Introduction

Building on 30 years of national and international learning and evidence, Local Area Coordination is growing in strength, outcomes and influence in England and Wales.

There have been 13 independent evaluations in the past 8 years, showing that where there is strong, integrated, contributing leadership (including with local people as strong, valued contributors and decision makers) and strong design (reflecting the connected role design and underpinned by strong values, principles and practice) Local Area Coordination delivers consistent, positive outcomes at the individual, family, community and systems levels.

It is directly contributing to building individual and family resilience, nurturing more welcoming, inclusive and supportive communities and supporting more personal, local, flexible services (systems change). It also contributes to regional and national policy aspirations around prevention and capacity building, strengthening communities and reducing demand for/dependency on services (better use of diminishing resources – financial benefit and value for money)

It is now starting to influence and inspire further international developments.

Welcome to colleagues from Singapore

Over the past 18 months, we have been sharing our learning about Local Area Coordination in England and Wales with colleagues from Singapore National Health Group (NHG), including a first visit to England in 2018 to see the Derby City Local Area Coordination programme and then being invited to deliver a keynote speech at the 2018 Singapore Conference around reform of health services.

In March of this year (2019), it was a real privilege to welcome a group of leaders from Singapore to visit some Local Area Coordination areas in Wales and England and to share both our learning, outcomes and contribution to reform of Local Area Coordination (as part of planning for their community health system reform process), as well as hear about the innovative work underway around the transformation of community based healthcare in Singapore.

“A good healthcare system is one that helps people to not need the healthcare system”.

Fabulous – a good piece of learning for us in the UK perhaps?

It’s also entirely in keeping with the focus, outcomes and evidence of Local Area Coordination in England and Wales, nurturing individual, family and community inclusion, resilience, capacity and mutual support.

It all starts with a good conversation – imagining possibilities

We were joined by Dr Wong Sweet Fun (Chief Transformation Officer and Senior Consultant-Geriatric Medicine, Yishun Health and Khoo Teck Puat Hospital), Ms Christina Low (Manager, Population Health Office, National Healthcare Group Headquarters (NHGHQ) and NHG Community Nursing), Ms Ng Tzer Wee (Deputy Clinical Director and Senior Principal Medical Social Worker, Central Health and Tan Tock Seng Hospital) and Mr Tam Sinma (Assistant Director, Community Transformation, Woodlands Health Campus).

In Swansea and Wiltshire they were able to visit some of the wonderful communities and meet local people who had been supported by Local Area Coordinators, local leaders

driving and expanding the programme as part of reform and also the Local Area Coordinators themselves. One of the people they met, who had been supported by the Local Area Coordination team, was Gary. Read Gary’s story

It was a real privilege to hear stories from local people about how they had led positive change in their lives and contributed to their local communities, with support from their Local Area Coordinator. Inspiring.

In both areas, it was also exciting to hear from strong, innovative leaders supporting Local Area Coordination as a positive driver for  change, transformation, integrated working and better use of (diminishing) resources within their communities.

There was a genuine leadership commitment to people and communities, respecting the rights, opportunities and valued contribution that ALL people can make in their local communities.

There is also a growing understanding and confidence that through a respectful, strength based practice that acknowledges and supports the authority of local people (they are the experts in their own lives), emphasises the importance and power of natural relationships and focuses on strengths, aspirations and sustainable local solutions (rather than deficits, eligibility and services), Local Area Coordination builds better outcomes and reduces demand for and dependency on formal services. It also is a catalyst for wider service reform.

Throughout the conversations, we also heard some fabulous stories from Singapore, with many people excited by their wonderful “Share a Pot” developments with local people and communities. You can find out more about this at https://www.shareapot.sg

We also met with research partners from Swansea University and Southampton Solent University to explore their independent evaluations and wide ranging outcomes of Local Area Coordination. Both evaluations show significant outcomes for individuals, families and communities, including positive impact on nurturing natural relationships (reducing isolation and loneliness), financial benefits and an understanding of the intentional design and practice features that build positive and consistent outcomes alongside individuals, families and communities.

Finally, there was a visit to the Isle of Wight to meet with local people who have experienced Local Area Coordination and local communities who are driving the development of the new Isle of Wight Local Area Coordination programme. Very exciting.

This is the story from Heather Rowell, Manager of the Isle of Wight Local Area Coordination programme:

“It was a great pleasure and privilege to welcome colleagues from Singapore to the Isle of Wight to share learning.  Both are islands, close to a mainland but very different. Singapore is a little shy of twice the size of the Isle of Wight, but with a population of nearly 5 million compared to 140,000 on our smaller island.  Singapore is one of the richest countries in the world, and yet our conversations explored the same issues and concerns including areas of deprivation, loneliness, isolation and the challenges and opportunities of an ageing population, and how to keep people healthy and well.

 

During their visit, our Singapore colleagues met with several Local Area Coordinators, who had also invited people they had been working alongside to share their experiences. They learnt about some of the resources in the community that had developed and grown through the Local Area Coordination work alongside local people and their communities. This included a Community Cafe in Freshwater, a safe shared space where people can meet together, there might be a group sewing, someone playing their guitar, playing table tennis or just chatting. The Crochet Café also shared how this new activity had changed lives, enabled friendships to grow alongside confidence. People talked openly about their mental health and how working alongside the Local Area Coordinator, doors had been opened, relationships with family had improved and they felt better able to cope with the difficulties in their lives.

We also invited partners including the time bank, parish councillors and community organisations to share their experience of working alongside Local Area Coordination and the power of equal partnership, sharing resources and learning.

 

Following a meeting with Solent University there was a conversation about the importance of ‘Trust, Time and Listening’ which was identified by the evaluation as the mechanisms that led to the outcomes. It is about much more than someone taking on the Local Area Coordinator role and ensuring those behaviours, it is being embedded in the community, in a role that encompasses many roles, being the local first point of contact and most importantly being recruited by, and accountable to the community in which you work.

 

Following the conversations with people who the Local Area Coordinators had been alongside, our Singapore colleagues asked some very probing and valid questions about dependency. Were we creating dependency, where people becoming too reliant on the Local Area Coordinators?  What people were saying was ‘I couldn’t have got to where I am without them’ not ‘I cannot live my life without them’ but knowing that they can have a chat with the Local Area Coordinator (who they know and trust) if life gets tough again provides that opportunity for early help and prevention.”

Our thanks to everyone who contributed their time, shared their experiences and helped us to make it such a positive time together. Your passion, work and outcomes are influencing other places.

It was great to get to know our friends from Singapore, to learn, to share and hopefully stay connected long into the future around our shared Local Area Coordination journey. It’s all about trusting relationships and shared passions and aspirations.

We also had great fun! Watch this space……

Ralph Broad 
Director of  Inclusive Neighbourhoods