NHS Lothian Health Inequalities Seminar The Community Empowerment Approach in Scotland

Community-led Health Creating the conditions with an approach to improve health that supports communities experiencing disadvantage and poor health outcomes to: identify and define what is important to them about their health identify the factors that impact on wellbeing take the lead in identifying and implementing solutions

Underpinning principles The most powerful agents of change are people themselves, everyone has something to give Our citizens, our communities, are our greatest assets, everyone has potential to make change Change through collective action is powerful and engagement in community life leads to more positive personal outcomes But, in terms of addressing health inequalities, direct intervention is required in communities experiencing long term disadvantage

In practice this means.. Addressing needs, assets, priorities and agenda for change led by community and agreed with others Working with people as community members not as individual members of the public Focusing on disadvantage, exclusion and inequality Promoting an empowerment approach to change Promoting agency-community partnership Promoting social model of health – especially the interaction with the medical model

The Community Empowerment (Scotland) Act 2015 Royal Assent on 24th July 2015 ‘Engaging, listening and responding to communities’ Greater influence over community planning, local service provision, land and buildings Participation in local decision-making Control over assets and resources The Community Empowerment (Scotland) Act 2015 received Royal Assent on 24th July 2015. The Act is highly ambitious and sets out a series of measures aimed at committing government and public services to engage with, listen to and respond to communities Easing the way towards communities having greater influence over community planning, local service provision, and the management/ownership of land and buildings. It sets out many opportunities for communities to participate in local decision-making, and to take more control over assets and resources that will help to achieve positive outcomes for communities across the country.

The Scottish Approach Prevention in communities before problems arise Coordination within and between services Rooted in tacking inequality Co-production – with communities for better services Partnership with communities – of “place” & of “interest or identity” Christie commission on public services Health and Social Care, Children's Act - emphasis on localities and primary prevention Assets based approaches to health and co-production of services Fairer Scotland dialogue & the Social Justice Action plan which will be in the Governments Manifesto Empowerment key to delivering the duties in the Equalities Act & Scottish Human Rights Action Plan – equal emphasis on Communities of place, interests and identity A major mechanism for Democratic Renewal & dialogue about Constitutional Reform A major policy framework which strengthens other policy and practice levers designed to support communities eg Assets for Health, Community Learning and Development plans

Key parts of the Act Community Planning New duties on CPPs - tackling inequalities Local Outcomes Improvement Plans & Locality plans Participation Requests Right to participate in outcomes improvement processes Focus on reducing inequalities of outcome Community right to buy land Extension of rights in this area to include urban areas, derelict land, etc. Asset transfer Right to use, lease or own community facilities/amenities Community Planning New duties on CPPs, focus on tackling inequalities Local Outcomes Improvement Plans to replace Single Outcome Agreements Locality plans Participation Requests Right to request to participate in outcomes improvement processes Focus on reducing inequalities of outcome Apply in a wide variety of contexts Community right to buy and asset transfer Extension of rights in this area to include urban areas, derelict land, etc. Incorporates changes to the Land Reform Act Common good allotments / part duty

Purpose of Participation Requests Highlighting community needs, issues or opportunities Involve people in change or improvement Not intended to replace good engagement or participation Opportunity for communities to establish a formal dialogue For communities to pro-actively influence the agenda. Participation Requests are potentially of great value for communities that have identified a need, issue or opportunity that they wish to pursue. They also give communities the opportunity to set out how they can be involved in helping to achieve the desired changes or improvements. They should not be viewed as a replacement for engagement and participation processes which already work well, but as an opportunity for communities to establish a formal dialogue where they find it difficult to be heard, or where they pro-actively want to influence the agenda. A process with reporting requirements for each OIP– people have additional opportunities for influence

The Act - real opportunities Community participation enshrined in legislation Can no longer be dismissed as “non – statutory” Addressing disadvantage and inequality – explicit within the Act Support to communities to participate effectively Specific duties on public bodies to deliver new rights to: participation requests shaping outcomes extension of community right to buy asset transfer Addressing disadvantage and inequality – explicit within the Act Emphasis on support being made available to communities (especially the disadvantaged and unequal ones) Recognition that communities (especially disadvantaged and unequal ones) will need advice, support and information Community participation enshrined in legislation – more accountability and collaboration between public bodies and communities Specifically we welcome the new rights in relation to: participation requests, shaping outcomes, extension of community right to buy, and asset transfer Breadth of participation opportunities – No immediate obvious limits on requests - addresses some key institutional and attitudinal blockages to empowerment in a potentially wide range of contexts.

…and challenges Act should augment not replace other engagement Communities - evidence - mandate & contribution Support required – particularly to disadvantaged communities Expectations – of communities and agencies Broader definitions of community – harder to deliver Appeals & Enforcement – varies across the Act Danger of only using the Act provisions negatively to address conflict with agencies rather than positively or pro-actively to make proposals – the act should be seen as part of a process which builds on, not replaces pro-active good quality engagement with communities – or of legitimate engagement with elected members lobbying etc Evidencing mandate - Constituted groups / Development Trusts / SCIO’s Although the Act is flexible with Communities requiring different levels of governance evidence for different things. The draft guidance does provide information about constituting as a group – important to ensure that form follows function and that helpful advice on constituting for example doesn’t create a hierarchy of perceive representativeness. Many communities (and community organisations) will need significant levels of support to make use of the provisions of the Act (resources?) – particularly those in disadvantaged communities. Will the opportunities be taken up by these groups? This is against the backdrop of an existing CCB crisis locally which is getting worse Expectations - communities & public agencies Are often in tension Need good relationships and trust to flourish – cant legislate for that With participation - conflict sometimes part of the process Broader definitions of community – harder to deliver Need new alliances Could surface some tensions Will need to be thought through if to avoid tokenism Appeals mechanisms – different diff parts of the Act. Enforcement regime is still unclear Recognition of need for good planned part approaches PRs focus attention on need for these as a consensual option

Making it work Most supportive participation framework to date Part of a process of democratic renewal Will need a huge culture change in agencies and services And independent support for equal citizen participation Without support resources – inequality could be worse And now its up to all of us to make it happen! Participation Requests are potentially of great value for communities that have identified a need, issue or opportunity that they wish to pursue. They also give communities the opportunity to set out how they can be involved in helping to achieve the desired changes or improvements. They should not be viewed as a replacement for engagement and participation processes which already work well, but as an opportunity for communities to establish a formal dialogue where they find it difficult to be heard, or where they pro-actively want to influence the agenda. A process with reporting requirements for each OIP– people have additional opportunities for influence

Useful information For further information about SCDC or CHEX contact: Susan Paxton at 0141 248 1924 Email: susan@scdc.org.uk For further information about the full range of SCDC & CHEX programmes and activities visit our website at www.scdc.org.uk www.chex.org.uk Latest briefing on the Community Empowerment (Scotland) Act - http://www.scdc.org.uk/news/article/scdc-briefing-community-empowerment-scotland-act/ Briefing on Participation Requests - http://www.scdc.org.uk/media/resources/policy-and-practice/SCDC%20briefing%201-16%20on%20participation%20requests.pdf Updated information on the implementation of the Act at www.gov.scot/Topics/People/engage/CommunityEmpowermentBillFAQs