School, parent council, Church hall, community café, community worker, nursery school, out of school care, miner’s welfare, community council, community owned and managed bowling club.  However, Community leadership is single issue focused and driven by individual areas of interest. There is no one leader with a forward vision for wider place. Community aspiration is difficult to identify. Many of the leadership are older persons who are very passionate about their particular issues.

 In 2004, a community plan was created to bring the community groups together. They wouldn’t do it but would take ownership of individual areas. There is nothing sustaining the partners working together.

 Housing policy: As in all communities, there are different groups of people that align themselves with one group or another. There is also a mix of new housing. And a housing association. The community complains that Raploch residents were re- located to Fallin.

 Fallin does not have any strategic place in the CPP structures. Regeneration has not been strategic or coordinated.

 Statistically, the SMID index indicators have worsened over the years. Particularly skills and qualifications.

 Fallin is very independent and feels ‘detached’ from Stirling.

 The term Eastern Villages is not one that those communities identify with. It is a manufactured phrase.

 There are ways of ‘getting in’ under the fence so to speak.