Latest / SoWhoCaresAnyway / SoWhoCaresAnyway E8 Connecting People, Creating Hope

Transcript

SoWhoCaresAnyway E8 Connecting People, Creating Hope · SoWhoCaresAnyway

Hello and welcome to So Who Cares Anyway, the podcast that shares learning, innovation and ideas from the world of health and social care and beyond.
My name is Ruth Germain and I'm inviting you to join me each week with my inspirational guests to hear about who cares.
What they do, their passions, their knowledge and ideas, and importantly, the difference they are making to improve the health and wellbeing of people in our communities.
I consider each of my guests to be incredible individuals working with people in new ways or with key messages to share.
People from healthcare, social care, the voluntary sector, community groups, and more.
To join me each week to find out, so who cares.
Anyway, to find out more about me, who I am and what I do, please head over to my website, www.reflectiveruthconsultancy.com,
where you can also catch up with previous episodes and read my blogs Hello, and welcome to the next episode of So Who Cares Anyway? And in this episode, I have the pleasure of speaking with Dr.
Mark Spencer, who I was linked with through my discussions with Adam Lent.
Any of you that listened to that will have heard some of the stories around the work that Mark is doing in Fleetwood and his approach to general practice, doing things differently and working with his community.
So I think that's enough of an introduction from me.
I can see that Mark is smiling at me there.
So I think he's agreeing with my introduction.
So I'm going to pass over to Mark and just let you expand on that a bit further, please, Mark.
Yeah.
And hello everybody.
I've been a GP at the Mountview practice in Fleetwood.
For very nearly 34 years, GP principal and Fleetwood is a coastal community just to the Lancashire coast, resident population of around about 28, 000 people and a significantly disadvantaged community driven by high unemployment levels, really.
As a community, um Fleetwood's purpose was as a fishing town and back in the 1970s,, our fishing fleet was decommissioned,, and very little in the way of employment opportunities has come to the town since, so we've now had a couple of generations, of young people struggling to find work and low aspirations as a consequence.
And then all of the health issues that face similar disadvantaged communities with life expectancy around about 10 years lower than the England average and all of the health conditions.
that are associated, with deprivation.,
We have significant prevalences, so mental health issues such as depression, anxiety, heart disease, chronic respiratory disease, dementia,, all of those health,, conditions exist, in high rates across my community.
Thank you.
That gives quite an insight into your population, and I think that's something that's been talked about quite a bit, isn't it, about coastal communities and deprivation and things like that.
So I wonder if you just take me a little bit more and describe a bit more about what's actually what you've been doing.
So from what Adam was telling me, you've been taking quite a different approach.
So I suppose there's two bits I'd like to hear about.
led you to the approach you're doing? And then perhaps a bit later on, we can delve into what it is that you're actually doing now as well.
Um, so I need to go back about 10 years.
And people often say to me, Mark,, what you're doing in Fleetwood is really, really good.
But it's taken 10 years.,
We need to learn,, how can we do that in six months?, And you can't.
So everything I'm going to talk about requires time, and I think we are where we are now because we're 10 years down the line, not because we've picked up a model from somewhere else and try to impose it on our community.
This is our community really doing things for itself rather than being done to.
So we started to think differently, about 10 years ago, and the reason for that were many fold, really.
We as a group of clinicians across general practice in the town, about 10 years ago, we were really struggling to recruit gps.
Not like many practices, even now, but back then, 10 years ago, it was very, very hard.
And we would normally have around 15 whole time equivalent gps across our community, in three different practices.
And back then we were down to our last eight.
And in my own practice, where there should have been six of us, we were down to the last two.
And not only were we having difficulty recruiting GPs, that was the same for nurses, managers, admin, and the whole thing.
And we were also being told Marmot was publishing his reviews, his first review into health inequalities.,
And Marmot was saying, obviously there's a very wide disparity between.
Those that have and those that have not and we're certainly in a community of the have nots and we felt we were working so hard to try and improve the health of our population.
