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Faced with rising levels of substance use, partners in West Dunbartonshire are taking a new approach to try to tackle the issue. Then area's become Scotland's first early adopter of a whole system approach, with the aim of reversing a complex culture that leads to health inequalities. Jacqui McGinn, Health Improvement & Inequalities Manager at West Dunbartonshire HSCP explains…

“West Dunbartonshire HSCP’s Health Improvement Team began developing the Prevention Strategy for the Community Planning West Dunbartonshire Safe thematic group in November 2017.  From previous experience, we were aware of the challenges of fostering shared ownership, maintaining momentum and sustaining delivery in an ever changing environment.  With increasing pressures on resources and varied priorities across partner organisations, we were aware that the concept of ‘prevention’ was often misunderstood and sometimes overlooked.  We placed our focus on prevention in line with the Community Empowerment (Scotland) Act 2015, with the duty to improve outcomes and reduce inequalities.

A flexible process

Whole system working involves making best use of collective resources, encouraging ownership and empowering people and communities. In order to maximise influence and stakeholder involvement a three stage approach was proposed:

  1. Scale of Challenge: gathering evidence and analyse
  2. Mapping and scoping: focusing on existing success and activity
  3. Engagement: work with stakeholders to bring together a strategy

Our strategy aims to prevent, delay or reduce use of substances and reduce related harm, directly or indirectly by using a variety of approaches (policies, programmes and/or activities). 

Seven action areas, based on the evidence of effective prevention and reflecting an upstream approach were agreed:

  • Reduced availability
  • Healthier and safer environments
  • Engaged communities
  • Supported parents and families
  • Resilient individuals across the life course
  • Accurate public information
  • Supported individuals

Whole system working is a collaborative process and the overarching strategy is designed to be greater than the sum of its parts. We have strived to create a system of leaders and followers, with our shared priorities forging links with associated plans, which helps to join-up existing services to best meet local needs.

Of course, this is a dynamic process and we’re constantly reviewing the way we work and changing course if need be. We’re now more than a year in and, so far, the process certainly feels different to the way we worked before, which is an encouraging start.

Finding out the right whole system approach for you will differ from area to area. Importantly, though, everyone who comes together to tackle an issue like substance use wants the same outcomes, so it’s crucial that partners work together to make the most of these opportunities.

In the coming months we’ll be working with partners at the public health reform team to start to evaluate our work and use that evidence to underline our progress to date, while pointing the way to future changes as our approach evolves over time to best serve our communities.

Further information

Chief Officer at the West Dunbartonshire Health and Social Care Partnership, Beth Culshaw, discussed her ambition for the whole system approach with Campbell Hart.


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