Community Development Now More Than EverThe current challenge and the response we need

Sandy WatsonChairman, NHS Tayside Board

The Current ContextPublic expectationsModernisation agendaOutcomes-based approachCommitment / leadership; responsiveness / consultation; sound governance; sound management of resourcesReview and option appraisalPartnership / accountabilityRationalisation and consolidationRights / standards / standardisationFinancial burdens

Current Financial SituationScottish budget has doubled over past decade2-year pay freeze south of the borderVAT increase impact on supplies, medical equipment, drugsScotland deferred impact of 6bn saving double impact in 2011/12

Scottish Block Finance & Demand 2009/10 2017/18 (% real terms)

Chart1

00

-2.042

-5.74

-9.16

-12.98

-12.0710

-11.212

-1014

-9.516

IFS

Demand

Sheet1

9/1010/1111/1212/1313/1414/1515/1616/1717/18% Change from 09/10

IFS0-2.04-5.7-9.1-12.9-12.07-11.2-10-9.5-3.8

Demand02468101214168.1

Sheet1

0110

-2.0410/1110/112

-5.711/1211/124

-9.112/1312/136

-12.913/1413/148

IFS

#REF!

#REF!

Demand

Sheet2

Sheet3

Fortunes are not made in boom timesthat is merely the collection period. Fortunes are made in depressions or lean times when the wise man overhauls his mind, his methods, his resources and gets in training for the race to come.

George Bacon Wood (1797-1879)

The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew and act anew.

Abraham Lincoln

Demographic ChallengeLarge growth in over-65s

Tayside over-65s increase of 18% over 10 years; over 85s by 45%

Additional 148 beds by 2016/ 517 by 2031

Three other important strands

Community Planning(formalised by Local Government in Scotland Act 2003) The key agencies involved in promoting the well-being of the communities they serve should come together at council area level in a process animated by the local authority, to develop a vision of the key issues facing the area and how they are collectively going to address them. In so doing, they should develop a Community Plan, which would set out the partners shared vision for meeting the needs of the area. The report also stresses the importance of engaging with and involving communities themselves in this process.Donald Dewar

Better Health, Better Care - Action Plan

..This document sets out a new vision for the NHS. That vision is based on a shift from the current position where we see people as patients or service users, to a new ethos for health in Scotland that sees the Scottish people and the staff of the NHS as partners, or co-owners in the NHS. I want us to move to a more mutual NHS where partners have real involvement, representation and a voice that is heard.

Nicola Sturgeon, MSP, Deputy First Minister and Cabinet Secretary for Health and Wellbeing

Some very important changes:Greater prominence to health improvement and health inequalities, including the health of very young children, which can have life-long implications for peoples health and wellbeing

Much stronger emphasis on working with people population, patients, carers, and NHS staff both in changing and delivering services

Evident increase in the scale of the strategic agenda for the NHS and an explicit indication that the pace of change should increase

Much stronger emphasis on the health agenda being the preserve not just of the NHS, but involving other organisations

An indication of a wider strategic horizon for the NHS beyond the health agenda position reinforced by the Concordat between the Scottish Government and local government, which emphasises a simplified approach to performance management through Single Outcome Agreements

Independent Commission on Good Governance in Public Services: Langlands Report The governing body should decide how the quality of service for users is to be measured and make sure that it has the information it needs to review service quality effectively and regularly. As part of this, it should ensure that it has processes in place to hear the views of users and non-users from all backgrounds and communities about their needs, and the views of service users from all backgrounds about the suitability and quality of services. The governing body should use this information when making decisions about service planning and improvement.

Community Engagement

. The process of involving communities in the planning, development and management of services. Community engagement takes many shapes and forms. It can involve simple exercises in consultation through to the formation of multi-agency partnerships with community representation at the centre. Underlying community engagement is the commitment of the service providers and planners to listen to those for whom the services are planned.

Communities Scotland (Community Engagement How to Guide )

Buzz Words

Empowerment increasing the ability of individuals and groups to influence issues that affect them and their communities

Participation supporting people to take part in decision-making

Inclusion, equality of opportunity and anti-discrimination recognising that some people may need additional support to overcome the barriers they face

Self-determination supporting the right of people to make their own choices

Partnership recognising that many agencies can contribute to ensure that resources are used effectively.

Co-production active relationship between staff and service users as co-workers

ADD:Social marketing

Co-production

Social MarketingWhat is it?

putting people at the heart of policy, communications and delivery to encourage behaviour change

A few thoughtsProvision of services for people > culture of dependency

Partnership with users

Get better at explaining > ownership

Training (interagency) + community capacity building

Involvement in building the boat as well as steering and rowing it

Not just another initiativeChanging the way we do business

Review vigorously

Measure progress

Be honest about where weve got to

The Process Requires: Honest analysis of strengths and weaknesses. (Does this organisation really know where it is?)

Vision

Development of a powerful top team

Importance of communication

Maintaining progress

A way forward?List current successful developments

Identify key factors for success

Operational plan/ template?

How can we build on what works well?

Go with the peopleLive among themStart with where they areBegin with what they knowOf the best leadersWhen their task is accomplishedTheir work doneThe people all remarkWe have done it ourselves

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