And, yet Marmot was saying that whatever was happening in those communities, it actually wasn't making much in the way of a difference.
So we started to think differently and think about what have we got as a community? Rather than expecting the cavalry to come over the horizon and save us because a lot of very well meaning people have been in the town over the preceding decade or two to try and improve health care, to try and improve, job availability, try and improve education and Marmot is saying actually things are getting worse.
And one of the things that we have in the town.
is our biggest answer, are our residents.
Yes.
and our biggest asset is the community.
So rather than healthcare professionals thinking that our patients are the problem, coming to see us too often and causing us to be too busy and not having the capacity to provide, What people feel they want.
We, started to completely change that, and start thinking of our residents, as the biggest asset that the community has, and those of us within healthcare and, but not just healthcare.
Other public services such as education, such as local authority, starting to work hand in hand with our residents about what's really important for them for them individually.
For their families and for the whole town.
So we started a conversation.
And the question was, what matters to you? And that conversation now has been going on for 10 years.
And that conversation happens in a formal sense.
We have regular.
community events once a month, set time every month, but we also have more informal dropping sessions at the library, at church halls, where we actively listen to our residents.
And everything begins with listening.
And one of the very first things that our residents were telling us was important, was their feeling of being very isolated, being alone, the community not functioning as a community.
And those feelings of social isolation and loneliness were having a huge effect on people, particularly people's mental health.
You know, that deteriorates significantly when we're not in contact with other human beings, but people's physical health also suffers.
So, people wanting to connect with other people was very much at the heart of those very early conversations.
And out of that grew an entity, a physical entity that's called Healthier Fleetwood.
A resident led, social movement.
I, if you will.
And if anybody goes onto the Healthier Fleetwood website, which is healthy fleetwood.co
uk, you'll see the strap line there that says Connecting our community.
And that's been there, ever since we started.
And still that's at the very heart of what we do.
The next thing that was really important to residents was pride in the community.
As a fishing community, but back in the heyday of the town,, 1940s, 50s, 60s,, very thriving town with a real sense of purpose and a real sense of pride.
Once that sense of purpose was lost, once the fishing trade was disbanded, once the strollers were decommissioned, there was a real A lot of pride, in the town.
Residents start to think that the town was looking very scruffy, very dirty.
The high street wasn't somewhere that felt welcoming.
There was litter everywhere.
Gardens were overgrown.
The whole feeling of the town.
was one of loss and despair, and in a sense, it was a little bit like the community had gone through a bereavement, and it was still going through a bereavement, and so one of the very first things that we started to do very simply was just doing litter picks, going around the town, picking litter up on the high street and picking litter up on the beach.
And then what we found was as people started coming together as a group of human beings, not only were they connecting with other human beings, doing things with other human beings.
It's also very good for our health.
Yeah.
That there were things then that folks wanted to do, that didn't exist in the town.
For example, there wasn't a singing group and some of the residents wanted to go singing.
And so a singing group was established, a group called Harmony in Health.
So it's not a choir, it's not for people who have got beautiful voices and are very harmonic.
It's for folks that just love to sing.
And they come together on a Tuesday afternoon, and sing, and they've been singing ever since.
And then the local authority gave a beautiful venue for them to sing in and singing leaders.
I wouldn't, don't want to call them choir masters, but somebody that would lead the singing gave up their time to come and do that.
And what was half a dozen people one week was 20 people the next week was 40 people the next week.
And at times it's like over a hundred people.
In that group, and then other groups were starting crochet groups, befriending groups, walking groups, art groups, and the number of groups was starting to grow.
So not only were people connecting with other people, when you do something and you do it regularly and you do it often enough, whatever that something is.
you start to find that your own self confidence starts to improve.
And as you become more confident in that thing, gardening, cooking, you then want to do it more.
And then you want to do it more with other people, and a real momentum starts to happen.
And then the most important thing that follows on from the listening, and the listening about what matters, is the residents then taking control.
