What is an empowered city?

Recently Tom Riordan, Chief Executive of Leeds City Council, quoted the following words: "The 19th Century was a century of empires. The 20th Century was nation states. The 21st Century will be a century of cities." This is both a fascinating insight and a clarion call. It reflects the discussion in the city of what Leeds can be and should be. In everything from theatres to places to eat, Leeds has so much to offer.

Pria and myself recently met and part of our conversation was on the theme of empowerment. Empowerment is a word that gets used a great deal. But what is empowerment? And is it really possible? Empowerment in our view is where a person discovers their own power and possibility. It is that paradigm shift where a person sees their gifts and starts to own and release them. This certainly happens. The problem we see with empowerment is not that it doesn't exist ( it does! ) but that we get the picture of how it happens all wrong. We have certainly heard good colleagues talking about 'empowering people' or 'We need to empower him or her' The problem with this is that it portrays us as the ones with the power and the others as not having power. Our task is then seen as somehow giving of our power to the other. We would suggest the real picture is that we cannot empower anybody as empowerment is not a magical power we can give to another. Each person has to discover their own power and potency. What we can do and this is really significant is provide the space, relationships, approach and support for this to occur. I (John) have worked with homeless people for 20 years on the streets of Leeds and have seen people empowered in incredible healing ways as they found their identity, skills and options. It was the clients who did the work and made and lived the changes. Hopefully I supported that process and didn't act too much as an obstacle. The great strength of this understanding is that we recognise that all of us already have great gifts and power but there is a need for this to come alive and flow.

This theme led to a discussion of how Leeds is and can be an empowered city. Where the culture, programmes and partnerships tap into potential of people and support its activation. One example of where this occurs is MAP. MAP is the the Migrant Access Project. It is chaired by Mick Ward, Head of Commissioning at Adult Social Care. A number of leading agencies in the city are part of the board including LASSN, Touchstone, York Street Health Practice and Leeds Refugee Forum.  The project trains people from different communities ( such as the Eritrean, Sudanese, South Asian and East European communities ) to act as networkers. A networker is a bridge  builder between communities and services. These networkers receive training in how benefit, housing, health and other systems work and act as a conduit for accurate and clear information for communities to access services. The Migrant Access Project has completed a fifth round of training to networkers which ended in May of this year. Since then a weekly drop in has been set up to support the networkers. This is proving successful in gaining an insight into community issues and how best to resolve these. The emphasis here is on creating awareness, improving access to services and involving partners to meet with communities. One example is a networker who has a desk at a One Stop Centre and offers support, advice and signposting to members of different communities. She does not take people to services but supports them access them.

There is in this work important themes that can be seen in terms of empowerment. The first is that the networkers are given support, training and ongoing assistance. This allows this work of finding confidence, knowledge and networks to occur. This inner work of growing and becoming a networker is not only for oneself but for service to the wider community. The networker is constantly going out to create conversations and connections. They are continually creating bridges everywhere they go. This tremendously supports services to understand and deliver services in the most understanding and effective way. It also supports communities understand and access services. These links make a real difference as people access the housing, health and social care they need. This model also helps people make that transition to become great citizens of a city. By this we mean people who make the commitment to invest in and contribute to the city.

This is empowerment in practice. People seeing and offering their gifts so our city can be the best for health and wellbeing where the poorest improve their healthcare the fastest. This vision of statutory, third sector, networkers and communities working together for the city and each other offers a picture of what we are doing and can be. It is a present reality and a future promise. The good news is MAP is not alone. Across the city agencies, people and communities are working together for the future. These projects - from St George's Crypt to Genesis to Pafras - all show what we can do together. An empowered city is a city of hope which values people, shares skills, celebrates gifts and serves communities. It's a wonderful thing, that with so much bad news in the world, this work is going on in Leeds.

