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Friday, 30 December 2011

Homework for 2012

As mentioned in my previous post, I am going to be gathering materials over the next few weeks to inform the design of two healthcare interventions: a self-care management document and 5 Key Messages, with dissemination programme. 

So here is the first post of one of the useful discoveries, a video from the California Healthcare Foundation about coaching patients for successful self-management.

If you have any additional suggestions for any written or broadcast material on self-care management or the use of 'key messages' with patients with chronic conditions, please leave a comment.

Wednesday, 21 December 2011

More on Design Thinking

My head is full of an exciting health project which kicks off the New Year and for which I will have responsibility. It will involve using design thinking to shape three interventions aimed at reducing the number of people with diabetes who lose their sight as a result of of an eye condition called diabetic retinopathy. We will be developing the interventions and testing them in my home town, which is an added bonus. 

With this in mind I have been glued to some of the latest videos posted on

Two leapt out at me, one very short (2 minutes) that demonstrates why creativity needs time and one which outlines what design thinking is, and how it works (28 minutes). I am posting them both. Hope you enjoy.

Thursday, 15 December 2011

Big Society- A story and a film

There were reports in the UK press yesterday of a Parliamentary Select Committee which came to the conclusion that the government's 'Big Society' policy was little understood and confusing to people. Commenting on this on Twitter, I referred followers to a blog that I had posted a few months ago about Big Society called 'Right Stick, Wrong End'. I believe that the politicians have grasped the right idea but by giving the impression that it is all about citizens running public services, they are limiting the possibilities and turning people off.  

The impact that Big Society could have is illustrated by this story and film from my past work in Bradford.

In 2004 more around a hundred people - all with a good idea to improve their neighbourhood by making it cleaner and greener - came together to agree which ideas should be awarded some funding. The money that was to be spent, £700,000+ , came from central government. Some were individuals with a passion for a particular action, others were from neighbourhood community groups, others were from schools or larger voluntary organisations. They shared the desire to take action to improve their neighbourhood environments. Many of them had never applied for funding before.

Local politicians and their partners from the public, voluntary and private sectors had been persuaded that involving local residents in making these funding decisions was worth trying.

It was one of the first examples in the UK of what has become known as 'participatory budgeting'. This short film of one of the two decision-making sessions shows the process that we developed.

At the start of the film, you hear the comments of Richard Wixey, then the Director of Environmental Services in Bradford. What Richard learnt from the process is what makes this such a good example of what 'Big Society' could mean.

As he listened to the tens of ideas that people were pitching, he began to understand something of the types of actions that local residents were prepared, and able to do. 

These included 'greening' areas that were being used for flytipping; running education programmes to prevent littering or to encourage recycling; developing allotments and pocket parks; organising neighbourhood clean ups and beautifying public spaces for people to enjoy. 

The process also clarified the sorts of things that local residents could not do. They could not enforce the law or run large scale rubbish collections and recycling.

It led him to reflect that in addition to concentrating on the core of what only his department could deliver, perhaps some of the budget should be used to support and encourage people to take the actions that they were prepared to take. This would both improve the quality of neighbourhood life for everyone and make his department's work more effective.

Within twelve months the funded projects had been delivered right across Bradford District enhancing the environments of eighty neighbourhoods. 

This then is the core for me about what Big Society could be about. Local residents, local government and partners deciding together what it is possible and proper for 'reasonably resourced' individuals, families and communities to do for themselves or in partnership with others; and then to agree what it is that we need government (local and national) to do.

To ensure that where people and communities are not reasonably resourced, or where improvements to community life would be enhanced for all, then a very modest amount of the public budget could be invested in individuals and groups to make their contribution.

It makes economic sense too in hard times for the public purse. Our Bradford experience of devolving funds to neighbourhood partnerships showed that for every £1 of public money invested, the partnerships brought in a further £10-20 to augment that original investment.

The Big Society policy needs to be clearly expressed in terms the nature of the partnership between government and citizens that is proposed. A proposal for a partnership that is good and right in and of itself, not a shirking of responsibility by central  government just because the public purse is strapped for cash.