Taking control of their own lives, taking control of what happens to their own family, and taking control.
About what happens in the town, and I hear so often about communities that feel dumb too.
The very well meaning organizations, state run organizations, charities, volunteers, want to come into a town and save a town.
That's what's been happening for decades, and Marmot will say, actually, that doesn't work.
What works are communities being in control of what happens in those communities.
Communities being at the heart.
Of what happens in those communities and professionals and residents working together on delivering things that really matter to that community.
So what we've got now is residents that are genuinely listened to.
And they feel genuinely listened to we have residents that are connected and I'm hoping that there isn't anybody that is feeling socially isolated across the town.
And I know residents feel better connected than what they did.
Residents are much more involved in the doing in the community and residents are certainly in control in that.
The local authority, the NHS, housing, all of those agencies now work with residents to deliver solutions, not parachute in.
A solution that's happened somewhere else and hope it's going to happen in the town because we know that doesn't work when you've then got people that feel listened to people that are connected together as human beings and are connected to all of those services that are there to support them, like the local authority, like the NHS, like housing, like schools, but when all of those agencies are connected as well.
And most importantly, the locus of control rests with the community.
What you then start to notice is the creation of a hugely important thing, and that thing is called hope.
Because what I've noticed as a clinician is When somebody is going through a really difficult time, and that difficult time might last months or years, when you are going through real, genuine difficulties, and there's no sense that anything is ever going to get any better, and you lack any hope that there's ever any solution to this, we start to adopt behaviours.
The helpers get through the day, and those behaviours are things like smoking, they're things like drinking lots of alcohol, they're things like illicit drug use, they're things like increasing the amount of prescription medication you're requesting, they're things like binge eating, they're things like gambling, and all of those things help us get through a day.
Obviously, all of those things are really bad for our health, and people know that, but still choose to do them.
And in a sense, those things are very self destructive.
And that's why clinicians will frequently say to somebody, things like, you need to stop smoking, because if you carry on smoking 20 a day, it's going to kill you.
Every contact counts.
That person will then say to you, well, it's the only thing I enjoy doing, so I'm going to carry on.
And what really made me think 10 years ago, was a single patient that was sat in my consulting room, and I've told this story many times.
And I'd said this to him.
As lots of clinicians do.
He was an alcoholic, been an alcoholic since childhood, and were, had severe cirrhosis and was still drinking very heavily.
And as all clinicians do, doctors, nurses, therapists, you try out, if you carry on drinking, it's gonna kill you.
And he said to me, you know what, doc? I know you're trying to help me.
But it's not the thought of dying that's stressing me out, it's the thought of living.
And he had absolutely no hope whatsoever that tomorrow was going to be any better than today.
And he didn't really care whether he got to 40 or not.
And within a month he was dead.
And so bringing hope to individuals, those individuals then, what I noticed, they then start to address those behaviors.
So I've seen folks, go along to Harmony and Health, and just through the power of singing, have lost maybe a third of their body weight.
They've gone along with BMIs of 40.
And within six months have ended up with BMIs less than 30, just by going to singing, but it's being connected.
To other people, it's going along to an activity that you enjoy doing.
It's improving self confidence.
And then people do start to take control of their own lives.
They do start to think about tomorrow.
They do start to think about the grandchildren.
They do start to think about five or ten years down the line and what their future could look like now that they're more hopeful.
And then people have a reason to stop smoking, have a reason to drink less, have a reason and the lady that tells this story, she wasn't consciously trying to lose weight.
She just noticed that she wasn't eating as much food as she used to eat.,
And Pauline's story, Pauline is now the resident lead across the town.
So Pauline takes the meetings.
She's got a leadership role.
She's a resident with a leadership role.,
And Pauline's own health issue.
Really started with having to care for, not having to, wanting to, care for her husband who'd had quite a severe stroke.
Which then led to Pauline being less connected with other people because she was having to be the main carer for her husband.
And that led to sedentary lifestyle, eating, smoking, and being severely obese with COPD.
