This case study was developed as part of the SLC’s work on the GM Active Pivot to Active Wellbeing strategy aiming to address health inequalities through the transformation of public leisure services.
Health inequalities in Bury are stark. Men’s life expectancy can vary by 15 years depending on where they live, while for women it’s 11 years. Bury needed something radical. Transformation was the answer.
The Wellness Strategy is Bury’s approach to improving health outcomes and tackling health inequalities in the borough.
The Bury Wellness StrategyIn two adjacent wards, Sedgley and Radcliffe, men’s life expectancy varies by some 15 years. For women, there is nearly 11 years life expectancy difference between the Radcliffe and Summerseat wards.
These sorts of inequalities are deeply entrenched and have not been solved by traditional approaches and interventions.
This meant that a wide range of partners needed to come together with members of the community to define the problems and co-create new ways of working.
This challenge was made harder by the council’s need to find £30m of annual savings. So, the pressure was on from two directions: health need and financial need. This could only be addressed by true transformation.
There were no shortcuts in developing the Bury Wellness Strategy. It required a range of partners to talk, share and collaborate. They began to understand the problems in the borough, the causes, potential solutions and new ways of working.
The agreed vision (see figure 1) was to provide both a universal offer and a targeted offer, with the latter focused on the most deprived communities. Solutions would be developed in partnership with residents in those communities.
An integral part of this work was the development of the relationship and contract with Public Health.
Public Health commissions the Live Well service to provide health trainers and exercise referral officers. They offer one-to-one support for behaviour change on issues such as stopping smoking, movement and weight management.
Live Well is also working with a federation of three Primary Care Networks (PCNs) who will be using funding from the Additional Role Reimbursement Scheme (ARRS) to recruit eight full-time equivalent Health & Wellness Coaches to focus on cardiovascular risk factors, bowel screening, frailty and falls.
This will be delivered via a drop-in service to improve the accessibility for users.
It will be followed-up via small groups sessions which are more efficient than one-to-ones.
Measuring the success of the strategy is an ongoing challenge. On one hand, there is plenty of quantitative data about input measures such as numbers of people seen or the number of interventions.
But on the other hand, there is currently no data on impact. The council is currently looking at tools such as Cost Benefit Analysis and Social Return on Investment to demonstrate the impact and the financial savings that can be made through a preventative approach.
But there’s also a need to win over hearts and minds via human stories – a qualitative perspective. To address this, the council has created a series of person-centred case studies and a high-quality video which captures ‘on the ground’ stories of partners and local residents.
However, a key learning has been that partnership working, place-based working and a whole systems approach is not easy. It requires hard work: listening, explaining, influencing, shaping and planning. But in doing so it has created a positive, can-do attitude among partners with a high level of trust and an expectation that everyone plays their part.
