Councils have faced huge financial challenges over the past decade and these show no signs of ending. Demand for services is rising while austerity has led to drastic cuts in their income. According to the LGA: ‘by 2020, local authorities will have faced a reduction to core funding from the Government of nearly £16 billion over the preceding decade. That means that councils will have lost 60p out of every £1 the Government had provided to spend on local services in the last eight years. Next year [2019] 168 councils will receive no revenue support grant at all.' (Local Government Funding, Moving the Conversation on)
In response to these challenges many councils have sought to build on, or develop, new ways of doing things. One of these has been to adopt an asset-based approach. To achieve this shift and take it beyond the small scale to the transformative, requires culture change, leadership and political commitment.
This chapter draws from all the contributors to this review to argue that this shift needs to be system-wide and built on developing relationships between partners and on a transfer of power within councils and partner organisations and between these and communities. This argument is illustrated by drawing on the contribution by Councillor Keith Cunliffe and Kate Ardern in which they describe how Wigan Council moved, following devolution, to a system-wide approach to addressing the challenges the borough faces. This has building on community assets at its heart.
Traditionally the response a council makes to an emerging priority has been to identify and implement an intervention to address or minimise its impact. According to the National Philanthropy Centre: ‘each time we develop an intervention, we paper over the cracks and layer yet more complexity onto an already complicated and confused system.
The problem with this approach is that the interventions only last as long as there is the political will to support and fund them. There are few examples of such interventions becoming hard-wired into mainstream services or of these addressing the root causes of structural, societal and systemic disadvantage –even from times of plenty' (Systems Change, a Guide to What it is and how to do it).
Taking a whole-systems approach is about seeking to address the root causes of problems and changing how they are tackled in a way that moves beyond the margins into the mainstream. To truly effect change, support for different ways of doing things needs to happen at all levels, from the national to the neighbourhood.
The contribution by Cassetti on the Spanish approach to partnership working illustrates how this was nationally-led and permeated all levels across the system. ‘In Spain, the National Health Promotion and Prevention Strategy, centres around working collaboratively across different sectors and encourages the creation of local health alliances where different sectors come together to plan collaboratively actions to promote health and wellbeing in local areas or municipalities.’
In Scotland an asset-based approach has been led by the National Assembly with support from the Scottish Community Development Association. As McLean states in her contribution this is now ‘firmly located in Scotland’s policy and legislative ambitions for the future’. While there has not been this sort of national support in England areas like Greater Manchester are supporting an asset-based approach across the region. In other places the lead has come from councils as illustrated by the examples from Gateshead, Leeds, Oldham, Wigan and York.
Whether it is at national, regional, district or community level, progress is dependent on effective and innovative leadership at all levels and political support for a transformational shift in how things are done. Local authorities are well placed to take the lead at a regional and district level but to be truly transformative, system change has to happen across partners. This relies on building constructive relationships based on trust. Councils and partner agencies need to work harder to build trust with their communities and demonstrate there has been a genuine transfer of power to individuals, families and citizens that allows them to exercise more control over their lives.
In Greater Manchester devolution has provided opportunities for local determination of how resources are deployed and enabled a more asset-based approach. Cunliffe and Ardern describe how in Wigan the financial challenges they face and the opportunity devolution presented to do things differently, has led to ‘politicians and senior management fundamentally re-thinking how they could create a new relationship with residents and communities’. The outcome has been the development of the Wigan Deal based on the following set of public service reform principles:
- A new relationship between public services and citizens, communities and businesses. Do with, not to.
- An asset-based approach that recognises and builds on the strengths of individuals, families and communities rather than focusing on the deficits. Having a ‘blank mind’ when having conversations. Treat citizens as full of strengths to be revealed.
- Behaviour change in our communities that builds independence and supports residents to be in control.
- A place-based approach that redefines services and places individuals, families, communities at the heart. Stay close to neighbourhoods and mobilise people around them.
- A stronger prioritisation of wellbeing, prevention and early intervention.
- An evidence-led understanding of risk and impact to ensure the right intervention at the right time.
The Wigan Deal has led to significant improvements in public health outcomes and importantly has proved popular with residents. Staff are central to this success, including appointing the right staff to support transformation, two of the most important attributes being energy and motivation for change. Innovation is key to progress and staff must be given the time and space to try new things, to make mistakes at times and learn from them. Wigan has developed a culture of ‘giving good people the time and space to do great things. Evidence-based working is important, but evidence can only be achieved in the first place by trying something new’
Ardern in her blog, Bottom-up working for effective place-based leadership, on the NHS Confederation website says: ‘new staff are recruited to core characteristics of being positive, courageous and accountable... for more longer serving staff, we have needed to understand better how the culture of organisations can discourage innovation and staff using their own judgement.