And despite all of those medical interventions that the NHS had to offer, Pauline continued to eat what she was eating and continue to smoke what she was smoking.
And she was at her GP's maybe once a week is what Pauline says.
Within a year of being involved in Harmony and Health, she'd stopped smoking.
She's lost a third of her body weight.
She's come off some of her medication and now five or six years down the line, she virtually never goes to a GP other than just for a checkup once a year.
That's so impactful.
And you multiply Pauline's story.
By 100 by 1000 and you can see our town how individuals and families and groups of residents, and then create a more hopeful future for a town that still has high unemployment levels that hasn't had the cavalry come in and build a factory.
But people through being connected, through being more self confident, through being in control, people are healthier for all of that.
So that's the mainstay of Healthy Fleetwood.
Wow.
That's such an incredible story and so impactful.
And I don't know if you'd read it, I think it just came out recently, but, was the report about, Grenfell and one of the things it was talking there was.
about listening to people, but what you've taken on from that, because I think there's so much about co production, co creation and all of these different things now, is about being prepared to act.
And actually you started with this really simple act of just going out and picking up litter.
People say to you, what matters to me? And we all talk about what matters to you.
How can we help you achieve that? But you listened and then you acted.
And of course, once people saw that in my mind, what I'm thinking is they're thinking, Oh, actually, Mark's not just saying this is not just asking.
It's not just listening, prepared to go out yourself and whoever else, those other GPs, those other people from the general practice to actually go out and do something.
beyond just giving me that prescription that I'm going for regularly.
He's prepared to do something else and I think that's something that so often is missed.
So from that small bit, you've taken us on quite a long journey there as to what you've done and what you've achieved, Mark.
Yeah, thank you.
And as, healthcare professionals, we have a place in the community.
But often as healthcare professionals, we really patronize people.
We're forever telling people what to do when, when we label somebody a patient, when they're sat in front of us in a consulting room or they're in a hospital ward or outpatient clinic, and we're saying, take this medicine, take that medicine, have this test, have that test, go and see them, go there, go there, do that, do that.
And all of the time we are patronizing those folks.
We are taking away control from them, and we're taking away their self confidence to be in control of their own health and to manage their own health.
Stepping back from that as a clinician, and, to be fair to our local authority, who've been brilliant, stepping back from constantly being in control and giving up that control.
To individuals and to residents and to the whole community is actually really liberating and one of the things that I think we were losing so many clinicians 10 years ago, and I was so close to giving up as well.
And I'm in my 60s now.
So I was in my early 50s then.
And GPs all around me were leaving in their fifties and nurses were leaving in, their fifties and managers were, and I certainly felt this way and a lot of my colleagues felt this way is, that you do a day's work and you probably see 40 or 50 people and a lot of those folks have very, very complex health needs.
And at the end of the day, as a clinician, I was absolutely exhausted.
And I was late, and I was stressed.
And then you think back, and you think, have I helped anybody? And often the answer was no.
And I think that's why people leave.
Because people get into healthcare because they care.
And because they want to make a difference.
And day after day, week after week, month after month, if you're absolutely exhausted and feel that you're making no difference whatsoever, that's when you leave.
So we got a way of working now that the rare event that you're stuck with thinking, I don't know what to do to help this person.
And it's got a name now, one of the things is called social prescribing, isn't it? Primary care networks have got social prescribing link workers.
Back in the day, 10 years ago, we used to call those people community connectors, and they were community volunteers that did that.
And we've still got a lot of community connectors and volunteers that, that do that now.
So, linking somebody back into the community, connecting somebody with other human beings, encouraging people to go along to any of the community groups that they want to go to.
Having somebody that will actively listen to them, not for 10 minutes in a consultation, not for half an hour as a one off, but for however long it takes over a cup of tea and cake And then again the week after, and again the week after, and again the week after.
Being listened to, I've found, encourages people to be more motivated to do something, rather than here is some more medicine, which is very demotivating.
So we've got this whole, as I say, it's a social movement.
