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  1. Bernd Sass permalink
    February 10, 2016 10:04

    Yes, all well and good but still some missing links to real (disabled) people and patients driving local services and support through co-production as in user-driven commissioning!

    It’s still professionalisation (and business / service responses to need) which often stand in the way – not personalisation. Why do we not call for self-assessment, self-referral and peer support to become regular, formal components of commissioning contracts?

  2. February 10, 2016 11:38

    Mark, thanks for this, and Bernd for your comments here too.
    There’s lots to think about on this. It would be interesting to understand more about the perceptions and insights of these commissioners/planners – why they construct their system response as a pathway – which to me infers a linear course – I’m sure it’s not like that for many of us! Also, who decides on vulnerability – to what? Shouldn’t we be speaking of opportunities, aspirations, as well? Part of me thinks such commissioners need to be very bold and run with investment on community led action that builds health. But then the results aren’t readily evidenced in year to that years outcomes framework….

    My other reflection is on the creation of a mirror infrastructure world – that commissioners spend/invest in community sectors orgs that mirror in terms of process, language and “performance” that of the commissioning world – I’d be more interested in seeing how such public sector agencies used resources (£) into local neighbourhoods for direct action on stuff that keeps people well, resilient etc. And, we know the ‘evidence’ is there for this….The very stuff that isn’t “delivered” through a “(social) Prescribing” protocol and which isn’t accessed through the GP setting!

    However, I don’t think it is an either / or scenario. I think the public sector involved in health and all that means should recalibrate toward a community and neighbourhood located agenda – where individual and more so collective action can be affected that brings about social supports and connectivity, from which much can and will flow!

    Back to the coffee pot ….

  3. Lee Beresford permalink
    February 12, 2016 09:28

    Mark – delighted to read your post above. I work for NHS Wakefield CCG. We are very interested locally in the greater potential of our communities (and the grassroots resources within them) to advise, educate, support and to hold or resolve as greater part as possible of their own health and well-being needs. I accept THE comments re the mirror infrastructure world challenge – but would argue as an experienced NHS commissioner that an ‘intermediate period’ is practically required where some ‘bridging’ can occur – this will I believe – necessitate some unwanted (but temporary) mirroring as what we are talking about here is new territory for many health commissioners and they currently lack ability to call upon the ‘re-assurance’ of substantial NHS policy, practice and procedure (de rigeur for confident commissioning in the NHS) in achieving the future conditions you refer to.

    • February 12, 2016 09:36

      Thanks for your comments Lee – I think it is really positive that CCG commissioners are engaging with this agenda – I agree we are in a transition phase – the key bit is of course to recognise this – as you have done. I note your point with regard to NHS Policy and Procedures, there is an ongoing debate about trying to rebalance NHS Commissioning so that it favours innovation a bit – even though that may bring greater risk with it. I suppose the latest NHSE Guidance on Five Year Forward View implementation is meant to help free the system up a bit. In Wakefield you do of course have some excellent work and organisations already – not least the contributions of NOVA – who I am sure you will be familiar with – best wishes – Mark

      • February 12, 2016 12:20

        Delighted to have had your blog shared with me by Alison Haskins, CEO of NOVA Wakefield… Echo many of the thoughts/contributions above & would add that the ‘Whole-System’ approach we have adopted here in Wakefield via its Provider Alliance, (which is being led by NOVA, in the case of Social Prescribing – or what we like to describe it as Community Solutions) is facilitating a pace & dynamisms which is both healthy & constructively challenging – long may it continue…. JJ, Director Provider Alliance Wakefield

  4. Elaine Appelbee permalink
    September 22, 2017 20:51

    The NHS and Social Services ( adult and children) serve individual patients/clients. At best they work with families. This has always seemed to
    me to explain why there has been a struggle over many years to help those agencies understand that the communities in which their patients/clients live have a fundamental role to play (for good or ill) in the quality of life and outcomes for those individuals. Whilst there is a failure to grasp this, there will be a failure to invest in community infrastructure that can make a powerful, positive difference that saves both lives and public money.

    • September 25, 2017 09:40

      Hi Elaine – good to hear from you. I agree – it is interesting and a bit dispiriting that community work, community development, etc is one of those agendas that comes and goes on a cycle that probably lasts about two parliamentary terms. Ironically the strand that should provide one of the greatest sources of stability and support – community and neighbourhood – is too often treated in an impermanent and marginal way at a policy level.

  5. November 24, 2017 10:42

    Love this, Mark. Very well articulated set of observations / arguments. Interested in thoughts on how digital (especially) social media and connectivity tools fit into the equation if at all?

    • December 3, 2017 17:50

      Cheers Sam – hope Poczero and you are doing well over in the Midlands!


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