Commissioning: Community resilience
Richard Selwyn
Tuesday, August 29, 2017
With austerity being the new norm, commissioners must tap into their community to make ends meet, says Richard Selwyn.
I'm fascinated by our approach to communities. More often than not, we are reductionist, trying to cut up communities into population groups so we can draw maps and plan interventions. I was struck a few weeks ago by my three-year-old daughter talking about her friends at the childminders; how she develops, makes connections and becomes more resilient is already personal to her. My daughter's community is not mine — so how can we think of geographically similar people as homogenous? Perhaps each resident has a different community comprising local, family and friends, community of interest, and digital connections. And perhaps the best strategy is to find a way to support everyone's personal communities.
Cuts in the community
Why am I so interested in communities? If you add up all the cuts to early help services across local government, the NHS, police and benefits system we are going to be approaching £50bn by 2020. As a commissioner it is a simple sum — if we reduce early help by £50bn then we have got to find a similar impact on outcomes from somewhere else. The biggest resource we have in any area is the community — so that has to be the answer.
There is also some evidence and insight to help our understanding. Robert D Putnam, professor of public policy at Harvard University, researched social capital (community resilience) in American states and compared this to outcomes. Northern states had generally high social capital, southern states generally low. His study, Bowling Alone, found correlations between social capital and educational attainment. He also found a correlation to levels of crime and murder, happiness, heart disease, stroke recovery and cancer rates.
The correlation is not proof of causality, but good community resilience might improve progress. I'm looking forward to the next NHS England strategy that takes this seriously and promotes social capital to tackle cancer rates.
Maybe there is something in community connections that help people to be more resilient, and the body reacts positively. We know loneliness in the UK can negatively influence health outcomes, and feelings of inequality probably have a similar impact. But commissioners want numbers. What should we change in communities, how much do we have to change it, how much will it cost, and what is the impact on outcomes and cashable savings?
A new model
This is where it all goes wrong. We don't have a model, we don't have the money, we don't have the belief, and even if we did, would we really do a good job socio-engineering communities? These are good questions and I've been thinking about how a new model might take us forward.
Four characteristics of communities
Connections
- Good neighbour volunteers
- Neighbourhood watch
- Parish councils
- Local activities
- Social media
- Crowd funding
- Local area co-ordinator
Knowing where to get help
- Self help guides
- Community heart
- Voluntary sector capacity
- Neighbourhood networks
- Digital forums and tools
Emotional resilience
- Faith groups
- Community training
- Co-production
- Signs of safety
- Mindfulness
A Culture of Reciprocity
- Street parties
- Public messages
- Social change
- Time banking
The table above shows four characteristics we want in communities:
- Connections - between individuals and groups
- Knowing where to get help - both locally and digitally
- Emotional resilience - developing this is key for individuals and families
- A culture of reciprocity - creating the circumstances where inhibitions are lowered and people are more willing to reach out and help each other.
I've listed in the table a few of the activities in my local authority which help each of the four characteristics. For instance, the aim of local activities such as painting the playground fence is not rust-resistance, but because people build connections through the activities, and are able to draw on each other for help if they need it. It's open to debate, but personally I think local partners have a role to seed and create the environment to let connections and resilience flourish. We can even set Key Performance Indicators and count the impact.
With an engineering background, I see things in black and white. If we're taking billions out of early help for children, then what other bright ideas do we have? The community must step up, and we must help it to (with the gentlest of nudges).
Richard Selwyn is a member of the Association of Directors of Children's Services resources and sustainability policy committee @rjselwyn