ABSTRACT
The purpose of this chapter is to offer a practical, low-cost and participatory tool to support the reorientation of health services, one of the six statements from the Ottawa Charter for Health Promotion.
There are many different approaches and models to health service design. Services can be designed by a specific organisation for their team to deliver and may or may not involve ‘patients.’ Some focus on a care pathway design across partner organisations, again this may or may not have involved the people the services are designed for. In the UK context, healthcare service design often starts with data to be improved, costs to reduce or a workforce capacity challenge to manage.
Bate and Robert state, “there is also the issue of the gap between the rhetoric or ideology and the practice. In most countries, despite the longevity of the ‘patient involvement’ concept, healthcare systems are still not putting patients first. A recent report [The State of Healthcare 2005, Healthcare Commission] suggests that the health service in England could often seem to be designed around the needs of healthcare staff rather than patients”.
The model advocated by this chapter is inspired by Cormac Russell, Director of Nurture Development, and starts by finding out what resources and skills the community already has. It follows an asset-based community development methodology. Building trust and working together to decide what services can add to a community, is a different approach and one that should become increasingly relevant if the new NHS plan for neighbourhood health is an authentic approach to truly understand the power of communities.
