Weston-super-Mare consortium: Harnessing community assets to tackle inequities and reduce social isolation in end-of-life care and bereavement

Lead Research Organisation: University of Bristol
Department Name: Bristol Medical School

Abstract

Serious illness and bereavement affect us all, but our experiences of them are not equal. People living in the poorest areas of the UK are less likely to get the care and support they need if they become seriously ill or a loved one dies. They are also more likely to be socially isolated and lonely - which can be made even worse by serious illness or bereavement. This project is based in Weston-super-Mare, a deprived coastal town in North Somerset. Nine of its neighbourhoods are among the poorest 10% in the country. The population is growing, getting older and living with more frailty and long-term, complex health conditions. There are also high levels of mental health and addiction problems.

The project team will create a strong group with a shared aim ('a consortium') that unites health and social care workers, people providing community assets (collective resources which are available to individuals and communities, e.g. arts organisations, charities and community groups), academics, and people with lived experience to work together to reduce health inequities in Weston-super-Mare and the North Somerset region. Our consortium will focus on inequities related to end-of-life care, bereavement support, social isolation and loneliness.

During the 9 months of the project, we will hold 3 consortium meetings and work together to:
1. create a directory of community assets and interview key people to understand how health and social care and community assets can best work together
2. design and evaluate creative and cultural activities to be held over Dying Matters Awareness Week (DMAW, May 2023), with members of the public employed as co-researchers
3. hold creative workshops with local groups (people with drug and alcohol addiction problems, young people, and older men) to facilitate conversations about grief and illness, raise awareness of local support, and help inform our DMAW events
4. review existing evaluation data from arts/creative organisations working in Weston-super-Mare over the last 5 years (2017-2022) to identify what activities have best engaged and benefitted the community, and draw on this in designing DMAW events
5. map available health and social care data and determine how it can be used to help understand, measure and reduce inequities
6. hold a final consortium meeting to: review all our work; consider how we can apply our findings in other deprived coastal towns; and agree research questions and methods for a future joint funding application

The project will benefit: 1) the Integrated Care System (ICS), strengthening their relationships with community organisations and the public in Weston-super-Mare and providing information (community asset directory, map of datasets) to enable equitable end-of-life care and bereavement support; 2) community organisations, by bringing recognition and funding (via linking with the ICS) and helping them reach more people (via linking with the consortium and awareness raising at events); 3) creative and cultural organisations, by enabling them to engage and empower local community members in an evidence-based way, providing training to artists and increasing links with the ICS and community organisations; 4) members of the public, who will learn about the care and support available to them via the ICS and community assets and benefit from opportunities to express their experiences and socialise in creative workshops, attend free events, participate as co-researchers and at consortium meetings; 5) academic researchers, by modelling new multidisciplinary, collaborative ways of creating research and building evidence about how community assets can help reduce health inequities; 6) policy makers, by making recommendations for how ICSs can best harness community assets. We will engage with these groups via consortium meetings, blogs, the project website, journal articles, reports, presentations at community/ICS events and a policy brief.

Publications

10 25 50
 
Title Good Grief Poster campaign 
Description 8 images created with local residents in collaboration with Fevered Sleep; these were turned into large posters for billboards throughout the town, on display from May 2023 for several months. 
Type Of Art Artwork 
Year Produced 2023 
Impact Difficult to track impact of the campaign posters however likely to have engaged people in the festival and helped improve grief literacy. 
URL https://superculture.org.uk/listings/grief-gatherings-poster-campaign/
 
Title Good Griet Weston festival (exhibition, performances, workshops) 
Description Good Grief Weston was a festival about grief and bereavement which took place in Weston-Super-Mare in May 2023 over 8 days. Approximately 3000 people attended the festival. Full programme available via url link. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2023 
Impact Results from our evaluation (paper in progress): Of 204 completed surveys, 64.5% were from women, age range =15 to =75 years; 88.2% identified as white; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (73.0%), inspired (70.1%), felt part of a like-minded community (52.5%), talked to someone new (48.0%), learnt about grief/bereavement (34.8%), shared or expressed experiences (29.4%) and found out about local support (20.1%). 71.3% reported that through attending they felt more confident talking about grief. Median experience rating was 5 (IQR 0) (possible range 1=poor to 5-=excellent). In free-text comments, most participants expressed appreciation for the festival and described the benefits of attending. Two focus groups were conducted (n=8 participants, all women), lasting c.1.5 hours. Focus groups added rich descriptions of the festival's value, and data to inform the next festival. 
URL https://superculture.org.uk/projects/good-grief-weston/
 
