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Susan’s story

The story below outlines the journey that Local Area Coordinator Marissa (based in the City of Derby) and local citizen Susan (whose name has been changed at their request) embarked on together over the last few years. Marissa shares some of the principles and practices which are central to the Local Area Coordination approach.


 When I first met Susan, she was struggling with the move to Derby, away from her family, friends, and familiar life. Financial constraints limited her housing options, and she was under significant stress which was affecting her physical and mental health. Susan was also caring for her husband who had terminal cancer. She reached out for help through an occupational therapist and was introduced to me.

How things progressed

Initially, I focused on building a relationship with Susan, understanding her current life, priorities, vision for a good life, and specific goals. Susan had moved to Derby during the lockdown, exacerbating her physical and mental health issues. She needed formal support and felt isolated, not knowing anyone in the local area. We discussed her interests, leading to her joining a local knitting group. Initially nervous, Susan attended with me, which helped her to feel more comfortable, knowing she had a friendly face alongside her. The group became a place for connection and fun, not just knitting.

Where next

Within weeks, Susan was enjoying the group, learning to knit, and forming lasting friendships. When her husband sadly passed away, these new friends provided vital support, attending the funeral and offering comfort during her darkest times. Susan described the group as her ‘lifeline’, helping her through grief. She is now an active ‘knitter’, making baby hats for the local hospital’s neonatal unit, and giving her a sense of purpose and community contribution.

What worked for Susan

Local Area Coordination is highly accessible, with no thresholds or complex referral pathways. Support isn’t time-limited or session-restricted. Susan’s occupational therapist explained all about Local Area Coordination, allowing her to decide if it was right for her before introducing us. This approach enabled me to build a positive relationship with Susan without predefined agendas or targets. We had time to develop trust, making Susan comfortable with sharing her story.

We follow principles such as ‘natural authority’ and ‘choice and control’, recognising Susan’s deep understanding of her life. Susan led the decision-making process about what her good life looked like and the support she needed. We discussed options together, but Susan always had the final say.

Photo of Susan showing some of her knitting
Susan showing some of her knitting

The impact

Susan now feels more confident, connected, and in control. Reflecting on her progress, she believes she would have struggled significantly without her new network, possibly requiring formal intervention or hospitalisation. Instead, she sought support from friends at the time of her husband’s death and now offers support to them in return.

Susan continues to fulfil her passion for and connection with healthcare by knitting hats for the neonatal ward, maintaining her relationship with the NHS as a retired employee. Susan has made real progress towards building her good life: becoming a more active citizen, contributing in her community, growing her network, and being there for others too!