In the second of two blogs, Kate Ardern, director of public heath in Wigan, celebrates Wigan Council’s success by reflecting on the Wigan Deal, the real and measurable impacts it is making on Health and Wellbeing in Wigan, and where this way of thinking and working is going next.
Wigan’s Deal for Health and Wellbeing originated in work supported in 2012 by NESTA, and a group of community activists in Scholes, a neighbourhood in Wigan centred around Sunshine House, a former dementia day care centre and now a vibrant seven-day-a-week community hub of health and wellbeing and social enterprise led by the community. The energy that came out of these discussions, and the desire for new ways of working set the tone for a new relationship between local people and the public sector in Wigan.
What we can see now, is that the ideas that came out of Scholes seven years ago, now part of the DNA of every public organisation in Wigan, are now having a measurable and quantifiable impact the health and wellbeing of our communities.
- Our healthy life expectancy is still improving, while for much of the rest of England it is not.
- Our female healthy life expectancy is now at the England average
- Our male healthy life expectancy is the fastest growing in Greater Manchester
- Our smoking rates have fallen from 30 per cent to 16.1 per cent, which are still far too high, but much better than the position we were in seven years ago
- Our Health Movement For Change which totals 23,000 citizens currently includes 1,350 Health Champions, 495 Heart Champions, 856 Cancer Champions, 10,000 +Dementia Friends and over 200 Young Health Champions
- And since 2011/12 our alcohol related unplanned admissions are down by 16 per cent, compared to 4 per cent average in the North West while the trend for the rest of England is an increase of 0.3 per cent.
So, we are happy to say that health outcomes are improving as a result of our approach. They are absolutely not there yet, but they are improving in a continuous trend. And where they are not improving we are looking at different asset-based solutions to problems. Our breastfeeding programme, for example, is not delivering the improvements we might have wanted, so we are exploring less professionally-led, more community-asset based approaches. Our core principles as a place come through this. We’ve tried something, it’s not worked as well as we’d hoped, but we’ve learned and we’re now trying something else. Try something, learn, try something else.
And we’re also looking to take our place based plans down to the next level of granularity. Wigan Borough is a place, but really people live in 14 townships each of which has its own proud history and cultural assets. The next stage of our development in The Deal for 2030 will recognise this, recognise neighbourhoods, and bring power, hope and health even closer to people.
Local communities helping themselves
This way of working goes much further than the social prescribing model described as part of primary care networks in the NHS Long Term Plan.
Social prescribing is not community-asset based working. We need to become careful that social prescribing is not just another way of the system thinking that they are experts and designing solutions without fundamentally giving power back to people and communities. That’s the key to what we have done in Wigan and I’m not sure that the NHS Long Term Plan fully captures that.
We need to invest consistently and systematically in the talents and ideas of communities and in civic society to really involve people in improving their wellbeing. Through The Deal for Communities Investment, Wigan Council has made a £10.5 million investment to date in neighbourhood, in letting go and in people’s ideas and passions. This investment has led to a significant growth in micro enterprise and real conversations with every part of our community. It’s also led to recognition and understanding the idea that what society and place means to people is critical to the way that they think and act. Giving people hope and a stake in their community and their future encourages people to take good decisions.
Sometimes we can improve population health with national top down initiatives. Tobacco control legislation and seatbelts are great examples of improving people’s lives in this way. But more often we need to recognise that many people’s life choices are influenced not by the threat of a four-hour trolley wait, but by having control over their lives, hope and confidence for the future and the prospect of fun with their families, friends and loved ones.
Wigan’s Deal is about citizens’ hope and aspiration.But it’s also about a challenge to existing ways of working. It’s about professionals giving up control, and politicians changing the power relationships that they have with communities. The Deal challenges what the concept of power, public service and political leadership means in 2019 England. Populations need the confidence and space to want to help themselves. That is my job: to create an environment where people feel invested in for the chance of a better life. That is our strategy for improving the health and wellbeing of the people we are honoured to serve.
Kate Ardern is director of public health at Wigan Council. Follow on her on Twitter @KateAlvanley and the council @WiganCouncil
Wigan Council runs regular Deal Days to share their learning.