Title Short film about Good Grief Weston 
Description In May 2023, the network came together to deliver the Good Grief Weston festival with over thirty workshops, performances and grassroot community activities which aimed to open up conversations around death and bereavement. Two short films were created about the festival by local filmmaker Paul Collins. 
Type Of Art Film/Video/Animation 
Year Produced 2023 
Impact Local and regional engagement with the festival and approaches to support the festival in 2024; fed into our Phase 3 funding application which was successful. 
URL https://vimeo.com/843810012
 
Title Where we walked photography exhibition 
Description This was a peephole into six Weston landscapes that carry special memories for six local people of fondly remembered walks with beloved pets or people. The photographic portraits were exhibited at the Good Grief Festival Finale at Loves on May 8th, alongside their stories, and also turned into postcards that signpost local walking groups and support service. The project was led by Alliance staff member Helen Wheelock. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2023 
Impact Engagement with the festival by the housing association staff and residents, extending the reach of Good Grief Weston. 
URL https://superculture.org.uk/listings/where-we-walked/
 
Description Achievement 1: We built a strong, functioning, multi-sector network uniting academia, health and community partners, funders, and PPIE, with membership and future research priorities articulated. Through community meetings and qualitative interviews we generated key learning about what is needed to create a more even playing field across sectors to achieve the vision of Integrated Care Systems:
• Smaller stakeholders need larger organisational partners to reach out, initiate or reciprocate initiatives for cross- sector collaboration
• Smaller partners often lack resources and scale to participate and/or be represented at regional meetings which would be a pathway into more integration. Addressing this would improve integration of important sectors in the community.
• More collaboration at the higher, decision-making levels across sectors is needed.

2: We launched a publicly accessible data dashboard and online directory of community assets in Weston and North Somerset relevant to serious illness, bereavement and social isolation and loneliness - categorised by location, type and scale of provision - to inform the public, the ICS and VCS providers, and facilitate social prescribing services.

3: We co-produced a programme of over 30 engaging co-produced public activities for Good Grief Weston festival, attended by over 3000 people. Attendance at events informed and supported the community, raising awareness of end-of-life care and bereavement support, encouraging open conversations about 'what matters most' and grief, and supported the development of a compassionate community. We evaluated the festival in collaboration with community co-researchers (publication in preparation).

4: We sought out new collaborators for a Phase 3 funding application to optimise and evaluate models of integration of community assets in coastal communities, with applicability to national efforts to reduce inequities in palliative and end-of-life care and bereavement support. We teamed up with Dr Barbara Mezes, PI on another phase 2 project in Blackpool and Hastings. Barbara and Lucy as co-PIs brought together co-applicants across the regions and we submitted a Phase 3 funding application which was successful.
Exploitation Route Overall, study outputs will support the ICS to meet the legal requirements of the new Health and Care Bill to provide palliative and end of life care and bereavement support. It will also support the ICS's goal to integrate inpatient and community care, level up access to care and support, and potentially reduce hospital admissions. Study PI Selman is part of a team developing an end-of-life care Health Integration Team (HIT) which will help translated findings from this research into practice. Our findings and methods also have relevance and learning for researchers working in the field of creativity and health as well as public health approaches to mental health and wellbeing and bereavement; much of this learning will be put into practice in our Phase 3 project.
Sectors Communities and Social Services/Policy

Healthcare

URL https://docs.google.com/spreadsheets/d/1Pzy7FgoKjOPoiVMElm-_FKrOq_ovqukczDWR8J-GBh4/edit#gid=0
 
Description We were delighted to see our project featured in the Creative Health Review launched December 6 2023: https://ncch.org.uk/creative-health-reviewhttps://ncch.org.uk/case-studies/weston-super-mare-community-network. Through this we hope to contribute towards momentum to recognise the importance of creative community assets in health and as a way of alleviating health inequalities. Through Good Grief Weston festival there is also evidence of our contribution towards changing local societal attitudes to grief, death and dying, improving grief literacy.
First Year Of Impact 2023
Sector Communities and Social Services/Policy,Healthcare,Culture, Heritage, Museums and Collections
Impact Types Cultural

Societal

 
Description Submission of evidence to House of Lords Integration of Primary and Community Care select committee inquiry
Geographic Reach National 
Policy Influence Type Contribution to a national consultation/review
URL https://committees.parliament.uk/work/7269/integration-of-primary-and-community-care/publications/wr...
 
