A couple of months ago, I visited Maggie’s Centre West London. The centre is based right next to Charing Cross Hospital and offers free, practical, emotional and social support to people with cancer and their families and friends. The building itself is a beautiful and calm oasis, full of daylight, bright colours and spaces for conversation and reflection. It’s the type of place that is reassuring to know exists.
I was struck by one thing from the conversations I had with staff and the people using the centre. While the professional support on offer was key and hugely valued, it was the centre’s role as an open space for sharing thoughts and experiences with peers that was highlighted again and again as the central anchor when receiving a cancer diagnosis, throughout treatment and beyond. People made friends at the centre, they swapped tips, had fun together and supported each other when things were tough.
Maggie’s Centres are a brilliant example of what we at Nesta call ‘More than Medicine’¹. The centres function as a natural extension of clinical work, taking the starting point of the individual and what matters to them. And what matters to many people using the centres is the opportunity to receive informal, or formal, support from their peers.
This chimes with a research review of more than 1,000 published studies which we recently conducted with National Voices. The aim was to better understand which types of peer support are most effective, what costs they incur and what benefits they bring.
Overall we found that peer support is worth investing in as a way of supporting people living with long-term health conditions. There are potential wide-reaching benefits: better mental and physical health, cost savings, and wider social value. However, we also found that the research base is still in development and that there is little research that adequately assesses cost-effectiveness or would help commissioners to build business cases.
The bigger picture: the NHS as a social movement
Plugging the gaps in the research is becoming increasingly important. The NHS Five Year Forward View set out a vision for the NHS to develop a new relationship with patients and communities and support people with a long-term condition to manage their own health and care.
The background for this is twofold. Firstly, life expectancy has increased as people live longer and some, with one or several long-term conditions, for many years. This calls for a healthcare system that looks beyond curing people from acute and infectious disease. We need to be able to support people to live – and live well – with long-term health conditions.
Secondly and equally important, the Forward View sets out how the NHS of the future needs to transcend organisational barriers and become not ‘just’ a national health service but a national social movement for better health. We all have a role to play in looking after our own health and the health of others – and the NHS has a role to play in making it easier to do so.
In effect, peer support is an example of how social movements and networks can benefit the health and wellbeing of an individual. It is therefore vital that we get much better at understanding the costs and benefits of peer support, and putting the existing knowledge into practice.
Nesta and National Voices are working together on Realising the Value, a new initiative to find, test, and share the best ways in which people with health conditions work with their communities and health professionals. Realising the Value is delivered by a large consortium of partners with a strong track record and expertise in the area of putting people at the centre of their own care.
A quote from one of the visitors at Maggie’s Centre West London describes how cancer “hijacks your life and drops you into a situation where you have to learn a new language”. In our vision for a person-centred, people-powered health system, the support of peers, family and friends complements clinical and professional services to form an integrated whole. Learning the language of a new condition is never easy, but it helps to learn together.
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¹ See also our work on People Powered Health, our recommendations for boosting citizen participation and volunteering in health, or the Nesta and Cabinet Office Centre for Social Action Innovation Fund to test different types of peer support and gather evidence on them.
Johanna Ejbye is a senior programme manager in Nesta’s health and ageing team. Follow the organisation on Twitter @nesta_uk
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