Wednesday, 30 July 2014

Champions for health

This is the story of a project that we formally closed last week. It was an initiative called Health Champions and ran for two to three years in Leeds. It started when Jane Willliams, Strategic Development and Commissioning Manager (Mental Health) for NHS Leeds, brought the three of us, Isobel, Charlotte and myself together. We represented the third sector (St Anne's Resource Centre), NHS Leeds Integrated Commissioning Team and a service of Leeds Community Healthcare NHS Trust. Our brief was simple. To reach out to the 13 key non health homeless agencies in the city, bring them together and create a network of health champions. These agencies included St George's Crypt, St Anne's Resource Centre, Holdforth Court, Emmaus and the Street Outreach Team. These health champions would make strong the links with established health services, raise health and wellbeing as a key issue in their organisations and work with the NHS to co-create health solutions to their clients issues.

We had a very successful training session at the old Public Health Resource Centre in Armley. We followed this with seminars on subjects chosen by the health champions and also topical issues. These included dual diagnosis, personality disorder and TB. Some vibrant open days were also held. These were open to people using services and agencies and were all very well attended. In total there were three open days, the first two focusing on mental health and alcohol. The last was an event called 'Making the Links' and brought together housing, health, faith sector, food provision, law, probation, floating support, Public Health, sexual health services and many others. The aim was to have all these services concentrated in one place so services and clients could, as we entered a period of great challenge and change, be able to 'make the links to make the difference'.

The three of us worked hard for and with this project. What were the lessons? What did we see as we tried to build this from the ground up? There were many things we learned. We will try to pinpoint three that we think have real value not just for our personal learning but for the city. The first one was that there is no place where health stops. To explain this it's best to recall that Leeds has three health trusts (Leeds Community Healthcare NHS Trust, Leeds and York Partnership NHS Foundation Trust and Leeds Teaching Hospital NHS Trust) as well as Public Health which is part of the local council. When we did the training we did an exercise to see what health work these 'non health' workers were working with. We saw masses of health and wellbeing work across services and the city from these colleagues. We heard and saw how colleagues were dealing with everything from drug addiction to mental health to physical mobility problems. This shows us we cannot just put up a sign saying 'Not Health' as there is no place where healthcare stops or doesn't exist in the homeless sector. This has especial relevance for the city of Leeds. Its health and wellbeing vision is that we all create a caring and healthy city where the poorest receive healthcare the fastest. In the training we were seeing that this commitment to the poor and sick was something non-health services were already doing and working with. Health and wellbeing should be seen as the work of us all and we should all seek to align ourselves to work with the city and its vision.

The second lesson was how well the three of us worked together. Sometimes partnerships don't actually work together that well. Why did this one? We would venture the following answer. Two of us had already worked together (St Anne's and York Street) and there existed a very positive history of good work and respect.  There was also a real exchange of ideas and listening between the three of us as well as humour. We think the biggest help was that we all sought to give. We didn't focus on what we got but rather on what we could give (and interestingly got so much back from the project). Partnerships sometimes flounder because people may seek to control and not focus on the common good and goal. That didn't happen here. The common vision and this giving attitude made the project a real joy as well as hard work at times.

The last lesson is to use the common parlance - one size doesn't fit all. We could create the framework but we learnt we had to let it develop organically. Different services took the training and work and applied them in different ways in their services. There was something here about how we balanced management and autonomy. Again we would suggest that there is a wider lesson here. Often the best services have this balance and sometimes a tension resulting from this dual reality. Without the leadership and management there would be no steer or direction, Without the autonomy and room for growth there would be no creativity or new life. Sometimes holding this balance can be a challenge but in this tension lies the path of allowing possibility to emerge and making sure things stay on track.

This article has brought the three of us back together to remember and celebrate the Health Champions Programme. But we were not the stars of the show - just its organisers. The real stars were the workers and service users who worked in this programme. They were the people who worked in the centres, hostels and teams responding to need and linking in with health for the best outcomes. It's fitting to end by saying thank you to these good people who made the difference for the better and still do.

John Walsh, York Street Health Practice
Charlotte Hanson, Public Health, Leeds City Council
Isobel Worswick, Former Manager, St Anne's Resource Centre

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