31st October 2018
Improving prevention outcomes through a place-based approach
We are living longer but for some people, these extra years are lived in poor health. As we get older, our risk of lifestyle-related long-term conditions increases. Our risk of ill-health is related to a wide range of broader social factors and is also influenced by our own behaviours. Prevention of avoidable illness and promotion of wellbeing and resilience is a major systems-wide priority in which leadership from local government plays a vital role.
One way to embed prevention more effectively across society is by focusing on place-based approaches, working with communities building on local assets to have a positive and sustainable impact on health outcomes. When advice, care or treatment is needed, place-based approaches help people receive this close to home, from people and places that they trust, working in an integrated way improves experience and outcomes.
Successful place-based approaches rely on us moving beyond institutional boundaries and encouraging local services to work collaboratively. Integrated care systems are becoming increasingly important to improve public health and reduce health inequalities, based around the needs of local populations. While every approach will be different based on the needs of local populations, here are five ways to strengthen place-based approaches to improve public health outcomes.
1. Encourage genuine co-design and co-delivery: Involve members of the community in setting priorities, monitoring and evaluating services and initiatives. Working collaboratively leads to improved outcomes for people who use services and has a positive impact on those who deliver them. Think Local, Act Personal is a national partnership committed to enabling co-design and co-delivery. It has over 50 organisations committed to transforming health and care through personalisation and community-based support, including PHE, central and local government,
the NHS, the provider sector, people with care and support needs, carers and family members.
2. Map and mobilise local assets: Encourage members of the community to identify and develop the skills, knowledge, networks, relationships, and facilities available that contribute to collective health and wellbeing.PHE’s Health asset profiles can be used to explore local data on protective factors and its SHAPE digital tool is also available to support local asset mapping. See for example Wakefield District’s Joint Strategic Needs Assessment resource, which lets users understand individual and social determinants affecting local health and wellbeing and the role that community services across the region play in helping tackle these.
3. Measure health and social outcomes that people value: These include wellness, social connections and improved neighbourhood environment, protective factors that can help buffer against risk factors like smoking, obesity, and drug and alcohol use. Outcomes remain difficult to measure but are best done at a local level. The What Works Centre for Wellbeing has produced a local wellbeing indicators guide and dataset to support localities.
4. Normalise conversations around prevention: Local authorities can help normalise prevention by promoting and prioritising prevention programmes such as the NHS Health Check, working with other community services, such as the fire service, to help deliver early interventions to those who need it most. They can also help by supporting initiatives that normalise conversations around risk-factors such as pressure and cholesterol by making them more visible, for example encouraging the installation of blood pressure testing machines in non-clinical settings. For younger people, PHE has a number of school resources to encourage healthy student behaviours that it can be useful to signpost to.
5. Promote All Our Health resources to community settings: Public Health England’s All Our Health framework helps anyone working in health and care, in clinical and non-clinical settings, to embed prevention within their day to day practice and make an even greater impact in preventing illness, protecting health and promoting wellbeing at a local level. The All Our Health resources can also be embedded as part of training and continuing professional development to help professionals recognise the value of asset-based approaches to reducing health inequalities, alongside and as part of healthy public policy and prevention services. PHE’s All Our Health framework provides prevention advice on a range of topics affecting local areas, from obesity to mental health and homelessness. For families and children, supporting children to have the best start in life and shape healthy behaviours requires strong local collaboration across a range of services in local communities including maternity, early years and health visiting, GP and dental practices, and schools. Our Health ‘townscapes’ are a useful way to show visually how areas can focus on improving outcomes.
Professor Viv Bennett, Chief Nurse, Director Maternity and Early Years at Public Health England