We, have a social movement that as the NHS, we can tap into that.
And we can connect our residents into that social movement, as well as still use that medical model when we need to.
And We're now fully recruited.
All our GP vacancies are full.
All our nurse vacancies are full.
All our manager vacancies are full.
And again, I've said this before, Ruth, and this is the honest truth.
We've got a waiting list of people wanting to come and work in the town in healthcare.
I can believe that.
People contact me all the time, Mark, let me know when the next job's coming up.
Yes, we spoke briefly, didn't we, before this call and one of the things I've said to you and I think might come out a few times in this podcast, I worked clinically in general practice and advanced nurse practitioner and one day I was told by one of the partners, it's a storm out there.
get your head down, get them in and get them out.
Yeah.
That was the day I decided to leave.
But actually what I moved into was strategy to try and change that because I felt like it was the only thing I could do.
But certainly if I live near as you, I think I've probably been knocking on your door and you took the question out of my mouth, has that made a difference to your recruitment and retention? My other question, I know you're going to say something.
So do come in if you want to.
But my other question is, has it made a difference to the number of staff that you need, the types of people that you need and maybe the way that you work? So I'm envisaging this bit where you're going out to the community, there's lots of different groups and things going on, but for the practice or the practices within Fleetwoods, does that feel a lot different now or is it working in a different way? It's working in a very different way.
And so this is the journey, I think, that general practice has been on anyway, moving into integrated care provision.
And the very first thing that we did, as I say, we were with three practices and we're still three, three separate individual practices.
So 10 years ago, when that recruitment retention issue Was at its worst.
One of the things that as three practices we decide to do is to work together much more closely to share resource for clinicians to cover across practices to help each other out.
As teams get smaller and smaller, a member of staff going off sick can then become quite critical.
So working together as three practices rather than working individually as three separate practices.
That started with us 10, 10, 11 years ago.
And then through the National Association of Primary Care and the emergence of the primary care home was then starting to think about population health management and how do you align resources to those in great need.
We adopted that model.
And I do believe, because I've been told that the way that we've been working positively influenced.
The emergence of primary care networks, which is groups of practices working together in communities of around 30, 000 with an integrated neighborhood team.
And what's then benefited, I think all of general practice across England is the investment that NHS England has put into those primary care networks.
And it's allowed those primary care networks to target that investment.
where those clinicians feel there is the greatest need.
And for us, without a doubt, that was in mental health.
support.
So bringing in, we've now got six whole time equivalent mental health professionals, additional to the secondary care mental health professionals that we had previously, and pharmacists and paramedics.
And again, we've recruited to all of those posts, in addition to all the vacancies that we had.
So we got quite an extended Primary health care theme now across the three practices and across the primary care network.
Equally, if not more importantly, all of those other providers of health care are connected.
So connecting our community doesn't only mean connecting residents together or connecting residents into services.
It's actually connecting services together.
So how do we connect with not only district nurses, health visitors, but also our hospice services, our substance misuse services, community pharmacy, there are huge resource community pharmacy and being connected with community pharmacy and looking at what pharmacists can do in order to increase capacity.
So, you've then got an extended network of about 100 120 clinicians across the town, focusing on what matters to the town.
So when we listen to residents, and the data ties with this, we think about population health management, what does the data say, What the data says and what our residents say are very well aligned.
So that's mental health, mental health, mental health, and mental health.
What the data doesn't tell us is actually the mental health issues that are prevalent amongst our children.
Because when you look at QOF data, QOF data only reports on adult mental health prevalence.
So we know our prevalence of depression in adults in Fleetwood is 22%, the national average is 10%.
There are more than twice the national average of adults with depression.
A lot of those adults can trace the origin of their depression back to their childhood.
What we were hearing listening to our community during and shortly after COVID, was that the mental health of our children was seriously deteriorating.
Our teachers were telling us that, parents were telling us that, healthcare professionals were telling us that, but the data wasn't there because we only get QOF data for adults.
So, we did two things.
