1. Co-Production in Tayside Paul Ballard Deputy Director of Public Health NHS Tayside Honorary Senior Lecturer Dundee University Medical School

2. Dundee Tayside

4. Stress Lack of Direction Loss of Hope Learned Helplessness Health tends to decline in communities where levels of interaction are low and where people feel insecure (Smith Institute – 2008) Poverty and Health

5. 5 Citizen Control 3 Partnership 2 Consultation 1 Informing (Source: Adapted from Sherry Arnstein -1969) Ladder of Participation 4 Delegated Power

6. Partnership Processes Local Communities

7. Health Equity Strategy (HES) Communities in Control 2009: Continuous evidence from Public Health persuaded NHS Tayside of the need to create a multi- agency Health Equity Strategy

8. HES Process April-June 2009-Community Engagement September 2009-HES endorsed by Health Board October 2009-Formal Consultation March 2010-Final HES endorsed by Board

9. HES – Key Elements Utilise co-production and assets based approach Focus energy and resources on early years Focus greater effort on behavioural change

10. What is Co-Production? Co-production means delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. The challenge is to work with communities, not to find out what they want and then provide it, but to enable them to take control and provide their own solutions.

11. Elements of Co-Production Building on people’s existing capabilities Recognising people as assets Reciprocity and mutuality Peer support networks Blurring distinctions between people and professionals Facilitating rather than delivering

12. Assets Approach Assets are concerned with bringing people and communities together to achieve positive change using their own knowledge, skills and lived experience around the issues that are important to them In terms of community assets … evidence supports the positive role of social relationships and social networks on … mortality and morbidity (Holt-Lunstad et al – 2010)

13. An Asset includes any of the following: 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 enhances well-being 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 – known as ‘social capital’ – in a community, including friendships and neighbourliness

14. Other Key Drivers to Co-production in Tayside Christie Commission Sir Harry Burns CMO Inspirational examples (e.g. Beacon Hill)

15. Developing our Expertise Healthy Communities Learning Events (2005-12) Connecting Communities C2 - Masterclass and Residential training (2011) - 2 day training Angus/Perth (2012) Governance International – JIT sponsored Co- Production Toolkit training x2 Tayside Workshops (2012) Community Capacity Building – local training with Local Authority partners NHST Co-production Workshops – Public Health

16. Public Health Directorate Training The Co-Production Star (Source: Governance International)

17. Changing the World One Baby at a Time Project Example: The Family Nurse Partnership (FNP)

18. To share talents and skills in a mutually beneficial way. To make a positive difference in the local area. To promote community spirit. To establish and strengthen neighbourliness. To build bridges across social groups. To build trust in the community. To share talents and skills in a mutually beneficial way. To make a positive difference in the local area. To promote community spirit. To establish and strengthen neighbourliness. To build bridges across social groups. To build trust in the community. Remit

19. 30 members 9 organisational members 132.5 hours exchanged

20. Dundee Healthy Living Initiative

21. Healthy Communities Collaborative Community-led Health Equal and reciprocal partnership comprising local people and professionals to effect changes in communities and improve health care and well-being

22. Pupil-driven Programmes Delivering pupil-driven educational programmes derived from what is of value and importance to 19 disadvantaged 13/14 year olds

23. Equally Well Test Site StobsWELLbeing Promote mental wellbeing and address influences acting as a catalyst for change Community engagement SOS: Sources of support – pilot social prescribing scheme Mental Health Literacy Programme including Mind Yer Heid Outreach Activity Picnics in the Park Others: Logic Modelling, Local Community Plan, SOA etc.

24. Leading by Example Cash4Communities Innovation Fund £2M Innovation Foundation Partnership Outcome/Change