Description National partnership to tackle health inequalities in coastal communities
Amount £2,440,000 (GBP)
Funding ID AH/Z505419/1 
Organisation Arts & Humanities Research Council (AHRC) 
Sector Public
Country United Kingdom
Start 02/2024 
End 01/2027
 
Title Mortality Database for North Somerset 
Description A new mortality data dashboard was created during the project in collaboration with North Somerset Council and Weston Hospicecare. The dashboard provides open access to data collated from multiple sources. It also integrates a directory of community assets in Weston and North Somerset relevant to serious illness, bereavement and social isolation and loneliness, created by Voluntary Action North Somerset as part of the project. 
Type Of Technology Webtool/Application 
Year Produced 2023 
Impact Used by local and regional stakeholders to identify potential partner organisations, understand local inequalities, access list of support services and inform grant applications. 
URL https://app.powerbi.com/view?r=eyJrIjoiZDVhY2ZjN2EtNjg3NC00YWRiLWE2MTMtMGMxMGQ0NzUyYmQwIiwidCI6ImNjO...
 
Title Understory digital map 
Description We created a digital map using Understory software (created by collaborator the Onion Collective) with members of the consortium. 
Type Of Technology Webtool/Application 
Year Produced 2023 
Impact The map is available to the community organisations and members who created it and provides a snapshot of the social capital present in the local community as well as a useful resource for members to search for others working in specific fields or focus areas. 
URL https://www.onioncollective.co.uk/?pgid=lq3pysp1-58c9eab7-ed17-414b-895a-0408e3009eca
 
Description Networking events/public meetings 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact We have held 5 open community meetings as a network since the project start in November 2022. These have been attended by diverse groups of 30-55 people from the local area and the wider region. Their aim has been to inform and engage people in the work of the consortium, including new partners; map community assets; discuss emerging findings from the research; and design our Phase 3 project.
Year(s) Of Engagement Activity 2022,2023
URL https://wsmcommunity.blogs.bristol.ac.uk/outputs/
 
Description Podcast: Mobilising Community Podcast Series: Part 2- Bev G Star and Lucy Selman 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact On 21st September, Bev G Star and Lucy Selman talked to Kiz Manley about the Weston Community Network as part of the Mobilising Community Podcast Series. The podcast was widely disseminated by the UCL team evaluating the funding stream.
Year(s) Of Engagement Activity 2023
URL https://open.spotify.com/episode/5m1MjEL0xqWEUBClQ7yzZl
 
Description Presentation at Integrated Care Board 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact I presented at the One Weston ICB board meeting in October 2023 about this project and our Phase 3 funding application.
Year(s) Of Engagement Activity 2023
 
Description Presented at the third international seminar on Public Health Research in Palliative Care 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented to c.100 conference attendees, mainly researchers, clinicians and third sector. Title was: Using routine data to understand inequity in palliative, end-of-life and bereavement care: A cross-sector project in a coastal community
Year(s) Of Engagement Activity 2023
URL https://pure.ulster.ac.uk/files/128670969/3rd-International-Research-Seminar-2023-final-1.docx
 
Description Presented at the third international seminar on Public Health Research in Palliative Care (2nd presentation) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented as part of the conference to a mixed audience of researchers, clinicians and third sector. Title: Building death and grief literacy in a coastal town: Good Grief Weston festival
Year(s) Of Engagement Activity 2023
URL https://pure.ulster.ac.uk/files/128670969/3rd-International-Research-Seminar-2023-final-1.docx
 
Description Webinar: launch of the data dashboard 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact In October 2023, the Network launched a new data dashboard created during the project in collaboration with North Somerset Council and Weston Hospicecare. The dashboard provides open access to data collated from multiple sources including the Joint Strategic Needs Assessment, census data (2021), ONS death registrations, English indices of deprivation, Department of Work and Pension, school attendance and employment data and hospice data. A webinar launching the dashboard was attended by 50+ stakeholders.
Year(s) Of Engagement Activity 2023
URL https://uob-my.sharepoint.com/personal/ggxam_bristol_ac_uk/_layouts/15/stream.aspx?id=%2Fpersonal%2F...