Greenwich Prevention System: whole system approach

Moving towards a whole system approach There are three inter-connected levels at which action needs to be taken: Population Level Community Level Individual Level Healthy public policy Tackling the wider determinants of health Social marketing, large scale campaigns & awareness raising Make Every Opportunity Count Empowering individuals and communities Building social networks Increasing participation Developing assets Building capacity to address determinants Increasing resilience Supporting individual health behaviour change (e.g. stop smoking) Increasing access to services & resources Improving navigation between services Population effects can be achieved if carried out at scale 50% of all premature deaths and 26% of ill-health are preventable by tackling the key causes, risk factors and underlying wider determinants as set out in the Greenwich JSNA Issues Picked up in the GP forward view Universally accessed Increasing pressure on patients – particularly in deprived areas Untenable workloads in primary care Social and economic drivers Frequent attenders To turn down the “tap of demand” there needs to be system-wide action delivered at scale All parts of RBG can influence through the policies and decisions it makes and the services it provides

Moving towards a whole system approach: Community level Interventions Outcomes Community and stakeholder engagement Street/ doorstep interviews Community ‘world’ cafes Profiling; asset mapping; service audit; appreciative inquiries Community and stakeholder co-production and action workshops Community development Local volunteers Training and skills development Participatory design and delivery Individual effects - ↑ Confidence Self esteem Self efficacy Formal & informal networks Sense of control Skills & knowledge Employability & employment Effective use of services Improved community health, wellbeing and resilience Well CommunitiesCoordinator Health related behaviour change Employment income, financial resilience Improved access to and uptake of more effective, efficient, community focused services Well Communities Delivery Team Community Health Champions Community effects ↑ Participation Social connectedness Sense of control / ownership Perceptions of place and of safety Cohesion Resilience Identifies: community perceived needs; priorities; motivation and aspirations; & key success factors for each community Develops: priorities for community action; community participation in interventions to address social, economic & environmental determinants of health Supports: Co-design & refocus of local services Communities defined primarily by geographical neighbourhoods (* Model and steps using the internationally evaluated Well London / Well Communities approach)

Moving towards a whole system approach: Individual level