Building a Well Communities Research Consortium to address health disparities through Integrated Care Systems

Lead Research Organisation: City, University of London
Department Name: School of Health Sciences

Abstract

Community assets such as strong community networks and groups, arts and cultural activities, parks and green spaces have been shown to be associated with a wide range of health and social benefits but there are challenges for heath and care systems to realise these benefits at scale. Not everyone is able to benefit from these types of assets, with those from marginalised groups who often experience poorer health least likely to benefit.

This Research Consortium will explore how local health and care systems can better interface with, develop and mobilise community assets to improve health and reduce health disparities in two contrasting geographical contexts. The Consortium will adapt a framework called 'Well Communities' to develop, plan and co-ordinate its activities. Well Communities brings together a range of asset-based community development and co-production approaches that have been tried, tested and refined across more than 40 of the most disadvantaged neighbourhoods in London and are now being transferred into the Northamptonshire context. The Consortium will build on this work to research and develop ways to scale-up, spread and embed such approaches within new Integrated Care Systems (ICSs) within and outside of London.

The Well Communities Research Consortium will focus on two broad research questions:
1) What are the drivers of disparities across communities and how can new ICSs interface with, and help develop and mobilise, community assets to help tackle health disparities?
2) How can models designed to support ICSs to interface with community assets be scaled-up, embedded, sustained, and accessed to contribute to improving health outcomes, reducing disparities and creating healthier communities?

This case for support is for a nine month project to build our Consortium to fully address the questions above in a subsequent three year research programme. With a focus in particular on arts-based and natural environment assets, a wide range of disciplines and cross-sectoral non-academic partners - who do not usually work together - are needed to successfully design and undertake the research programme and ensure impact. To build the consortium we will use methodologies from the Well Communities framework, including World Café, whole system workshops, participatory systems mapping and arts-based methods. These methods will facilitate engagement and co-production and develop new relationships and partnerships between people with lived experience, researchers, health and care system stakeholders, community and voluntary sector and those working in arts based and natural environment focused groups and organisations.

Publications

10 25 50
 
Title Mapping Kiosk 
Description The Mapping Kiosk, an art project by Partisan Social Club and led by one of our co-investigators was a mobile artwork serving to gather and share the opinions of neighbourhood residents about their local area. Consisting of three lightweight tables and three large maps of the neighbourhood, the kiosk provides a platform for discussions on how residents and their families interact with their neighbourhood. Responses were written or drawn directly onto the maps. Additional resources such as flyers, invites, and badges are used to draw people in and encourage engagement with the project. Integrated into the Well Communities engagement process, the Mapping Kiosk was designed to be versatile, utilized in public outdoor locations and stationed at the CSEAD world cafes. To maintain a consistent and engaging experience, the artists ensured a colourful and coherent design for the kiosk, fostering recognition of the project's branding and encouraging ongoing interaction with it. 
Type Of Art Artwork 
Year Produced 2023 
Impact The innovative mapping kiosk was visually engaging and facilitated in depth and focussed discussions 
 
Title Walls on Walls - Old Ford 
Description Collaborative arts collective 'Walls On Walls'* designed and facilitated a creative participatory arts activity that integrated into the three world cafes in one of our two demonstrator sites in our consortium building project. This was focused on a series of group walks around the neighbourhood for community members and other stakeholders where they were encouraged to listen, record audio, take photographs and make short videos of their experience of different aspects of the neighbourhood, which tacitly addressed themes of wellbeing and the surrounding (natural) environment. As well as this process-led intervention as creative action, further outputs from the series of walks included a short film, audio soundscapes, postcards and a hand-bound one-off edition book of photographs, drawings and words from participants - displayed as a multimedia assemblage at a later co-production event (a 'Working Together' workshop). *Artists involved represented documentary filmmakers and producers, composer, electronic musician and field recordist, and set design and architecture 
Type Of Art Film/Video/Animation 
Year Produced 2023 
Impact The creative activities encouraged people to engage with the project and with other residents and stakeholders and helped communicate the nature of the project, so that all voices could be heard. Shared language and cultural connections between the research teams and the residents, facilitated full participation and in-depth discussions 
 
