I could write about engaging with communities or first tell you about the ‘grumpy mums'? Yes, I thought so, grumpy mums it is..
The grumpy mums was the name of a parent and toddler group set up on a deprived housing estate in Cornwall for families with complex needs. Grumpy mums was the working title for the group when the nurse and health visitor set it up. The mums saw the funny side of it and the name stuck.
Within that group were parents with children on the Child Protection register, parents with criminal records, substance abusers, the post- natally depressed and those with disabled children.
A local Positive Parenting scheme heard about the group and sent a rep along to talk to the parents about signing up for sessions. Patronising, middle class with no idea of what their day-to-day lives were like would best describe how this rep was received by the parents.
What did interest them though was a visit by the local college. The lecturer saw that the skills these parents needed – to know how to play with children, first aid, understand child development – were also ones that would be taught on a City and Guilds course for trained crèche leaders
So 10 Mums signed up to a 100 hours of learning and nursery placements within local schools. The tutor agreed to come to them so learning took place in the hall on the estate. A crèche supervisor was paid for so that the Mums had space to learn.
Social services were quite horrified that mums whose children were on the child protection register were being trained to provide play opportunities and supervise other people's children, though they were never unsupervised during placements and training.
It emerged that one of the mums couldn't read or write but she was able to complete the course as she verbally answered criteria in her workbook.
The organisers of the scheme said one of the most uplifting moments was when they saw the mums ‘play' with their children for the first time ever.
All the mums went on to FE courses, three got jobs as classroom assistants and all their children came off the child protection register for good and did well at school.
CCGs will have their own community challenges and they will become even more challenging in these austere times.
The riots are an important message about inequality. We can begin to tackle social injustice and improve health protection if we see our communities no longer as problems, but as solutions.
Lose your communities and you lose the plot.
CCGs often remain unsure about how to do this well. The ‘grumpy mums' approach above is an asset-based approach that has proven itself in many communities over the last 15 years [i]. Called HELP. It is an accelerated form of community development and supports residents to collaborate, grow leaders, gain confidence and work in a coordinated and effective way with statutory agencies to shape services to meet the needs of the estate. HELP is a DH-funded project that uses a tried and tested 7-step process that helps communities move towards a resident-led partnership Harnessing trained community development workers, HELP works with residents and NHS and other local staff to develop a sustainable and cost-effective intervention in local estates selected by the CCG and local authority. It should also be possible to work with communities of interest, such as people with diabetes.
The resident partnership usually works with a range of services, including health, education, housing, police – it becomes a hub of activity and change.
Community development has a long tradition in the UK. It has been based mainly in local authorities but, as its effectiveness has become more apparent, the NHS is beginning to see its relevance. There are a number of approaches with a good track record . We now have evidence [that asset-based community development can:
- Offer excellent patient and public involvement
- Assist in tackling health inequalities
- Assist in individual behaviour change
- Improve health protection
In addition, evidence suggests that the process is cost-effective [v]. We estimate a saving through HELP for local statutory services of £655,162 over three years on a £145,000 investment in community development over the period. This is a return of 1:4.5, comparable with other studies.
Experience with HELP shows surprisingly rapid change. Services begin to shift within a year. Statutory agencies begin to see new ways of working as they meet the residents in new and collaborative ways. Leaders in the estates emerge, problems get solved – not always easy, but, often for the first time, there is a movement for improvement. The process changes agencies, too.