Laura Griffith, IMPACT’s Deputy Head of National Embedding, sat in on a great webinar by the International Foundation for Integrated Care earlier this week, and reflected on the importance of making asset-based approaches as inclusive as possible.
Asset-based approaches represent a fundamental shift in the design and delivery of health and social care services. Rather than focussing on the challenges and how professionals and care services can address these challenges, an asset-based approach starts with what is important to the individual. It explores the personal, family, and community resources available to achieve their chosen outcomes.
Asset-based approaches are becoming increasingly popular both with commissioners and communities, but there is still a challenge in addressing inequalities and diversity. Whilst on the one hand asset-based approaches have been presented as a potentially empowering way to address the social determinants of health and wellbeing, they have also received criticism for ignoring more structural drivers of inequalities (Roy, 2017) including ethnic and socioeconomic inequalities.
In this interesting IFIC webinar, a panel addressed these challenges head-on with a range of practical examples and reflections on what has worked in practice, and where the challenges still lie. The diverse panel was chaired by Professor Robin Miller who from the start acknowledged that there is an inverse correlation between the level of need in communities and the amount of assets available to address that need. He argued that asset-based approaches must work hard to be inclusive and work for the people they are designed to serve.
The panel included Sarah McLaughlin of older person’s charity Mid and East Antrim Agewell Partnership and IMPACTAgewell®, Ewan King, IMPACT’s Head of National Embedding and CEO of Shared Lives Plus, and Adam Lent, CEO of the think tank and local government network New Local.
Sarah began by describing the development of the IMPACTAgewell® partnership created in 2017 and initially funded by the Dunhill Medical Trust. They now work with all but one GP practice in the area and are available on referral to any person over 60. In 2022, IMPACTAgewell® became the site of the first IMPACT Demonstrator project where two steering groups (a community and a practice group) set out key challenges to be addressed. These included: increasing engagement from professionals, including GPs, social workers and pharmacists; increasing the accessibility to older people from minority communities; strengthening collaboration with and across the community sector; and widening the learning and impact of this work.
At the webinar, we heard from Billy, a client of IMPACTAgewell®, and Joanne McKeever a project officer. Billy described how, following the death of his daughter, he became increasingly isolated before he was helped by Nicola from IMPACTAgewell®:
“The whole thing was made worse by the isolation of COVID at the time, I have no family at all, and some good friends. With the help of Nicola I have a bit more confidence living on my own, [with] the practical help and the emotional support. Maintaining a degree of a mental health approach is a good service that Agewell provides.”
Billy went on to describe how he slowly regained his confidence and mental wellbeing and began to take part in social activities again.
Ewan gave an overview of Shared Lives. The Shared Lives scheme matches someone who needs care with an approved carer. The carer shares their family and community life, and gives care and support to the person with care needs. Shared Lives first began in Liverpool and now supports around 10,000 people. Shared Lives carers have an inspiring track record of supporting a diverse range of people – from young people leaving care, those with mental ill health, learning and or physical disability, after hospital treatment or older people to those with dementia. However, Ewan openly acknowledged that recruiting carers from diverse backgrounds remains one of Shared Lives’ key challenges.
Adam described his work with New Local, working with around 70 councils and health bodies across the UK. New Local also strongly focuses on strengths-based work and aims to put communities at the heart of everything they do. Adam said that it was both a really troubling time for public services, but also an exciting time as the pressure public services are under is leading them to develop more community-led approaches.
What united all the panellists was the need to engage as many different people and organisations as possible – creating a “coalition of the willing” – to press ahead with innovative approaches, whilst not waiting for everyone to support a particular way of working. In addition, panellists discussed ways of organising participatory events such as citizen assemblies to community appointment days. As described by Adam, community appointment days are where more traditional health services (such as physiotherapy) were in the same room as community groups, charities, and sports groups making it possible to do in-person referrals. This aims to cut waiting lists with the added potential of the initiative to enable a much more person-centred approach by beginning to address the causes of sometimes complex problems and issues.
Throughout the discussion, panellists described the development of the work they had been involved with and fed in informal lessons that they’ve learned from national programmes. Whilst social care, and how it works can health, can sometimes be fragmented – some key lessons remained the same such as having to work within a system to maximise results, but also challenging the way a system worked when it was felt it came up short.
Works Cited
Roy, M. (2017). The assets-based approach: furthering a neoliberal agenda or rediscovering the old public health? A critical examination of practitioner discourses. Critical Public Health, 27(4), pp. 455-464.