1. ‘What can Coproduction produce..
… using the C2, 7 steps ‘from isolation to
transformation?’
“We thought we were doing up houses…
we were actually doing up lives!”
Hazel Stuteley O.B.E., R.G.N.& Dr Jonathan Stead F.R.C.G.P.
Programme Directors Connecting Communities C2, PCMD, University of Exeter
2. Beacon Estate, largest and poorest in South West 1995 – 1999 outcomes included:
All levels of crime reduced 50%. Employment levels up 71%
Improvement to over 1000 homes. Unemployment reduced 71%
Child protection rates reduced 61%. Asthma rate reduced 50%
Educational attainment improved 100%. Post natal depression down 48%
Best of all complete rebirth of community spirit !!
4. So what’s the link between strong, self-managing
communities and health & social well-being?
Compelling evidence that:
• Failing to manage your environment causes chronic
stress leading to poor health behaviours
• Anti-social behaviour causes ill- health
• Chaotic early life changes way the body functions and
the brain develops
• Having no sense of influence or control in decision
making about where you live, harms health
• FACT…residents, supported by service providers, can
lead and sustain transformative community change &
improve their own health
• This is also highly cost-effective for all organisations
5. Step 1
“Never doubt that a small group
of thoughtful, committed
citizens can change the world.
Indeed, it is the only thing that
ever has.”
Margaret Mead
US anthropologist (1901 - 1978)
6. 9 mums and 23 children from Beacon Estate Cornwall , launch the 2000 NHS plan
in London and tell Health Ministers how they have turned their lives around and
improved their health , wellbeing and educational attainment of their children
7. C2 CONNECTING COMMUNITIES
A 7- step evidence-based model
THE CONCEPT IS SIMPLE
C2 brings residents within a target
neighbourhood together with
service providers to work together
as equals, forming a self-managing
resident-led, operational partnership.
Their joint aim makes neighbourhoods
better places in which to live and work.
RESULT….transformation of place,
health status & engagement.
8. ‘ Does what it says on tin’: connects
communities in three ways:
1. Within themselves – networks and
cooperation amongst local residents.
2. With local service providers and public
agencies – building a parallel community
of interest amongst the front-line
workers and others.
3. With other communities – getting and
giving inspiration directly from one place
to another.
9. Co-creating receptive context for
transformative change in which residents lead.
Enabling key factors :
• New relationships Emergent Results
• Trust & respect • Community self-
• Interdependence organisation
• Active listening • Increased social
networks
• Working/thinking • Health creating, cost-
differently effective initiatives
• Connectivity • Dispersed leadership
• Co-learning • New health- seeking
• Shared agenda behaviours
• Visibility • Long term culture &
• Think big/start mind-set shift
small
Creation of new order by recasting interface
between residents and service providers
15. Wandsworth Council subsequently invested £140k to restore Community
Centre to be managed by residents, offering wide range of health
enhancing activities for all ages.
17. Operation Goodnight
A voluntary young peoples curfew during summer of 2008.
Anti social behaviour dropped by 67% and it brought the
community together
18. Green Fingers Redruth North
Getting disaffected young people back in full time education and
employment whilst also improving environment of the estate
19. First cohort of 20, 10 achieved NVQ level 1 in horticulture,12 moved on to level 2,
16 went into FT employment, 14 passed First Aid Cert.,12 areas of open space
were improved and 130 individual gardens maintained for elderly and infirm.
20.
21.
22. CAMBORNE COMMUNITY DANCE TEAM……
transforming community through dance
(named after their post-code)
25. 1995-2011 Over 1000 young people engaged. Results inc:
•35% increase in Educ. Attainment . Truancy levels reduced 80%
•School behaviour incidents down 90%. 60% reduction inhaler use
•Evidence of large scale health behaviour change eg reduced obesity
rates & smoking, self-harm, fruit consumption increased.
•Employment and FE opportunities. Community ASB levels down.
•At least 6 Y.P. prevented entering CRIMINAL JUSTICE SYSTEM
26.
27.
28.
29. The Queen honours outstanding volunteer group in
Camborne with prestigious Award
The TR14ers Community Dance Group from Camborne has
been announced as one of 130 winners of The Queen’s Award
for Voluntary Service, the MBE for groups of volunteers who
work in their local community for the benefit of others.
June 2011
30. Step 4
“ Health Equity - if we use what we
have, we have what we need.”
Dr Edgar Cahn 2011
31. TT
‘The real voyage of discovery is not in seeking
new landscapes but in having new eyes’
Marcel Proust
32. ‘It does not require a majority to prevail, but rather an irate,
tireless minority keen to set brush fires in people’s minds’
Samuel Adam 1775
33. Machine Complex adaptive system
• Hierarchical • Living agents
• Broken down into smaller • Built on relationships
parts • Ever-changing
• Certainty • Built on conversations
• Evidence base
• Issues emerge
• Protocols
• Toolkits • Unpredictable
• Check-lists • Operates best at edge of chaos
• Negative feedback loops • Positive feedback loops
• Power over • Power with
• Transactional • Transformational
36. Step Zero
“Go to the people, live amongst them, start with what they have, build with them, and when the deed is
done, the mission accomplished, of the best leadership, the people will say, “we have done it for
ourselves.”