John Walsh, Support Manager, York Street Health Practice

Pria Bhabra, Migration Partnership, Adult Social Care, Leeds City Council 

Hope in Gipton, hope in Leeds

I recently met with Jane Stageman, who represents Leeds City Council and Becky Malby, director at the Centre for Innovation in Health Management (CIHM) at the University of Leeds. Our aim was to discuss leadership work in the city. The meeting flowed with ideas and visions for the future. I've written this post as a way to recall the discussions and offer them as ways forward to a better, brighter city for all.

Becky shared the work of project called Action for Gipton Elderly which she had recently visited. 

This project seeks to offer support and care for the elderly who live in the Gipton area. It works to make sure elderly people have food in cold icy weather when they cannot venture out. It coordinates a team of volunteers who visit the elderly and it has an arrangement with local fish and chip shops to provide some free meals. The link to health and wellbeing is clear. Elderly people are offered contact and support and loneliness is challenged by community action. Elderly people will have fewer falls and possibly fewer hospital admissions as they won't have to venture outdoors in ice and snow to buy food and milk. They will also have local people to call if they have issues and difficulties. This is real community action in practice. It tells us that people and communities have answers and assets that we need to hear and support. Local answers from local people are a powerful health and wellbeing force. These projects also tell us something about what we human beings can do and be at our best - that we can care, organise and change things. The greatest enemy of human development is the attitude and spirit that says it can't be done or won't work. Projects like this say that it can and is being done, and the effect is the improved health and wellbeing of our elderly people.

The vision we talked of was around the concept of Leeds as an international centre of culture. This discussion led us to ask what 'good culture' or 'best culture' looks like. Is it nice statues or beautiful buildings? Is it well kept parks or first rate arts productions? Of course it is. Yet it has to be something more - something much more. In its last days, Ancient Rome had fine temples, buildings and sports, yet it was collapsing from within. No one was or is suggesting that Leeds is collapsing from within but what we did see in the discussion was that good culture was that which values and inspires people. The best culture is one where people can dream, hope and have compassion.

We have a real need to dream. Albert Einstein, probably the greatest scientist of the 20th century once said that, 'Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.' This is so important as it calls us to use our imagination to forge our future and plans. It's not without significance that the great Martin Luther King didn't say 'I have a policy' or 'I have a document', but rather 'I have a dream.' Hope is key too, but what is hope? We venture the answer that hope is the belief that we can work things through and make things better, despite whatever might block us or stand in our way. In the ancient world and in works like Aesop's fables, hope was represented by the swallow. This is because the swallow was seen as one of the first birds that appeared at the end of winter and the start of spring. Lastly is compassion, hearing the call of another and respond from the heart to them in their need. For us to be a centre of culture is to be a city that engenders and inspires these qualities. If we create a city of hope, compassion and imagination, that would be a city where the best in humankind will be at the centre of all we try to do and great culture will be second nature.

We so often hear that a society and humankind can be measured by how it treats its elderly. All across the city, people and communities are committing to projects that place elderly people at their centre. In Beeston, Nicola Dumphy has embarked on a project that supports the people with dementia (and their carers), and aims to build a supportive and connected dementia friendly city. This project will change the experience of living with dementia in Leeds for many by inspiring co-produced services that meet the needs of the city. Projects like these are conceived and thrive on hope, compassion and imagination. In embracing these as a city we can hold our heads high when others, as well as ourselves, look to measure our society and our culture.

The community initiative in Gipton, the commitment to build a dementia friendly city and the vision of good culture for Leeds are part of what this city offers to its people. Leeds is changing all around us. Great people are doing amazing things. This is both a sign and a source of our future. If we can do this now, what else can we achieve in the future? What would our city, a centre of culture look like? We hope this article can be a contribution to why and how we can create those cultures, conversations and communities where people care, hope and dream.

