Local intersectoral alliances in Spain

This case study is an example of the practical use of asset-based approaches in communities.

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The Spanish National Health Promotion and Prevention Strategy aims to promote health and wellbeing through the implementation of health promotion actions and policies based on the assets approach and intersectoral work. The implementation of the strategy centres around two main steps:

  • the creation of an intersectoral working group, the local intersectoral health alliance
  • the mapping of the local assets for health.

To create the health alliance, the strategy suggests including representatives from at least seven different sectors, with the idea of promoting health equity and health in all policies by tackling its social determinants.

Sectors such as the health system, education, social wellbeing, transport and mobility, urbanism, sport and the environment are considered as key players in this intersectoral approach to promote health and wellbeing. The task of the local intersectoral health alliance is to coordinate efforts to improve collaborative work, supporting actions to achieve health equity and to include health across all policies. At the same time, the local intersectoral health alliance has to map the resources for health available in their communities, those local organisations, activities or physical resources that are assets for health. To then raise awareness of these assets, an online web platform has been created to upload the assets map, Localiza Salud, which anyone can access to search for health resources in their area. The idea is that the actions promoted by the local intersectoral health alliance can enhance the potential of, or further develop, these assets for health.

Since the publication of this national strategy in 2013, a total of 215 local authorities have joined the National Strategy across Spain, 169 local intersectoral health alliances have been created, and more than twenty thousand local resources or group activities have been registered as assets in the web platform (Ministerio de Sanidad, Consumo y Bienestar Social).

York: promoting and supporting voices in the community

Behind its ancient city walls and along its narrow medieval streets, something new and transformative is taking place in York. Power is shifting and people are increasingly coming together to define what they want, and find new ways, to co-design and deliver services collaboratively. People’s strengths, skills and networks are being harnessed to provide self-sustaining solutions and a deep reservoir of community resources that people can draw upon to live well. A truly asset-based approach to building community and wellbeing.

The City of York Council Adult Social Care Department introduced a new ‘community operating model’ in 2016, focused on prevention, early intervention and asset-based community development. This involved working with cross system partners, and importantly with their vibrant voluntary and community sector. Together, they’ve reviewed the volunteering and social action strategy for the city, utilising the Cities of Service model: www.citiesofservice.org The ‘People Helping People’ strategy launched in 2017, focuses on a collaborative relationship between council and citizens growing social action to help address complex social challenges.

This model supports the council’s vision of creating the conditions needed for all people to enjoy healthy, active, independent lives. The city’s leaders have deliberately aligned multiple initiatives and principles, to enable a force for system change, and a new normal. We have shifted away from where social care intervenes at the point of crisis in peoples’ lives, often risking dependency, towards a new culture intervening upstream, maximising the individual’s agency and their community’s capacity to self-manage as the first option, encouraging active citizenship and voice. This is a more facilitative approach, reflecting collaborative leadership and shared purpose.

York is recognised for being at the forefront of ‘asset-based area’ thinking and continues to invest in programmes ‘which work’ with a recognised evidence base, such as local area coordination. These are increasingly seen as core to system change and not an ‘add on’. York’s strategic investment in prevention and recognition of the power of community and human connection is opposed to deficit based medical models. The council is finding that asset-based community development is providing the foundations for outcomes to be developed.

GoodGym, local area coordination and social prescribing are excellent examples of asset-based approaches that are addressing loneliness and social isolation as a part of the wider York model. GoodGym, commissioned by the council in 2016 became self-sustaining within two years, with more than 400 runners joining this social movement. To date, 658 ‘coach runs’ have been made to an isolated older person and 159 ‘missions’ to help on household tasks have been completed. In total, 7,823 good deeds have been done, including 250 group runs to help community projects. GoodGym York is one of the most successful of 57 programmes nationally, a classic example of people helping people. Metrics reflect 93 per cent of older people feel more connected after being visited by a runner whilst 92 per cent of runners agree that GoodGym increases their motivation to exercise. A selection of metrics and stories are featured on theGoodGym website: www.goodgym.org/ areas/york/coach-runs

GoodGym referrals come through place based arrangements including York’s local area coordination team whose creative person centred approaches to ‘walking alongside’ people creates an infectious flexibility across the wider system and action by people as valued citizens. The local area coordination team taps in to community capacity by exploring ‘good life’ conversations, unlocking hidden gifts, passions and skills, and encouraging active citizenship. In just two and a half years over 1800 people have been ‘introduced’ to the team and are now more connected, having developed meaningful relationships and are contributing as active citizens, helping to create more inclusive communities. Stories are an integral part of the performance framework, supporting corporate performance frameworks for the city to be transformed, reflecting the experience of being ‘treasured’ and not ‘measured’ and social capital in the city to thrive.

These examples are just part of this ever-growing iceberg which is inverting traditional service systems and relocating power to where it belongs, with the citizens who make our city. The council remains committed to the future of public services as ‘people powered’ with social action as the norm rather than the exception. York continues to demonstrate this and inspire other areas to follow.