Last week – I facilitated an awayday of the Darnall Well Being Project. This fantastic organisation based on the principles of the Peckham Settlement has been going for over 10 years.
Darnall is part of Sheffield and has a population of about 12,000. It is one of the more deprived parts of the city – but also has many strengths – a diverse population, great community organisations and of course Colin Starsmore one of the last proper tailors in Sheffield – who retired in 2014.
There were approximately 30 people at the away day of whom over half were local people who are involved as volunteers – as Community Health Champions – or users of the project or as staff – such as Health Trainers.
A couple of things struck me.
First – much of the funding for organisations like Darnall Well Being comes from the NHS – usually public health budgets in the PCT. This can mean that they are rely on champions in the NHS who understand what they are trying to achieve, and in particular value and understand the relationship building work that they do between statutory services and communities.
The problem arises when budgets are cut or requests for funding turned down. The NHS has little tradition of local democratic accountability and little expertise here. This means that funding decisions are usually made in internal meetings between professionals (in this case public health) and bureaucrats who are responsible for commissioning. The greatest degree of local accountability is when a decision goes to the PCT board for discussion – and most of us do not know when this meets, who is on it and how to influence it.
Of course most of us have little experience of lobbying PCTs and their boards and tend to rely on the advocacy of professionals employed by the PCTs. This is in complete contrast to our relationship with local authorities.
I am not claiming that local authorities are perfect here. But many more people understand how to bring pressure to bear on local authorities, how to lobby them, how to make the case for their communities. Whether this is through putting pressure on local councillors, attending council meetings or area meetings, petitioning the town hall, demonstrating outside it or even writing to the local press.
Because we do not understand local NHS processes, have little tradition of lobbying here and are seduced into thinking that somehow the discussion is more evidence based than that which occurs in local government we are disempowered and do not lobby and get in the face of commissioners.
We let NHS commissioners off the hook.
Second thought. On a more positive note I was interested to hear from a nurse at one of the practices in Darnall that one of the challenges they face – in an area with a very high prevalence of diabetes – is that they struggle to get people to go for check up visits and screening.
This led to an interesting discussion about the potential offer that Darnall Wellbeing could make. It is the health and well being organisation that has sustained and coherent links with people in the community. It is in the best position – using its networks – the expertise of its volunteers and service users – to promote screening and to support people attend screening. The away day agreed to follow this up and talk to GP practices about piloting this intervention. More on this as this develops