John Walsh, York Street Health Practice

Natalie Leach, Centre For Innovation In Health Management

Jane Stageman, Leeds City Council

Feeding our people

John Walsh speaking to attendees of the
Homeless and Food Aid meeting at St George's Crypt

I was asked to speak at St George's Crypt in Leeds at a Homeless and Food Aid meeting and training evening. This brought together services, faith communities and concerned individuals to work to make sure that people who struggle in Leeds can access food. A year and half ago the Yorkshire Evening Post pointed out how malnutrition cases seeking hospital admission has trebled in five years. Our good colleague, Councillor Lisa Mulherin, the chair of the Health and Wellbeing Board, said: "The numbers being admitted to hospital are shocking and potentially the tip of the iceberg. It’s an absolute disgrace that in a wealthy, modern nation we are seeing anybody turning up in hospital in that condition." Dr Ian Cameron, the director of Public Health in Leeds, said this increase in hospital admissions was a national not just local issue. 

This meeting was part of a response of a city to this issue. And it's not just homeless people or people on benefits but the low paid affected. We seek to draw together services and people to make sure malnutrition doesn't occur in our city and the hungry can be fed. Councillor John Hardy has played a central and leading role in this work. Services like York Street Health Practice and faith initiatives such as Unity in Poverty Action were involved from the beginning. These networks seek to draw together services and people to make sure malnutrition doesn't occur in our city and the hungry can be fed. See a piece in the Yorkshire Evening Post here. There is also now an All Parliamentary Inquiry into Hunger and Food Poverty, which is presently taking evidence under the chairmanship of Frank Field MP and the Bishop of Truro. 

The meeting had three speakers. It was a series which brought together people to look at needs which emerged alongside food. The topic this evening was mental health. I spoke about the Health and Wellbeing Vision of the city and need for a manifesto of good mental health work. This is not just what we do but also how we do it. The call focused on what we try to do at York Street - creating a positive space for the vulnerable, build kind and effective relationships and support people to identify and engage with hope. If we miss these things we end up working superficially. Emma Strachan from Public Health gave a great presentation about the positive work Public Health is doing in Leeds and how she will act as a link between the network and Public Health. The last speaker was Philip Bramson from Volition who spoke eloquently about mental health services in the city.

The meeting was attended by about 45 people - from churches, Adult Social Care, the Welfare Rights Unit, MIND, the food banks. Skyline, Archway and other organisations. Special mention must be made of Unity in Poverty Action who have done such amazing work in bringing together and supporting this network. The sense in the room was one of care and commitment to be with and support those in this city who find life hard. If we could bottle the energy, compassion and goodness of those present we would have a very potent power to move towards making Leeds the best city for health and wellbeing. This meeting showed me what makes great partnerships. Great partnerships are like a three legged stool. The legs are great vision, great work and great relationships. Pull one leg away and something essential is missing. Without vision we flounder. Without the work there is no change and without the relationships we don't connect.   

This blog is called 'Feeding our people' and it's true. The vulnerable, hungry and sick are not people - they are our people. They belong to our city and we are linked to them. We either work together to create comprehensive cohesion or struggle alone as isolated individuals. The first path is all about making a caring and supportive city. The latter is its opposite - it's negation. If we take the first way and really work together for this one thing will certainly happen, we will be the best we can be in the best city we can make. And that really is something worth working for isn't it?

 

John Walsh, York Street Practice

A local partnership with global impact

John Walsh, of York Street Health Practice, discusses his recent trip to Prague as part of a learning programme on street work...
 

In May I joined a group of students and academics from Leeds Metropolitan University (LMU) to travel to Prague to take part in and work to develop a powerful and innovative learning experience. This was the intensive learning programme on street work between four universities, LMU, Barcelona, Amsterdam and Prague, to which the project forms part of a three-year Erasmus-funded Intensive Programme (IP), which initially began in 2013.

 

The Leeds teaching programme, which is led by Darren Hill and Dr Erika Laredo from LMU, creates the space for 40 students from across the four universities to work with academics and practitioners on street work, research, theory and practice. The students come from a range of backgrounds including social work and youth work and had all done preparatory work on issues of homelessness, addiction and social theory. 