One, we went looking for the data.
And lo and behold, the data was telling us that the mental health of our kids was shocking.
147 of Fleetwood children had been admitted to A& E as a consequence of self harm within a calendar year.
Wow.
147.
That's serious enough to end up in A& E.
Think about how many children are self harming that don't end up in A& E.
Children on acute paediatric wards because of their mental health.
Issues children being absent from school.
And so then you think, so what are you gonna do about that? Or what are we gonna do about that? 'cause in the olden days you would ask whoever the ICB as they are now or in excess England, we need more CAMS professionals, easy solution.
We need more cams.
Professionals.
Look at the mental health of children who fleet with.
It's shocking.
We may not.
We need more Cams professionals.
Our way of going about it was actually to listen to our residents about what matters to you, what matters to your children, what matters to you as a child and as a young person.
So we went into our schools to do listening exercises.
We went to youth clubs, we went to the dance studios, we, brought parents together at a football club and, in various venues and we spent a year.
actively listening to our children, our families and our teachers and our healthcare professionals.
And the things that mattered were children didn't feel safe, that there were drug dealers outside schools, children were being asked to get involved in county lines, activities, and they wanted somewhere that they could go to that was safe.
So then we asked them what does that look like? And a youth hub was then created.
So we do things, we deliver things, we don't just talk about it.
So a youth hub, happened.
I'll tell you how it happened later if you want to, but a 1 million pound facility, for the youth of the town that they could, Go to and they do go to now.
I hope and last year.
That that's they've they've that's warm.
That's friendly.
It's got a kitchen.
It's got showers.
It's got a gaming room.
It's got Wi Fi and it's got.
Staff in there that are there to help and support the kids.
With regards to mental health issues that there was, a big ask for things like counselling, and to help children manage with this sort of lower acuity.
Mental health issues like anxiety and loss and bereavement and self confidence and things.
But they didn't want that delivered by the NHS in the healthcare setting.
They wanted that delivered either through schools.
They felt school was a really safe place for them.
Or again, the delivery of those things through the youth hub.
So as funding came in, that funding was channeled.
It was NHS funding, funding that came from the ICB, funding that came from NHS England.
But that funding, because we are a connected community, because all of those entities, we all feel that we're in this together, that money just went into a central pot, if you will.
And the vast majority of that money was spent in the schools or it was spent in the charitable sector.
It wasn't spent on CAMHS nurses.
But tell me about how that happened, because you didn't go to NHS England.
You didn't ask for more, CAMHS services.
So I can think about what you might have done, but I'd really like to hear about it.
Oh, well, again, you think about what, people talk about resilience a lot.
So, what does resilience actually mean? And I think it means looking at what you've got and making the best use of what you have, and supporting what you've got and developing what you've got and having some Realistic ambition and expectations of what you want to deliver.
So again, primary care networks, as funding came in for more staff, what NHS England said, as far as mental health professionals are concerned, you can only recruit to post for adult mental health services.
And that was a stipulation.
And, so we, we said to our ICP, that's a nonsense.
Why can't we recruit? CAMS, Mental Health Professional.
Well, you can't because NHS England say you can't.
Okay.
So we did anyway.
I was going to say, what did you do? And we just did it anyway.
And so we then had a full time children's mental health professional within our primary care network.
Called Liz.
And what Liz did.
Liz then undertook primary care based, mental health assessments of those children within a GP surgery, within two weeks of a referral.
Traditionally, if a GP referred to CAMHS, the waiting list was over 12 months.
The nearest CAMHS office was 16 miles away in central Blackpool.
And by the time the appointment came through and then you expect families that live in poverty to travel 16 miles to an appointment that they needed a year ago, the DNA rates about 90%.
So we brought in a pathway that.
Did a mental health assessment, undertook a mental health assessment on those children within their own GP practice within two weeks.
And less than 2 percent of those children then required a CAM, an onward CAMS referral.
And the vast majority of those children were then receiving support from what was already available in the community.
either from statutory services, or, from the voluntary sector and local charities.
