Asset Learning Programme - An introduction to assets March 6th 2012

2. Asset Learning Programme - An introduction to assets March 6th 2012

3. Asset Based Working Jude Robinson, John Lucy 6th March 2012

6. What this workshop is • Introduction and chance to reflect • Chance to plan asset based work • Chance to learn from each other

7. Our approach to asset based work

8. Our approach to asset based work

9. Creating Health “Communities have never been built upon their deficiencies. Building communities has always depended upon mobilising the capacities and assets of people and place” (Kretzman and McKnight 1993) “Many of the key assets required for creating the conditions for health lie within the social context of people’s lives and therefore [the asset model] has the potential to contribute to reducing health inequities.” (Morgan & Ziglio, 2007)

10. Assets for Health & Wellbeing • Asset based approaches are concerned with identifying the protective factors that create health and well-being. They offer the potential to enhance both the quality and longevity of life through focusing on the resources that promote the self-esteem and coping abilities of individuals and communities. • Drawing on concepts that include salutogenesis, resilience and social capital, asset approaches create the potential for unlocking some of the existing barriers to effective action on health inequities, so far characterised by more risk-based or deficit approaches. (International Conference, London 2011)

11. The Asset Approach • investigates key assets that support the creation of health rather than the prevention of disease • enables a community to use its assets around a vision or plan that solves local issues sustainably and uses outside support more meaningfully and efficiently.

12. Traditional needs assessment • Identifies problems and deficits in individuals and communities • Health as disease prevention, often single disease causality focused • Allocates resources based on deficit/ needs assessment/ IMD • Focus on individual level interventions • Responds with more or different/ re-configured services • Identifies the community as a problem area • The value of services as the answer • Belief that wellbeing depends on being a client • Dependence on outside services • No incentive to be producers, only consumers, passive recipients • Survival motivated challenge of outwitting the system • Dissolves community empowerment and networks

13. Asset focus • Salutogenic understanding of health as wellness, not as disease or its absence; • Focus on a multiple dynamic model of health and its determinants; • Maps the skills, capacity, knowledge of individuals and the social capital, networks and connections in a community. • Provides a different story of place; positive and outcome focussed picture, valuing what works well; • Builds community empowerment and solution focussed responses that are sustainable; • More community based and system level interventions; • Enables co-production of health & wellbeing, citizens as empowered producers, active participants; • Enables more efficient provision of services;

14. The Asset Model: Morgan & Ziglio, 2010

15. A glass half-full • The asset approach values the capacity, skills, knowledge, connections and potential in a community. In an asset approach, the glass is half-full rather than half-empty. • Fundamentally, it requires a shift in attitudes and values, and a shift in power

16. A glass half-full An asset is any of the following: • The practical skills, capacity and knowledge of local residents • The passions and interests of local residents that give them energy for change • The networks and connections - know as ‘social capital’ - in the community, including friendships and neighbourliness • The effectiveness of local community and voluntary associations • The resources of public, private and third sector organisations that are available to support a community • The physical and economic resources of a place that enhance wellbeing

18. Living Well North West

19. The contribution of the asset approach (NHS NW 2010) • Tackling the social determinants of health and reducing health inequalities • Focusing on health and wellbeing outcomes • Strengthening the Joint Strategic Needs Assessment • Fostering co-production of health and provision of health and social care • Building the Big Society vision of empowered communities • Supporting systematic engagement of communities in partnership • Maximising the role of the voluntary and community sector • Enabling greater condition management, self care and care closer to home • Improving individual and community resilience in challenging times • Improving demand management and service efficiency

20. Reducing Health Inequalities • Marmot Review “puts empowerment of individuals and communities at the centre of action to reduce inequalities” This requires • Social action • Creating conditions for individuals to take control of their lives • Removing structural barriers to participation • Facilitating and developing capacity and capability through personal and community development

21. “Traditional epidemiological risk factor approaches to health development such as programmes on smoking cessation, healthy eating and physical activity are insufficient on their own to ensure the health and well-being of populations” (Morgan & Ziglio, 2007)

