It sometimes feels as if the evidence for community based approaches is not strong. Think Local Act Personal, a national partnership aimed at transforming health and care through personalisation and community-based support, held a Network meeting dedicated to this issue on 16th January 2018. We went along to find out more and came away surprisingly optimistic.

Firstly, NICE (the National Institute for Health and Care Excellence) seems to be make good inroads into the development of guidance and guidelines for care and support. Peter O’Neill talked about the ones published so far. Topics include older people with social care needs and multiple long term conditions, domestic violence and abuse, transition between inpatient and community settings, transition from children’s to adult’s services. More are in the pipeline.

Peter explained how the guidelines are developed and that people using services and carers are an important source of information. It was encouraging that the absence (for good reason) of randomised controlled trials is not preventing the creation of a robust and systematic approach to evidence from a respected national body.

Evidence, innovation and value

Throughout the day, we kept coming back to a number of questions. Firstly, how does a quest to use an evidence base sit alongside innovation? If funders or others who have to give permission to proceed will only do so if you can show you are evidence based then how do you try new things? Sian Lockwood from Community Catalysts gave examples of where evidence had been the basis for funding and others where it had not mattered.

The second question is about what we mean by evidence, the criteria for success and the need to prove a ‘return on investment’. This is where the powerful story from Debs Taylor from Creative Minds put everything into perspective. Debs would be confident that the cost of the art course that changed her life has more than returned the investment. Off medication, in work not on benefits, children who can live their lives not be their mother’s carers. As she says in relation to the impact on her family “How would you measure the value?” I was left thinking that the evidence for art as a life changer in mental health was not a drawback when someone at South West Yorkshire Partnership NHS Foundation Trust set up the course. Thank goodness no one waited for it back then.

We went further into stories versus evidence with Gary Copitch from People’s Voices Media. His organisation specialises in gathering, curating and mobilising stories of people to provide insight that influence and inform people and organisations. Their approach is to find and train Community Reporters who use their deep knowledge of places to capture stories, using their mobile phones to film or record. Another great organisation and website we highly recommend.

The day was rounded off with a panel session after Nick Dixon explained how they are embedding person and community approaches in Greater Manchester Health and Social Care Partnership. It was fascinating to see how the whole system large scale change can be aligned with the need to hear voices at a much smaller local level. We will watch with interest.

My overall feeling is that there are so many good things happening in many different ways regardless of a perceived lack of evidence. Respecting people whatever their circumstances, building on community strengths, recognising value as something that might mean something different from one person to the next. Do we need evidence for these?

Photo by Matt Donders