1. Co-production in Community Led Health
Engaging Communities – Changing Lives
Pat Kendal and Jackie Doe
The Healthy Communities Collaborative first established in February 2005, is jointly funded by Health and Local Authority.
This work is unique in that it is explicitly community led by local older people working in co production with multi agency representatives to deliver on health and social issues right in the heart of their community.

2. Aims Behavioural Goals
Contribute to an improvement of the mental health and well being of older people in the project areas
2. Increase the number of local people involved in making a difference
Behavioural Goals
Increase in number of lonely and isolated people attending events
Increase in those taking part in regular exercise
Increase rates of volunteering
Increase peer support and community cohesion
Increase interest in and uptake of services available
The Mental Health and Wellbeing in Later Life Report gives the focus for our work, and we aim to impact on the mental and physical wellbeing of the older people in Alyth by working with local people as change agents to deliver on these behavioural goals

3.      Who Are The Teams Made Up Of ?
Voluntary and Charitable Organisations     
Community Members
Teams are recruited from specific areas, originally focusing on communities of around 10,000 population. The teams comprise of local older people, representatives from statutory and voluntary bodies including nursing, community learning, sheltered housing wardens, care and repair, Woman’s Royal Voluntary Service, Community Support Workers, Physiotherapy and Age concern to name but a few!
Everyone comes in as an equal, there is no professional hierarchy of “them” (the professionals) and “us” (the local people)
Health and Local Authorities

4. The Collaborative Method
Information
Event
Feedback
Event
Learning
Workshop
1day
Action
Period
Team
building,
Meeting with
and
encouraging
those
interested
Consultation
Filling out
questionnaires
Action Period
Team
building &
scoping
4-6 weeks
Through consultation with stakeholders, a new geographical area is identified and we carry out a scoping exercise of the area to contacts and identify groups we can approach to complete a questionnaire.
This gives us enough information to organise a large multi-agency information event in their community, ensuring representatives relevant bodies and information is available on anything highlighted from the questionnaires. Many agencies have their own requirement to consult with/impart information to individual communities and these co-produced events offer a financial and time efficient way of contacting a number of interested older people in a relatively short time as well as giving local residents access to information on services not readily available so it is a real win/win situation.
A Feedback event is held about 4 weeks later when people are advised of the main concerns raised from the consultation and information event and there is discussion about taking these issues forward through P&KHCC
People are encouraged to come along and get more information about HCC and the difference it makes at the learning workshop held about 2-3 weeks later when the HCC methodology is explained along with introducing the focus topic and examples from community members from existing teams share their successes!

5. The Community Action Model (NPDT 2001)
Topic
Stimulates
Desire for other
topics
Successful action
Introduce a topic into a community , support successful action on that topic, develop communities and sustain those changes, going on to support action on other topics. In the second year the teams chose to progress their work from Falls focusing more on keeping physically active and in the third year they have moved to Mental Wellbeing in later life
It’s an application of best practice in real life settings it’s about doing things
Teams are brought together, exposed to evidence of best practice and the tools to understand and implement that locally.
Enhances Community Development

6. The Formula Understand the need Come up with some ideas
Test those ideas (PDSA)
Understand what works and do more of it!
Following a workshop team members ( “professionals” included) each take an 8 day challenge. This is something they have identified as “needing doing”, it could be recruiting another person from a block of flats so far not represented or finding out details of any computer classes for older people in the local library. They bring this information back to the next meeting when, using PDSA methodology, ideas are identified, tested out and reported on in a no blame culture.
Teams tend to have a formal meeting once a month and to deliver on an action / deliver an event before the next meeting so there is at least fortnightly contact with most team members.

7. This is a common sense approach to change and improvement
It is a quick and simple, no blame method of working
We plan an action/intervention, try out the idea, meet back to study the results and work out how to modify the next action to ensure a more successful outcome.

8. A learning workshop is hard work but also a lot of fun for those attending.
PDSA methodology is explained and practiced, there are plenary sessions giving back ground information on the focus topic and ideas from existing teams and other areas of best practice are shared to give ideas of interventions that might be considered.
Throughout the day, the team come together, sharing and discussing what they have heard with facilitators giving confidence to identify, and record a wish list of possible actions to take forward.

9. Asking them to identify issues to address Speaking to local people
Trying out the ideas to improve life locally for themselves and their friends
This work is truly community led, by engaging with older community members who have local and tacit knowledge into the barriers and motivations of their peers, we get an insight into what really matters. Through this engagement, using social marketing methodology, we work with the older community members themselves empowering them to identify issues and come up with and test ideas to deliver on the desired behavioural changes required to impact on improved mental health and wellbeing.
Helping them to come up with ideas to try out

10. Five main areas of influence
Report findings
Five main areas of influence
Discrimination
Relationships
Physical Health
Poverty
Participation in meaningful activity
The teams were looking for a new topic and were given a choice of four possible options for them to vote on. They overwhelmingly chose the topic of Mental Health and Wellbeing in Later Life following the findings of the report of the same name. We organised a learning workshop to give the teams the knowledge and skills to take forward this new topic in their communities.

24. Focusing on Lunch clubs we are involved with in general, a logic model was created to highlight the inputs, outputs, and short, medium and long-term outcomes
Looking specifically at the inputs from the Alyth Lunch Club, they are now self sustaining and have voluntary help rather than staff etc

25. Benefits of this work Reduce isolation Promote Mental Wellbeing
Promote active ageing
Improve social capital
Where there was little frailer older people to do in many of the communities – local people are now organising events, helping include the more isolated members of their community, encouraging people to look out for and support each other
They have surprised themselves with their new found ability to organise things! They are empowered by the success and are looking for ways to further enhance the area for their peers
As a result of this ongoing work, they are providing excellent socialising and exercise opportunities promoting physical activity, all essential to maintaining health and well being in later life.
Other interests are being considered but the bonus has been a huge increase in social interaction and sense of community cohesion.

26. The success of the HCC Working in co-production reduces costs
maximises efficiency
shares skills and workload
builds community capacity
promotes community development.
The success of the Hcc is the commitment of local people targeting their peers with uniquely tailored interventions to influence behaviour change to those living in their communities. Working in co-production with the community members and the representitives from other areas a whole new world of possibilities has been opened up to them with a really positive “CAN DO” approach to life.

27. Perth and Kinross Healthy Communities Collaborative Contact
Jackie Doe, Project Manager Moncrieffe Ward
Perth Royal Infirmary
Perth PH1 1NX
Tel