That sounds like a fairly abstract question I know and it reminds me of a Louis CK stand-up routine, where he plays the part of someone trying to explain to an angry god what a ‘job’ is.
The premise of the joke is that a benevolent creator has provided everything we need to survive and the minute his back is turned the humans have massively overcomplicated everything, leading to a need for jobs, double shot Frappuccinos and bacon cheese burgers.
So there lies the problem for big thematic questions like this, because dealing with big problems is inherently complex, can’t be tackled by one organisation in isolation and there isn’t a narrative that’s easy to communicate.
Maybe systematic and endemic problems that impact our health can’t be solved at all (certainly not quickly) but I was heartened by my first ever visit to a Health & Wellbeing board.
Someone else, far smarter and more senior than me but also on their first visit said to me “this is a vehicle that can take us somewhere”.
Essentially, the board brings together everyone in a local area that has responsibility for healthcare or has some influence on it. In Gateshead that includes the hospital, GPs, the council, public health, the group that commissions healthcare services, NHS England and the voluntary sector.
The group then looks at key health issues, what we can do to solve them and thinks about solutions based around a whole system approach. This might sound simplistic for people working outside the public sector but it’s a very different way of working across the (probably artificial) boundaries imposed by each organisation.
If you look at almost any major issue in society – binge drinking or obesity for example – the stock response is about treatment or what the NHS does once the problem becomes acute.
In reality, there are many facets to these problems and by working together in a wider sense perhaps it can be tackled in a different way?
So, in my first meeting I learned that in our area a lot of the preventable deaths each year are connected with poverty and a cycle of issues connected to things like debt and the impact it can have over generations.
Because these issues are often linked and the responsibility of different agencies the group can help tackle it at a much broader level. For example bad diet and obesity contributes to a lot of preventable health issues, while our area also has one of the highest proportions of fast food outlets in the country. Health agencies can tackle some of this while the council can look at how they allocate planning for new food outlets.
Equally, it was fascinating to hear how everyone – from GPs to support services – continually see the same issues affecting the same people, but are now able to do something as one group, tackling not just treatment but also prevention and the associated social issues.
That ‘something’ is still at an early stage and it’s vital that the boards get the right levels of power and responsibility to deliver properly. From my first meeting the comms challenge is probably as wide as the group’s challenge, but to my mind these boards have five key opportunities:
1. Tackling complex social problems in a really joined-up way.
2. Taking a whole system approach to tackling these problems.
3. Targeting the right things that can make a real difference.
4. Lobbying for change.
Let’s hope they can be a success.