In The Year 2025…

…If man is still alive, If woman can survive…No, no, that’s ‘In The Year 2525’ by Zager and Evans. Paul Diggory from North Wales Housing Association says 2025 is the target for a movement that’s building across housing, health and social care to tackle avoidable health inequalities in North Wales.  

We took a conscious decision not to follow the typical project based model of collaboration. We figured that the situation warranted something stronger to bind partners together. As Betsi Cadwaladr UHB Vice Chair Margaret Hanson said “Many of us have been motivated to make a difference by our childhood experiences or events involving our own families.” So that shared desire became our starting point.

It led us to stage ‘2025’, an event aiming to bring people together with a common purpose. If tackling avoidable health inequalities in North Wales by 2025 seems ambitious, it’s meant to be. Leonard Bernstein once said, “To achieve great things, two things are needed: a plan and not quite enough time”.  We started with some thought leadership presentations. First, Dr Ruth Hussey, Chief Medical Officer for Wales, brought clear strategic messages about health inequalities nationally. The underlying factor in deprivation is economic wealth, not necessarily place. So maybe better housing is only part of the solution and we need to work on increasing people’s prosperity, perhaps through job creation and local enterprise.

Assistant Director of Public Heath Wales Jo Charles illuminated the challenge we face with some hard-hitting data from North Wales. Population growth, the difference in life expectancy at birth, the high rate of early deaths and respiratory disease in deprived areas all featured strongly. Amongst social housing tenants 11.3% reported their health as bad – the highest rate of any tenure. This is something the housing sector needs to collaborate on if we’re to succeed in reversing the position – with our friends in health.

It’s one thing bringing people from different sectors and organisations together, but how do you make cross-disciplinary groups function? Debbie Sorkin of the National Systems Leadership Centre gave some useful pointers. “Leadership across boundaries is difficult and intrinsically complex” she said. Yet what we’re looking to pull off is collaborative leadership of a network of people in different places and at different levels. How can we create a shared endeavour, cooperating to achieve significant change? Leadership lies with each individual – a sort of ‘I’m Spartacus!’ approach. We have to be a coalition of the willing (I think it’s safe to use that word again). And if we’re going to allow progress to flourish we must be prepared to give power away.

Our ‘world café’ sessions saw serious engagement with participants pitching on a range of themes including mental health and homelessness, health and well being, older people, adaptations and the potential for digitally enhanced care services. The positive energy and high levels of personal commitment in evidence were exactly what we’d hoped for. Ultimately, everyone who’d taken part was happy to wait for an opportunity to sign the pledge.

The steering group has since been drawing out key themes and putting in place the foundations for a work programme. The 2025 movement will concern itself with three strands of action to achieve its end goal: encourage, enable, deliver.

What should the movement be encouraging others to do? Maybe joint commissioning of research and evidence sharing? Or sharing elements of training budgets to build capacity? Using public narrative could encourage politicians to give their support and let’s not forget the importance of involving communities in the design of solutions.

What can it enable to happen? How about a better awareness of health inequalities and a greater appreciation of the value of ill-health prevention? Enabling resources to span boundaries and tackle problems in joint working. Alongside Margaret Hanson for Health, Flintshire’s Clare Budden is a key driver of the group: “I could see a range of projects or initiatives across North Wales, each focusing on something different depending on local needs or interests”.

And what can it deliver? Actions that allow partners to share investment and reward would be beneficial. We’ve talked about putting in place ‘Just Do’ teams for each key work area, identifying the outcomes expected and meeting each team’s training requirements. Monitoring and reporting progress and telling our success stories will be vital in growing the profile of 2025. Another key task is to notice those programmes and projects that are working well to tackle avoidable health inequalities so that learning can be shared and capacity built.

 

The priority right now is to ensure we maintain the momentum, continue to plan and build but also start to deliver some change on the ground. With Ken Perry of Do-Well Consultancy continuing to facilitate the initiative, there’s a chance to make a real difference over the next ten years. We’re going for it