This was a great example of how Leeds, in all it's rich complexities of academics, practitioners, students and former service users, could come together to learn and debate options and approaches across countries. Darren Hill, senior lecturer in social work at LMU and co-organiser of the programme, summed up well what this meant: "The students and staff will be studying international street work, visiting homeless projects in Prague, designing research proposals and sharing their skills and experiences. We hope that it will encourage the students to go into masters degree level study and move into street work practice. By drawing together a range of academics and professionals across a variety of disciplines, we aim to address the new knowledge and skills that professionals working within a street context will require over the next decade." More details about this can be found on the LMU website.

My memories of the two weeks are positive and plentiful, with particular things standing out. One was that the Prague conference on the ground was run and overseen by just one person - Barbara Janikova. Barbara is lecturer in the Department of Addictology, First Faculty of Medicine at Charles University in Prague. I was amazed at how one person supported us all and organised the operation on the ground, day after day. She was always there helping students and staff and we were all inspired by her. On the last day at the final meal, we were able to celebrate her and all she had done for us. While it is true that Barbara is an extraordinary person, it showed me again how one person can make a massive difference. It is a lesson I see often in the NHS and elsewhere, that it is really the people that matter. If we get the right people, people of care and vision, all the rest can follow. Without this, I think we run into real problems.

During the two week teaching experience, Jo Smith, my colleague from Leeds Adult Social Care, and I took part in different sessions. Jo is a mental health social worker for the homeless and works in the Mental Health Homeless Team, which is part of Leeds City Council, as well as in the CRI Street Outreach Team. Each day we ran sessions to encourage the students to meet and take part in interactive work; this was to support cross national discourse, discussion and work.

We worked with tutor groups looking at different aspects of teaching and research. My group looked at drug issues and visited an inspirational project, which works with those with drug problems in the city of Prague. It was interesting to hear about their challenges and work and it struck me how in Leeds, we are very fortunate to have built and continue to build strategic alliances for the poor and the vulnerable. These alliances see inclusion as not just including marginalised groups but address how a whole city can and should develop positive health and wellbeing agendas, vision and practice. This allows the generation of work from the bottom up and top down to occur and really start to change things. Two examples of this are the Leeds Health and Wellbeing Board Vision and the innovative work around homeless hospital discharge work (Homeless Accommodation Leeds Pathway (HALP), which Leeds Community Healthcare NHS Trust and York Street Practice have been key workers in). One person (who has extensive experience in services and service development) and attended the HALP launch in January commented to me recently how, when they attended the launch event, they were impacted by the incredible positive energy in the room and how everything was joined together, from the streets to strategic levels.

We used a variety of forms to teach and share in the two weeks. One interesting format was a staged debate between myself and my friend and colleague, Dr Asun Llene Berne, professor of Theory and History of Education at the University of Barcelona. I was asked to take the proposition that in times of austerity research should not be funded and the funding should go into practice and services. Asun argued that practice without research is lost, hence funding was necessary. The debate took place and we both presented our cases. I was struck by the high level of discussion, reflection and co-learning that the debate and the overall teaching experience created.  I believe with Darren, Erika, Asun, Barbara, Jo and other good colleagues such as Sue Lindsay, we already see international and innovative ways of learning and practice emerging. This offers new possibilities of health and education working in positive partnership to generate quality research, an improved discourse on the needs of our most vulnerable people and the evolution of the most compassionate and effective care possible.

Colleagues at LMU have written an article on York Street Health Practice (click here to read). In it they have a fantastic quote that this a is local partnership with a global impact. I hope we can build this into a living ongoing experience, which can generate a new international dynamic model  of collaborative work, research and practice. I'm proud that Leeds Community Healthcare NHS Trust are involved in something so potent and promising.

 

John Walsh

York Street Health Practice