22. Social Care Transformation: Building Community Capacity (DH 2010) “What would it look like if, in this area, people and local organisations were all operating in such a way as to make the most effective use of, and further develop social capital, in a way that includes those who are often the most isolated and marginalised?” • Building on people’s existing capabilities • Reciprocity and mutuality • Building support networks • Blurring distinctions: • Facilitating rather than delivering • Recognising people as assets Three main contributors to outcomes for people who might need social care: People, Organisations, Social Capital www.puttingpeoplefirst.org.uk/BCC

23. JSNA guidance • From April 2013 “the local authority and the clinical commissioning groups, together with local HealthWatch, will be required to prepare the JSNA through the health and wellbeing board, undertaking a comprehensive analysis of the current and future needs and assets of their area” • “In the context of the JSNA an asset could be anything that can be used to improve outcomes and impact on the wider determinants of health.” (JSNA & JHWS explained, 2011, DH)

24. Public Health Commissioning Responsibilities • “[Commissioning] underpinned by a robust analysis of the needs and assets of the local population” (Public Health in Local Government Commissioning Responsibilities, 2011, DH)

25. What is an asset? • An asset could be formal or informal resources, including capacity within other organisations or the community that can be used to improve health and wellbeing outcomes and impact on the wider determinants of health, such as the ability of population groups to take greater control of their own health and manage their long-term conditions. (JSNA & JHWS draft guidance, 2012, DH)

26. Principles of JSNAs and Joint H&WB Strategies • Real gains can be made if health and wellbeing boards look beyond needs to examine how local assets, including the local community itself can be used to meet identified needs. Not only does this approach generate energy and make the best use of all available resources, but it also stimulates innovation, for example through joining up services, to find truly local solutions to address local issues. (JSNA & JHWS draft guidance, 2012, DH)

27. Example: Wakefield

28. Wakefield - developing a rich and vibrant JSNA • Work with key players to gain ‘buy in’ • Trial 2 asset mapping methods • Improve use of existing hard and soft data - assets and needs • Trial asset mapping as community capacity building process • Lever in more meaningful participation • Growing Communities from the inside out. Trialling an asset based approach to JSNAs within the Wakefield District : Methods and Findings

29. Wakefield - how they did it • Project manager and steering group • Identified priority - Mental health • Extensive preliminary community development • ‘Careful’ training of staff • Briefing sessions for managers/ commissioners • Extensive partner discussions • Discussions with datahub • Community events - 5 ways to wellbeing framework

30. Wakefield - findings • A purely asset focus was probably only possible because of extensive prior work on needs • Difficult for some communities to stay positive and focus only on assets • Asset based approach to solve a need • Meaningful use of asset data by commissioners • Not just ‘what asset?’ • Why is that an asset? How does that help? Why did that have an impact? What was the impact? • Participation is extremely empowering and rewarding • Massive organisational culture change - long term • Different stages of development - ‘the gulf of understanding between analysts preparing the JSNA and frontline workers operating in the communities being served.’ • Smarter data collection & sharing precudres and protocols

31. Wakefield - action • ..lots… • Training programme for non community development specialists including elected members • Intensive work with commissioners on utilisation of the JSNA • Integrate assets and needs collection - toolkit • Ongoing CD work with communities with the least assets

32. An asset framework for JSNA ? • The factors creating health & wellbeing • The valued assets that help alleviate need • Data on assets can be drawn from: • Community asset mapping • Community consultations and engagement processes • Local surveys • Routine service data collection • Regional and national surveys • ?

33. Asset mapping • Mapping assets = • Self esteem • Sense of belonging • Social connectedness • WELLBEING • Asset Based Community Development • SUSTAINABLE WELLBEING • Community Exchange/ Timebanking • Befriending • Community champions/ advocates/ mentors/ navigators/ leaders • JSNA & Commissioning

34. Draft 1 Jude Stansfield

35. Learning from a Liverpool Approach:Liverpool PCT - Alt Valley NeighborhoodCommunity Asset Mapping Project Shane Knott, Neighbourhood Manager (North CCG), Public Health Unit, Liverpool NHS Primary Care Trust, Shane.knott@liverpoolpct.nhs.uk

36. Road Map • What are we trying to achieve? • FYI… some context • In reality – the problem and a common sense solution • What we did (and how we did it) • Development of the Asset Mapping Approach • What does it look like? • How has it been used?