So the community was providing the vast majority of the care that our families needed, rather than requiring specialist services.
And Because those referrals then virtually dried up, CAMHS got very interested in this and CAMHS wanted to know what we were doing.
And, so we now have a very joined up pathway that includes CAMHS and our CAMHS providers actually put a CAMHS professional in the town for us.
So our families are not having to travel 16 miles.
And we have developed a multi agency MDT to support our most, complex families.
Because again, what we noticed with those children is that a fair number of those families, at least one of the parents, had complex mental health issues, as well as the child.
So, in the olden days, you would have a CAMHS professional supporting the child.
I'm a separate organization completely for in the adult.
And now we have a multi agency MDT because we have children's mental health professionals.
We have adult mental health professionals.
We've got pharmacists.
We've got GPs.
Our community.
Consultant paediatrician is now involved.
We have a children's psychologist involved.
We got a neurodiverse pathway in place for autism, ADHD.
We got a social prescribing link workers involved and the whole of the charitable sector and the third sector wrapped around what matters to those 30 families.
And, what we're finding is less children self harming and children starting to go back to school.
So children starting to go back to school is huge.
Because if you think about what are the main determinants of health? It's not how much healthcare you receive, it's how much education you receive, and your opportunities for a good job.
So getting our kids back in school, and supporting our kids to get the highest qualifications they can, is the biggest thing that we can do to improve their long term health.
The kids going back to school is huge.
And as far as the YouTube's concerned we put a bid in to the well now We bought our community hospital, firstly, we set up a local charity called Fleetwood Trust, and our Fleetwood Community Hospital used to be an NHS hospital, the NHS abandoned it and it was derelict, so we bought it, and we've renovated it.
And a 1.
1 million pound national grant from the Youth Investment Fund, has funded our youth hub.
Wow.
And the staff in the youth hub, are from the community trust arm of our professional football club.
So you can be connected with your local professional football club is huge, the youngsters, so that's where that came from.
So all of that's gone back to that seeing the community as the asset.
So the community helping you to support, but importantly for those young people and children and those families about giving hope that you mentioned earlier on, you give people something you give them confidence, and then you give them hope, or you listen to people, give them confidence and then you give them hope.
And it's like throwing a pebble in a pond and those ripple effects starting to happen.
And like I say, we're 10 years down the line.
now.
So this hasn't happened overnight.
But for example, so again, listening to the young people.
When our youngsters were leaving school at 16, they were having then to travel into central Blackpool to carry on their education.
There was no post 16 education in the town.
Again, you ask families and children that live in poverty to get on two buses to travel 12 miles there and back to a sixth form centre.
They're not going to do it.
And they didn't.
And they don't.
So in that old community hospital, we, as Blackpool and the Fylde College, to locate into the hospital to start delivering post 16 education.
So our kids, which they're now doing.
So we've got that in place working with the Department of Work and Pensions.
So we've got twice the Lancashire average of unemployed 18 to 24 year olds and Lancashire is pretty bad anyway.
So to have twice the Lancashire average is pretty dire.
So we got a whole raft of 18 to 24 year olds on universal credit.
So working in partnership.
With the Department of Work and Pensions, the Job Centre, because they are part of this.
We've redesigned the support that those young people on Universal Credit are given.
So, rather than having to go to the Job Centre and sign on, those young people now go to the Youth Hub.
And the people that work for the Department of Work and Pensions sit in the youth hub, as do youth workers, as does the voluntary sector.
And the initial thought of the Department of Work and Pensions was, okay, let's teach people how to write CV, let's teach them how to go for an interview, and then they'll get jobs.
When we started listening to those young people, when they were starting coming in, having been sent from the job centre, The reason that they were a million miles away from getting a job predominantly was their mental health issues.
A lot of them severe mental health problems.
A lot of them were self harming.
A lot of them were, taking illicit substances.
Because of the connections with the primary care network, we were able to put mental health professionals into the youth hub.
