Introduction
This
Community
Health and Social Wellbeing Project
came about as a result of a partnership being set up between statutory,
regional and local development organisations. The partnership
has the following members: The Northern Health and Social Services
Board (NHSSB), the Northern Health and Social Services Council
(NHSSC) and a number of community networks that operate in the
Causeway area covering the coastal area from Glenariff to Castlerock
and Kilrea. These networks include Oakleaf Rural Network, operating
in the Coleraine area; North Antrim Community Network, operating
in the Ballymoney and Moyle areas, the Rural Community Network
and the Community Development and Health Network (NI) which both
operate throughout Northern Ireland.
The
Project is focused on commissioning, that is, the process of assessing
the health and social wellbeing needs of people living within
a given area and purchasing services to meet those needs in an
effective and efficient manner.
The
Project is based on the premise that developing a sustained confidence
within local communities in articulating their views and shaping
the services delivered to them is itself a healthy process which
promotes their future wellbeing.
The
aim is to develop a
partnership between the NHSSB and local
community networks and groups. The process of communication
to be developed will enhance an understanding of community needs
and of the decision making processes within Health and Social
Services, offering groups an opportunity to influence
decisions so that they meet local need and so assist
in the commissioning process.
This
way of working is new, both to the NHSSB in the Causeway area,
and to some extent within the Health and Social Services in general,
and to the community networks. The overall aim being to consult
with people in a meaningful way and encouraging their voices to
be heard. This principle is highlighted by ‘Well into 2000’
which sets out the Government’s vision for improving health
and social wellbeing. It encourages "fairness and participation,
better information and health promoting services" and partnerships
between the Health and Personal Social Services and local government,
business, housing, education and the voluntary and community sectors.
It emphasizes the need for full participation by individuals and
communities in planning and implementing strategies to improve
their own health and social wellbeing.
The
objectives of the Project are:
·
to develop confidence in local groups in order that they
may more fully articulate the health and social care concerns
of local communities and take increased responsibility for their
own health and wellbeing
·
to increase understanding among community groups
of the structure and decision making processes within Health and
Social Services
·
to develop a variety of means of collecting and sharing information,
both formal and informal, on the health and social wellbeing needs
of local communities
·
to encourage and enable participation of local
groups in decision making on health and social wellbeing
·
to develop mechanisms for ensuring that the views and needs
of local communities are formally taken into account within decision making processes
and that these communities are informed of the impact of their
contribution
·
to produce decisions which can be shown to have taken into account the needs and
values of local communities, balanced with the need to develop
better quality services within resource constraints
·
to formally review, at regular intervals, the outcomes of
the process of communication against the agreed objectives in
order to influence future development
·
to ensure that the process is embedded in existing community
and statutory structures in order to secure its sustainability and influence
in the long term
With
these objectives, the project fits well with the Health and Social
Services Regional Strategy 1997-2002. This Strategy sees community
development as having a "particular contribution to make
… in reaching and involving local people in need, in encouraging
active participation by local communities in needs assessment
and in seeking to maximise the participation of service users
and potential users in the decision making process".
This
report will establish how people in organisations and in community
groups and residents view the way in which the Board assesses
need and decides about purchasing of health and social care from
Trusts and other providers.
The
objectives were to describe and analyse:
·
the current consultative mechanisms for, and the quality
and usage of, information exchange between communities and commissioning
agencies
·
the Board’s current perceptions of, and practices
in, commissioning health and social wellbeing services on the
basis of its assessment of need
·
the current perceptions held by communities and agencies
(eg NHSSB, Northern Health and Social Services Council (NHSSC),
Causeway Health and Social Services (HSS) Trust of how responsive
decisions are to people’s needs
§
how the Project relates to policy issues about health and
social wellbeing
The
baseline study also served the purpose of introducing groups,
statutory agencies and voluntary groups to the project.
The
research was carried out over a two month period in the Causeway
area using a structured questionnaire based on the objectives
of the Project. Community groups, the project partners, health
and social care issue groups, statutory agencies, health professionals
and NHSSB and Causeway HSS Trust staff were consulted on their
perceptions and experiences of the gaps and obstacles that reduce
the quality and quantity of information exchanged by communities
and agencies in the commissioning process. The sample size was
structured to reflect an even geographical spread of community
groups throughout the area (see Appendix 2). Forty five interviews
took place, twenty of which took place with representatives from
community groups.
The
initial community group contacts were made through the existing
rural networks of North Antrim Community Network and Oakleaf Network.
Groups and workers were contacted initially by letter to inform
them about the Project, followed up by telephone conversations.
A time was then arranged when people could talk about the Project
and when the interviews could be carried out.
Interviews
were also carried out with representatives from the three Councils
and the district Northern Ireland Housing Executive offices, health
and social care issue groups eg Age Concern, Homestart and Alzheimer’s
Disease Society, health and social care workers and the decision
makers ie the Causeway HSS Trust and the NHSSB.
The
results of the interviews were put onto a database for analysis.
This was to serve as a record of current perceptions and as a
starting point from which progress and development can be determined
and measured.
The
findings are presented as commentaries on the topics that were
covered in the interviews. These topics include:
§
the meaning of health and social
wellbeing
§
how much people know about the structure
and decision making process within Health and Social Services
§
how confident people feel about
approaching the Board
§
who people would contact in relation
to health and social wellbeing
§
how much people think they are able
to influence decisions
§
how well information flows between
community groups, individuals and the health and social services
§
what needs to be put in place or
changed to make the process work better.
(Appendix 1 contains a copy of the questionnaire)
