At the Heart of Health

NESTA REPORT

I was very excited to hear that the RIPPLE Project, which emerged from a couple of workshops I facilitated in 2014 for the University Hospitals Coventry and Warwickshire NHS Trust (in partnership with Coventry University, the British Lung Foundation and local voluntary sector groups in Coventry), is beginning to gain momentum as a prime example of a “Person- and Community-centred approach for Health and Wellbeing.

Yesterday I facilitated a similar workshop in Wolverhampton of 45 patients, matrons, GPS, Hospice workers, Chaplaincy, fire service, community trust, Age UK & voluntary sector to bring together a community (and their assets) as part of a bid to become part of a second tier of six further similar projects in the West Midlands.

Anyway we found out that on Tuesday NESTA, the independent charity that works to increase the innovation capacity of the UK, had published its latest report entitled At the Heart of Health – Realising the value of people and communities, and that the RIPPLE Project was being held as a great example of enabling group activities that can be beneficial to support health and wellbeing.

What they highlight about the RIPPLE Project is:

Group activities in practice: RIPPLE – Respiratory innovation: Promoting a Positive Life Experience

People with Chronic Obstructive Pulmonary Disease (COPD) experience chronic ill health and are at risk of early death. The symptoms of COPD, including breathlessness and coughing, can lead to and amplify anxiety, low self-esteem and social isolation. These in turn lower mental wellbeing and can result in both poor self-management and a lack of engagement with key treatments, such as smoking cessation and pulmonary rehabilitation. People can become trapped in a negative cycle where poor self-management leads to worsening symptoms.

As part of the Health Foundation 2014 Shine Programme, University Hospital Coventry and Warwickshire NHS Trust took a whole systems approach to this challenge. A broad partnership was set up involving local patients and carers, primary and secondary care clinicians, academics, public health professionals, and third sector organisations to discuss and develop innovative solutions to the social isolation and anxiety observed in individuals with COPD.

After consultation with people living with COPD, the partners decided that an informal community-based clinic would act as a catalyst for increased involvement. This evolved into a group model which blended informal clinic and education sessions with social activities such as bingo, quizzes, singing and seated yoga every Monday afternoon in a community centre.

Results included:

  • Reduced social isolation and anxiety.
  • Increased mental wellbeing.
  • Improved confidence in ability to self-manage.

Preliminary evidence – involving a small number of patients – suggests that attending the RIPPLE programme regularly may reduce the number of unplanned hospital admissions. The patients involved in RIPPLE are chronically ill and as such, you would normally expect their condition to deteriorate, leading to an increase rather than a decrease in hospital admissions. The RIPPLE team has secured additional funding through the Health Foundation’s Spreading Improvement programme which will allow these findings to be further explored.

“Coming here, well, it’s given me a social life I didn’t have before…I feel like a fraud coming here now because I feel so good.”

A couple of other quotes from the report which is probably obvious why they appeal to me are:

In essence, asset-based approaches for health and wellbeing seek to create approaches that are participatory, enabling people to lead action for health, and are underpinned by a focus on what makes us healthy.

As with many community-centred approaches, this is an area where practice on the ground is ahead of the academic research. There is a lack of systematic or review-level academic evidence about asset-based approaches for health and wellbeing.

To date, evidence of effectiveness on asset-based approaches in the UK is limited to a few local, emergent solutions within particular contexts, with little practical guidance on how to put them into practice at scale.

The entire NESTA report can be accessed and downloaded here and is highly recommended.

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