Weaving a mesh of compassion around our local communities

In this article Helpforce Programme Manager Giles Piercy discusses how community groups in north west London have been supported after being hit hard by Covid 19.

In late summer 2020 Helpforce worked with Central and North West London NHS Foundation Trust (CNWL), the London Borough of Brent and two local communities, on improving emotional wellbeing and mental health after Covid.

If you want to find out more about this project, Helpforce have written a detailed report which can be found here and we also have a service guide that can be used if you are looking to adopt and adapt what has been achieved in Brent. This can be found here.

Background

Helpforce’s goal is to increase the impact and scale of volunteering across the health system. Typically our work involves supporting hospitals and other NHS trusts to increase volunteering in their own organisations. We are increasingly exploring the role of volunteers in stopping people needing services in the first place. We see health organisations becoming more interested in their role in prevention.

Many GPs now see it as their role to better understand the wider determinants of someone’s health and exploring the role they can play in their local communities to address these wider determinants. As Integrated Care Systems (ICS) develop NHS Trusts are increasingly exploring how they can act as “anchors” in their local community - i.e organisations whose long-term sustainability is tied to the wellbeing of the populations they serve.

What role does a hospital trust have in helping someone be in the best possible shape for surgery? Can hospitals support people who are discharged to settle in well at home, so that they are less likely to be readmitted? And how can voluntary sector organisations be supported so they better support people’s mental health and wellbeing, so that they never need to access statutory services.

In all of these there is a significant role for volunteers, and that is where we at Helpforce come in. We worked closely with local volunteers to develop thisproject and volunteers and volunteering will be at the heart of any future developments.

Context of Brent project

COVID exposed substantial health inequalities in some of Brent's communities which suffered some of the highest death rates in the country from the first wave of COVID. Local partners, Brent Council, two key local health trusts Central London Community Healthcare NHS Trust (CLCH) and CNWL, as well as NW London Clinical Commissioning Group came together, with a bold ambition to address these health inequalities in two of the worst affected communities:Church End and Alperton.

This programme “Brent Health Matters (BHM)” has made significant strides in these two communities, where they have demonstrated the impact that collaboration can have on addressing local health needs and priorities.

In discussion with Helpforce we agreed that we would work with BHM to support community led projects in both Alperton and Church End that were aimed at understanding how local people and local community groups could play more of a role supporting the emotional wellbeing of people living in Church End and Alperton. As one of the volunteers on the project put it, “the mesh in communities that holds people together in love and compassion is not as tightly woven as it could be - all too often the gaps in that mesh mean that people fall through to more acute services rather than being supported in their community”.

Our goal was to explore how to weave a tighter mesh.

What did we do

Working together with local volunteers, third sector groups and the statutory sector we codesigned and supported the delivery of a community led research project. We needed to understand what was actually going on in these two places and to what extent local people and local organisations knew what was available and felt able and empowered to help people.

What did we discover?

Very clear outcomes emerged in both communities.

Firstly, people really didn't have a clue as to what was available to support them. They probably knew how to contact a GP (but not always). Hardly anyone knew about the myriad of different groups in their community supporting them - from tenants and residents associations to community groups to faith groups. Furthermore, the people working and volunteering for those community-based groups had a very limited understanding of who else was providing services and support locally, and how they could be connected with them. Statutory providers working locally such as GPs, Community Nurses, social workers have a very narrow focus on their own area of expertise and certainly don't have the time to really understand what is there, on the doorstep (in addition to what they provide) to support local people.

Secondly, it came across clearly in both places that people would like to be better informed and better able to help themselves and their neighbours.

Thirdly there was no place or forum where people could come together to explore how they could improve things.

Developing local forums

Working with the volunteer community health champions, we’ve run a series of local forum meetings in both communities to share the findings of the research and have discussions, essentially asking “given what this research is telling us how do we build a stronger more resilient community that is keeping people held in a mesh of connections so that they don't slip through to statutory services''. COVID 19 tore through these communities and mental health issues related to COVID followed quickly behind. One local person at one of the meetings described the collective effort we were involved in as “creating a buffer so that the connections being made could limit the devastating impact of COVID”. But more than COVID, this was about building strong, sustainable, resilient communities that will better withstand the onslaughts that these so called “deprived” communities regularly face.

The forums have been challenging. These are places that suffer from extreme health inequalities. They have been let down and feel ignored, marginalised and sometimes abandoned by service providers and commissioners. For too long interventions by well meaning statutory providers have misfired because they are not rooted in a desire to empower local people.

In order not to repeat that mistake we agreed some pretty stringent rules:

• Don't dominate the conversation - really hard when people have strong views derived from their own lived experience

• No presentations from statutory providers

• This is your meeting we are just helping facilitate

• You members of the community have to come up with the plan - we can support you but it has to be your plan.

It hasn't been easy. Many people are not used to being asked to lead in this way. Usually they just get asked “what do you think of our plan?”

We were determined to shift the focus from being one in which the statutory sector “does to” or “does for” to one in which the statutory sector “does with” or better still: what needs to be done is “done by” the community.

What has emerged, in both places, is that groups have formed made up of local people, local community organisations and people working in the local area for statutory providers. These groups have developed and are leading on the development and implementation of plans to strengthen that mesh in their community. As well as a series of specific projects such as a community garden in One Tree Hill (a local Park) and the creation of a Dementia Cafe, in both areas, there has been a consensus that three things need to be done, and these must be led by local people. There is still a way to go but as one local forum member said “hope” is emerging.

Firstly, the local forums need to build a much better understanding of what is available locally, a list that can be kept up to date and shared. Because information gathering is usually done at a much larger area than a neighbourhood,the opportunity to promote hyper-local organisations that connect different people, whose interest doesn’t extend beyond the neighbourhood boundary, is often missed.

Secondly, local people want to be better equipped to support each other. This is where the state is playing an effective and important role in providing training and support to give people skills in issues such as Mental Health First Aid and Mental Health awareness.

Thirdly, in both communities the emerging forums are embryonic. They certainly have not achieved “escape velocity” and will continue to need support from providers (Brent Council and CNWL) to become fully self running and sustainable. Nevertheless, the will and commitment is there and there are enough local people involved to keep the groups going and encourage other communities in Brent and beyond.

If you want to find out more about his project Helpforce have written a detailed report which can be found hereand we also have a service guide that can be used if you are looking to adopt and adapt what has been achieved in Brent. This can be found here.