Because of the connections with the voluntary sector, we've got a brilliant charity in the town called Counselling the Community.
They brought counsellors into the youth hub, we managed to bring a, psychological therapist into the youth hub, and all of that was then focused on those folks mental health, their emotional well being, their self confidence, and self esteem.
Only then Did those young people start to hope that they could start to get some qualifications and then move them on.
So one of the steps was then volunteering.
So connecting all the volunteer sector organisations, there were routes into the volunteering sector.
Having Blackpool and the Fyre College in the same building, then allowed those young people literally to go across the corridor and start going to college.
So these, it's about 300 young people and some of them have never worked.
Of the 300 that have been supported so far, hundred and 60 are now in full-time education, and eight are in full-time jobs.
Wow.
And that is how we reduce health inequalities.
That is how we turn around that life expectancy.
That's 10 years lower than the England average, we do have to provide more healthcare.
We do.
But it's much, much more than that.
Listening, connecting, self confidence, being in control, education, training, employment, and hope for a better future.
Thank you.
It's an incredible impact that you've had, Mark.
And I know that, I'm talking to you, but it sounds like the whole community, somehow you've got everybody on board and driven.
I'm aware of time, so I just want to ask you, do you have any sort of key messages that you want to share with people? Or maybe even a call to action to say to people, yes, some really important things and I've said them already.
But it's worth saying them again, the importance of listening.
So we hear a lot about, I don't know, NHS England, ICB, local authority, doing an engagement exercise with the community.
So we're going to come and listen to you, but actually they've got a preconceived idea of the sort of service that they're going to impose on that community anyway.
That's not listening.
No.
This is long term listening.
Deep listening.
Listening in order to understand.
Second one is where does the locus of control lie? If you're an NHS leader, if you're sitting in the local authority, if you're sitting in the education authority, where does the locus of control lie in that community? Because if it lies outside of that community is never going to move on.
Locus of control needs to rest from within the community itself.
And those of us in the public purse, we need to work with our community and not think that we're that clever, that we've got the answers.
The third one and I know the King's Fund, Adam Lent and others at the King's Fund are about to launch this very shortly.
So I don't know whether I'm going to steal Adam's thunder or not, but I'm going to say anyway, and that's stop doing two communities.
Do with, don't do to.
He was on the podcast with his hashtag do with a few weeks ago.
So you haven't stolen his thunder.
Yeah, and the one I haven't said yet is the importance of having fun.
Lovely.
Because none of this is, none of this is dull.
None of this is sitting in a committee room with an agenda, with minutes, with action plans, with subgroups and none of this.
Is that bureaucratic? Let's set up a working group to look at what this is fun.
We go for walks.
We have meetings that look more like a picnic.
We have tea and cake.
We go singing.
We enjoy and it's heartwarming as well.
If it doesn't feel like it's fun, you're probably getting it wrong.
Find the fun and it takes time.
It takes time.
Don't rush it.
And a couple of times I've lost my way.
And I've lost my way because I keep thinking I've had a really good idea that's going to help.
But it's not about me.
It's about the community.
It's about the residents and the ideas need to come from the community.
That's really lovely.
It's been so insightful, so inspiring to listen to you and it's given me hope to hear that these sort of things are happening.
So thank you, Mark.
And I think those key words for me that I'm going to take away is about, having fun.
So giving hope and having fun.
So thank you.
And thank you for joining me.
Yeah, yeah.
Thank you for listening.
Thank you.
Thank you for tuning in to So Who Cares Anyway? I hope you enjoyed today's episode, finding it both insightful and inspiring.
Don't forget to follow on your favorite podcast platform so that you never miss an episode.
If you like what you heard, please leave a review and share this podcast across your networks and with your colleagues, friends and family.
Your support means a lot to me and it will help me to continue to invite interesting, inspiring guest speakers for these podcasts to continue.
So join me and my next guest next week for more stories and discussions on So Who Cares Anyway? Until then, take care and stay curious.