Lao Tze (600BC)
Notas del editor
Self intro: 40 yrs in NHS as community nurse and HV, during which time we ’ ve all seen amazing progress in cancer survival, transplant surgery, 50% reduction in death from cardiovascular disease in last decade We can be proud. The list is gratifyingly long and life expectancy has increased significantly ……BUT NOT IF YOU ’ RE POOR! and this is where I think we should be indignant, angry even. The inescapable fact is that the H.I. gap is ever widening and the prevalence of LTC remains overwhelmingly linked to poor socio-economic status .EVEN MORE SO NOW WITH RECESSION, CUTBACKS AND INCREASING LEVELS OF UNEMPLOYMENT particularly for our young people.
This is what transformation looks like!
----- Meeting Notes (01/06/2011 15:47) ----- THIS IS WHAT TRANSFORMATIVE CHANGE LOOKS LIKE
Beacon project demonstrated powerfully to me that transformative change will only happen when service providers are face to face with residents and internalize the lived experience for them. What we did with no start up money, no strategy, no committee, just a shared vision : Reorganised way we worked: got practice SW to free us up Re engaged statutory agencies, local gvt, police and education and got their commitment to listen Engaged key residents to form RA and unlock wider community to articulate and prioritise their issues face to face with agencies....crime, housing and jobs. Within 6 months got 2.2 million...formed BCRP to spend it...addressed their issues..transformation….side effect ....health improvement and lots of recognition! Having lived thru such a powerful process I wanted to produce a replicable model. In 2002 I was introduced to complexity theory. Eureka moment!!!. Founded health Complexity Group at Exeter, 2 yrs of research into Beacon….what worked and why, led to Connecting Communities, aka C2. These were all Mums with a ‘history’….they undertook a C& G course in creche leadership. Completely transformed their behaviours. They found a sense of coherance.
The focus of C2 is how to co-create enabling conditions for residents to lead and sustain transformative change and become self managing ,self caring and autonomous. They are the experts and hold the key to transforming their health…BUT THEY DON’ T KNOW THIS! NOBODY TELLS THEM. NOBODY TELLS THEM EITHER ABOUT HEALTH INEQUALITIES.INVARIABLY IN MY EXPERIENCE THEY ARE UNAWARE OF POOR HEALTH STATUS. THEY KNOW WHAT THEY NEED TO HEAL THEM BUT WE DON ’ T KNOW HOW TO LISTEN.
3 levels of connection
WE BOTTLED RESEARCH OUTCOMES INTO 7 STEPS PROCESS
point out different stakeholders, police,health.educ, Ch services, local govt, councillors, residents,housing and mention why ratio of key residents to agencies is low.
Wandsworth!!! Putney Vale L.E. Good fun…..results MUST be fed back quickly.
Ethnicity, diversity is no barrier to…..CATCHING THE VISION!
100% non reoffending rate where offenders known to police. Produced a ‘ culture shift ’ curfew hasn ’ t been needed since 2008.
Outcomes from year 1 of Greenfingers10 students achieved NVQ level 12 moved on to NVQ level 2 16 went into full time employment 14 passed one day First Aid training course 3 passed Paediatric First Aid training course 15 took course of 15 driving lessons and 4 went on to pass driving test
4 got @LANTRA@ certificates in brush cutting and chainsaw (yes really) LANTRA is not an acronym but is the sector skill council for land skills 3 took National Proficiency Tests Council (NPTC) in driving landscaping machinery 130 individual gardens were maintained for elderly and disabled 12 areas of open space were improved in conjunction with Kerrier District Council 1 new play area was created Support was given to a convent in landscaping their open space.
Began in 2004 with C2.for police in Camborne….22000 people, deeply stigmatised, butt of Jethro jokes, not funny for young people who are felt a sense of SHAME ,higher than NA children 18 yrs and under living in benefit dependent households, child poverty rates thru the roof!
Started with exchange visit at Eden ( Briersfield Y.P from Yorkshire who had reduced asb and crime by creating ‘ peace garden ’ )
Dance leaders at Eden. One of the best dancers Paul, profoundly deaf, poor speech, won Sadlers Wells audition.
Since 94 well over 1000 Y.P engaged. 35% improvement in GCSE results, truancy levels down 70%, school behaviour improved 65%, community ASB, health behaviours eg wt loss, fruit habit , employment etc etc
LIVE At NHS LIVE!!!
Sgt Dave Aynsley 2005….now representing young peoples human rights at the European Parliament in Strasbourg.
A high point for the TR14ers in 2010.
We’ve had some low points since but we’re resilient and we’ll be ok!