Understanding public health through community planning

A concerted national drive is currently underway to overhaul Scotland’s public health, but as we all know, talking the talk is easy compared to walking the walk, especially when you’re striving to deliver meaningful reform.

And that’s the challenge facing public health staff across the county. In recent weeks I’ve been travelling the country to understand what people think they need from the reform programme. As part of this process, more than 130 people from community planning partnerships and others shared their expertise at events in Aberdeen, Dundee, Edinburgh, Glasgow, Lockerbie and Orkney.

I’m pleased to say that our engagement events were rich and insightful sessions, with best practice highlighted alongside areas where we all might do better. There was broad recognition of the critical role of collaboration in local partnerships to tackling inequalities.

Perhaps the loudest and most important message that we heard is that soft skills matter the most when it comes to effective collaboration. Partners told us that good working relationships stemmed from the ability to actively listen, develop a shared understanding of their communities and the challenges that they face, and then committing to working together to make a difference – without these relationships in place collaboration will remain an illusive concept.

Another important message was that “one size doesn’t fit all”. The support provided to each partnership needs to be tailored to their specific needs. We heard greatly different experiences, with smaller areas sometimes finding it easier to work in partnership due to a simpler landscape, while urban areas had more complex relationships to navigate. But many smaller areas are also in need of more support from national bodies as they often lack the strategic and analytical capacity that larger partnerships have managed to retain. One of the challenges of delivering public health from NHS health boards is paying attention to the individual needs of small partnerships within health board area.

We heard about the desire to have more support to deliver local projects by embedding national expertise in local groups, and for easier access to relevant data and not just a national resource that they’d need to navigate and interpret. There was also recognition that more effort and resource is required to ensure that we can work more effectively with communities to develop local solutions.

There were concerns too about a culture of not sharing information, or not using data in a joined-up way, with different departments or organisations often working to their own priorities.

We also heard lots about the reform agenda needing to achieve a better synergy between local partnerships and national government, with the flow of information across different departments and organisations likely to be a key factor in realising our wider ambitions, as well as a commitment to supporting local collaboration. This is something that Scotland’s public health priorities were designed to address.

The meetings we’ve had in recent weeks provide just a flavour of the conversations we’re having as the public health reform programme gathers pace. Partners are all aware of the public health priorities and the role of the whole system approach. With this in mind we’re already working with early adopters to use the public health priorities to test out new ways of working, so watch this space.

What’s clear, though, is that good local networks depend on hard work and enthusiasm. Indeed, it will be through a positive, constructive approach that real change is realised, and to do that we need to work as one.