Description The main objective for this nine-month consortium building project was to build the Well Communities Research Consortium, an interdisciplinary and cross-sectoral research consortium working collaboratively and inclusively to research and develop ways to scale-up, spread and embed community and asset-based approaches within new Integrated Care Systems (ICSs) within and outside of London. We have established a strong research consortium which brings together experienced academics, people with lived experience, health and care professionals, and community asset organisations. The consortium has been built across two contrasting heath and care systems, representing very different geographies, as 'test-beds': North East London and Northamptonshire. Using, and further developing, a systematic framework and associated tools (the 'Well Communities Framework') the consortium has fostered new relationships between academic partners, integrated care systems and the community and voluntary sector and has stimulated new community-centred ways of working within health and care systems.
In the process of building our consortium we also achieved a number of secondary objectives. Through a comprehensive programme of co-production across both geographies using the Well Communities Community & Stakeholder Engagement, Asset and systems mapping & co-Design (CSEAD - pronounced 'seed') process we have:
(i) Identified and worked within two of the most disadvantaged neighbourhoods in each geography: Old Ford (North East London) and Kings Heath (Northamptonshire) to understand the role of community assets in promoting health and the barriers from the perspectives of residents (e.g. bringing people together, ownership and access to community buildings and spaces)
(ii) Identified barriers and opportunities within the system and prioritised action based on these (e.g. changing policies and procedures to open up assets; using assets to improve environments).
(iii) Produced detailed asset maps for each neighbourhood informed by participatory asset mapping and used system mapping to identify ways to address community priorities at a system level.
(iv) Developed a working blueprint and associated theory of change for a collaborative model to mobilise assets to tackle health inequalities which complements and adds values to current ICS place-based plans to tackle health inequalities. The blueprint consists of a framework for action at different levels (community development, organizational development and system change) with pockets of deprivation acting as community hubs to focus investment and uses arts-based approaches to support change at each level.
(v) Submitted an application for a three year research programme to test our co-produced research agenda though our blueprint and theory of change.
Exploitation Route Our blueprint and theory of change for community development, organisational development and system change focused on mobilising community assets for the most disadvantaged neighbourhoods can be used to guide policy and practice within integrated care systems. They can also be further tested by other researchers to examine impact on health inequalities, cost effectiveness and scale and spread.
Sectors Communities and Social Services/Policy

Healthcare

Culture

Heritage

Museums and Collections

 
Description The project has influenced the thinking and ways of working in the integrated care systems that we have been working with. There is already tangible evidence of changes in ways of working: our work has influenced the design of major new investments in health improvement programmes which has adopted our Well Communities blueprint for change and action is being taken to address community priorities identified through our Community & Stakeholder Engagement, Asset and systems mapping & co-Design (CSEAD - pronounced 'seed') process (e.g. lack of community spaces is being addressed through the expansion of plans to create a new community centre within a new Community Diagnostic Centre in direct response to feedback from the CSEAD process).
First Year Of Impact 2023
Sector Communities and Social Services/Policy,Healthcare
Impact Types Societal

Policy & public services

 
Description Way of working in integrated care systems to tackle health inequalities through community assets
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Contribution to new or improved professional practice
 
Description A series of co-production events with residents and health and care stakeholders 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact A series of co-production events and workshops were held following our CSEAD process (Community and Stakeholder Engagement, Asset & system mapping and co-Design) in two demonstrator sites - one in each of our two project geographies (demonstrator sites were neighbourhoods of around one to five thousand residents, chosen by partners using criteria such as deprivation, clustering of health issues, limited assets/community work within the area). The CSEAD process consisted of the following six steps: 1) Community profiling, assets & integrated care system mapping; 2) Community street conversations & wider stakeholder outreach; 3) World Cafes with stakeholder groups; 4) Whole system working together workshops; 5) Creating local agendas for change through system mapping and action planning; 6) Priorities synergies and resources meetings to plan implementation locally with senior decision makers; 7) Feedback, co-commissioning and delivery. These events led to a co-produced research agenda, a blueprint and theory of change for mobilising community assets to tackle health inequalities and detailed priority actions in each geography.
Year(s) Of Engagement Activity 2023
 
Description Presentation at the 'Creating Collaborations' conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Third sector organisations
Results and Impact A workshop on the Well Communities Consortium Building project was presented at the 'Creating Collaborations' one day conference. The aim of the conference was as follows: The National Health Service (NHS) and local governments regularly commission voluntary, community and social enterprise (VCSE) organisations to deliver health and care services. Whilst this offers considerable opportunities, it can often be challenging for VCSE organisations and commissioners alike. This one-day conference aimed to strengthen collaborative relationships between VCSE and health and care commissioners through sharing insights and learning from research, policy and practice. Together, we hope to help shape the future of VCSE and health and care commissioning relationships. Our worshop presented our consortium building activities and shared our draft blueprint for change for mobilising community assets within pockets of deprivation. There were 115 attendees. Participants were asked to reflect on whether the blueprint might work in their areas. This stimulated discussion on building capacity amongst third sector organisations to undertake community engagement and co-production in a more systematic way
Year(s) Of Engagement Activity 2023
URL https://www.bayes.city.ac.uk/__data/assets/pdf_file/0011/762059/Creating-Collaborations-Slides.pdf