A world of difference: change for the future

One of the themes of this years conference is sustaining positive change, providing perspectives on how communities can build resilience in the face of challenging times
Kin Ly
Assistant editor

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Creating fair employment and good work for all Ensuring everyone has a healthy standard of living Creating healthy and sustainable places and communities Strengthening the role of ill health prevention.

promoting healthy lifestyles and enable the public sector to support and promote that approach, then communities themselves would be much more resilient to ill health and able to support more vulnerable members more effectively. Practitioner input UK Public Health Association chief executive Angela Mawles presentation at conference will focus on the importance of strengthening community relationships and reinvigorating a sense of community. Angela will look at how community practitioners can contribute to this: Health visitors should be able to develop their role in working in neighbourhoods rather than focus on individual families. She notes: Health visitors, school nurses, community nursery nurses and other community practitioners are public health workers, people who understand the wider determinants of health. These are professionals who move freely in and out of neighbourhoods, who understand families and the need for them to live in decent homes and environments and that is how they are fundamental to community sustainability. Angela states: For example, a school nurse could look at how parents are involved in a childs school life, looking for opportunities for them to learn life skills such as cooking.

There is no doubt that the recession will continue to affect NHS services. Cuts have been made to budgets, staff and health services that are expected to worsen with the publication of the comprehensive spending review on 20 October. That is why one focus of this years Unite/CPHVA annual professional conference is to look further at the concept of sustainability. This will include opportunities to share practical advice on how best to sustain improvements in public health while the NHS and service users are suffering from the financial pressures of a recession, and how reinforcing and sustaining a sense of community could help improve health outcomes. Unite/CPHVA lead professional officer Obi Amadi states: We welcome delegates to this years annual professional conference, which promises to energise and motivate staff. Coming to the plenary sessions will stimulate thought around how we as public health workers can continue to make positive changes to health outcomes at a time when budgets are being slashed, services cut and the workforce reduced. Sustainable improvement University College London senior research associate Mike Grady, who was a member of the Marmot Review team, will be talking to delegates about sustaining the positive changes made so far and reducing health

inequalities. One of the He stated: We have made ways we can significant do this is by progress in that empowering we have improved the individuals and life expectancy communities for everybody, including those living in the most deprived areas of the country. However, what we have failed to do is narrow the gap between the best off and the worst off. That social gradient has continued, and if anything the gap has widened. What we want to work out with local authorities, primary care trusts and other key players in healthcare delivery is how we can sustain our efforts and narrow the gap between the best and worst off. He stresses: One of the ways we can do this is by empowering individuals and communities. The role of public sector services is one in which we create the conditions where people feel empowered to take control of their own lives. During his presentation, Mike will explore in more depth six policy objectives that would be central to a good framework for sustainable improvement in public health and to reduce health inequalities: l Giving every child the best start in life l Enabling everybody to maximise their capabilities and have control over their own lives

Influencing the future Such an approach would not only help to promote health and wellbeing, but would also make economic sense. Mike states: The cost of not addressing health inequalities in terms of productivity losses comes to between 31billion and 33billion a year, and the loss in taxes and welfare payments is 32billion a year. It costs the NHS 5.5billion a year, and the cost of obesity we think will rise from 2billion to 5billion by 2025 so there is a whole economic argument, never mind the human cost. Mike states that for those over the age of 30, 200 000 deaths a year could be avoided if health inequalities were addressed. Promoting resilience In addition to sustaining positive change, another aspect that will be looked at is sustaining a sense of community and how providing communities with tools to support this is an effective and economical way to improve health and wellbeing. Mike states: Public sector cuts are a huge concern and were trying to work out how we can get a change in emphasis in the role of the public sector and encourage them to create and enable communities to have a certain level of resilience. He adds: We know that a recession is going to impact adversely on health and wellbeing, but if we can get communities involved in

leaders who Individuals genuinely want to make in those a difference. communities She explains: can emerge They offer day-to-day as key experience of leaders what it is like to live in a community, more understanding of exactly what they and their neighbours need. They will be very familiar with the type of services and resources that they already have, and can work with community practitioners on how best to maximise these types of resources. Mike states that local government must ensure that such an approach is delivered: There is evidence to suggest that active participation improves peoples health. This lies at the door of local government, which can work out how local councils actively engage communities that in itself fosters confidence and self-esteem and improves health and wellbeing, both individually and collectively. Creative solutions After a first day looking at economic and demographic impacts on practice, the professional annual conference is offering two days themed sustaining positive change, with a number of professionals providing different perspectives. One of the key messages from this conference theme is the world of difference that promoting community sustainability could make. Angela notes: During these financially stringent times, we have to look at new and creative ways to make the most of the resources that weve got, otherwise the people who suffer most will suffer even more.

Other key roles Angela notes that families and individuals who actively promote the health of their community are able to offer important perspectives in addition to those of healthcare workers: Individuals in those communities can emerge as key

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16 Community Practitioner November 2010 Volume 83 Number 11

November 2010 Volume 83 Number 11 Community Practitioner 17