37. Community Asset Mapping • Selected Summary Objectives • “To adopt a systematic approach…” • “…through our commissioned 3rd sector organisations…” • “To specify a framework for action that includes promotion, earlier intervention, prevention and protection as the collective means to address mental health inequalities.” • Liverpool PCT. The Joint Strategic Framework for Public Mental health 2009 -12. • Development of a Social Prescribing pathway… • AV NPWG Priority to support GP Neighbourhoods

38. Alt Valley District

39. Health Delivery Team • 13 Team members • LPCT Public Health Neighbourhood Manager • LPCT North CCG General Manager • LPCT Community Engagement Officer • LCH Neighbourhood Lead, Community Food Worker Team Leader • PSS/Age Concern - Health Trainer & Community Health Ambassador • Cobalt Housing - Community Development Officer • RC Fagends– Smoking Cessation Team Leader • LCC – Neighbourhood Officer, Sports Alliance Manager, Extended Schools Officers, Active City Coordinator

40. NHS Health Trainers Service • Support patients to achieve health improvement goals • Targeted to receive referrals from primary care • Barriers to success for patients • Onward signposting • Issues: • Awareness of services • 1:91000 • Under-used service in Alt Valley

41. Social Prescribing G NHS 3rd Sector Community Asset Map (Patient) (Primary Care) Public Services and Housing (Health Trainer)

42. The Common Sense Solution • Need for “Community Asset Mapping” • Empower the HT! • Social Prescribing… • Wider benefits • Community Resilience

43. Method Alt Valley Health Improvement Team What do we need to know? What, Where, When, Who, How to contact and How much! How will we find out? Who will do the work? How long will it take? 6 Officers X 2 hrspw x 6 wks = 72 work hours Equivalent time costs? c.22k/52wks/36hrs X 12 hrs X 6 Officers = £846 (+costs)

44. First issue • Completed October 2010 • 482 weekly activities • 80 different providers • Family Services Directory & Advocacy Rights Hub • Learning • User friendliness, • placement of the asset mapping • Comprehensive? • Timeliness/Relevance

45. 2nd issue • June 2011 – reviewed information. • 685 sessions • Search codes and filter • Published via FSD & ARH • Learning: • Mapping Patient population • LCVS cross reference • Lack of input from social services

46. What does it look like?

47. Additional Project Work Pilot session of Delivering Health Messages (July 11) Community Resilience Analysis workshop (July 11)

48. 3rd Issue?? • June 2012 • Include • Kirkdale • Anfield • Everton • Include Social Services • Include IT contact points

49. How has it been used? “The asset map is really effective in helping me work with my clients, even now that I am more familiar with the area, I still use it to get contact details…” Nichola, Health Trainer …the asset map is a worthwhile tool and an asset for our community. It has developed our centre's network of organisations whom we now work in-partnership with and not just in Croxteth, but for other areas in Liverpool as well. Gerry, Manager, Porchfield Centre. • Case Study Examples • Health Trainers • 4 case studies • Community Health Ambassador • Cobalt Housing • Community Organisations

50. Health Trainers Caseload 1 “Phil from Fazakerley was referred from a CHATS event and was wishing to lose weight. We set goals to alter his poor eating habits and lack of physical activity. I referred to him to cycle for health group and although he enjoyed it the session time was unsuitable for him due to work commitments. Using the Asset map I identified the cycle group held at Fazakerley federation which he began to attend on a regular basis and motivated him to buy his own bike which he uses to travel to and from work now. As well as making new friends and improving his social & mental wellbeing, he has lost 13lbs in weight over a period of 6 months.” Caseload 2 “A client in Fazakerley was referred by their GP due to stress which happened as a result from struggling to complete financial forms, applying for jobs and CV. Although I could not help him myself, I signposted him to the local CAB and job café for support and info. “