1. Greenwich Prevention System: whole system approach

2. 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

3. 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)

4. Moving towards a whole system approach: Individual level