This means that sometimes we have to help colleagues unlearn some work behaviours and, in many cases, staff feel empowered and know they have permission to act. We encourage staff to learn new approaches, to hold asset-based conversations wherever they go, and to use their own judgement to make quick decisions in line with agreed guidelines. There are many fantastic examples of the difference this has made to citizens’ health and wellbeing and the morale and motivation of staff… Rediscovering their vocation is a common theme’
One challenge for staff has been building trust in communities that have seen new initiatives come and go. People have been told they would be listened to and changes made, only to have the same old services delivered time and again. Allowing staff time to work with communities and build relationships and trust has been key. Wigan has also learnt that, while it was often useful to work with established community leaders, they had to work hard to engage marginalised communities that might not be represented by those leaders
For any council seeking to build relationships and trust with communities, it will be crucial to have long-term, open-ended funding for community development which frees staff, including those in voluntary sector organisations, to engage with communities independent of commissioned outputs.
Not only is the local voluntary sector an ideal conduit through which community action can be fostered, but also in many places there are established ‘community hubs’ or anchor organisations that are located in neighbourhoods and have been present there for long periods and are familiar to local people (Building healthier communities: the role of the NHS as an anchor institution). Cassetti describes:
‘An increasing phenomenon in the US which has started to generate interest in Europe is that of anchor institutions to tackle the intermediate and wider health determinants. Anchor institutions are institutions with financial capital who are ‘anchored’ in communities, ie they are not likely to go away if a crisis come or market trends change.
They are generally non-profit organisations, mainly public (such as hospitals, health centres, universities) and are place-based. Anchor institutions can therefore establish policies to employ locally, source locally, build locally and work collaboratively in partnerships for (ideally) long term, thus favouring the sustainability of local health initiatives. They can become an important asset in the fight to reduce health inequalities as they can become ‘drivers of economic development.’
As noted above, leadership both at a political and organisational level, is critical to success in embedding asset-based approaches. A ‘dispersed’ leadership style is best suited to this approach freeing others up to build direction, purpose, a new relational culture and in fostering reciprocal partnerships and collaborations. As Ardern notes in her blog:
‘This way of working requires a different set of management styles than we sometimes are used to in the NHS, and the difference in management culture is one that NHS place-based leaders really need to understand and embrace. In local government, the officer code of conduct helps to set some ways of working and standards of behaviour for our leaders and the Wigan Deal takes these guidelines for public service even further.
Compare that (NHS management style) to our bottom up, empowered approach where we prefer continuous improvement and a culture where staff are monitored less and encouraged to challenge themselves to improve the way that they work It’s a very different approach and one we feel is working for people in Wigan.’
Those leading asset-based approaches need to understand to process involved. Attempts to illustrate the stages of development that are needed when adopting asset-based practice at an organisational and system level through the use of a Theory of Change (ToC) could be useful. An example is given in Head, Heart and Hands: Asset based approaches in health care and clearly illustrates the cultural change needed.
Theory of change
Reframing thinking, goals and outcomes Exposure to underpinning ideas, reassessment of current practice and priorities towards asset-based working and the identification of champions to drive change
Recognising the assets available to achieve the change Mapping and describing the individual, organisational, associational, economic, cultural and physical resources available to communities
Mobilising the assets for a specific purpose Understanding and agreeing how community assets can be connected and used. New relationships, new approaches to leadership, systemic action across organisational boundaries
Co-producing outcomes On the pathway to the long-term goal. Co-production of services and outcomes by professionals and citizens. The coming together of equals, each with assets and strengths, around a common goal or a joint venture
Head, Heart and Hands: Asset based approaches in health care
Critical to the cultural change needed is the need to let go of power. Ardern comments: ‘As leaders, we empower staff. As organisations working in Wigan, we seek to nurture citizens’ experience and talents celebrating their good ideas and helping make good things happen. We are happy to ‘lose control’, and that philosophy is an important one to reflect on.’
The journey to achieving positive outcomes in Wigan has not always been smooth and the challenges for health improvement remain great but as Ardern says ‘we don’t learn without acting, and we don’t learn without making mistakes. We are constantly reflecting on what we do and supporting an environment of continuous improvement.’
The real innovation challenge is not about having the ideas, but working out how to turn those ideas into action. We’ve cited many great examples in this publication, but that journey is still all too rare in the public sector. It requires resilience, leadership, risk–taking, effective decision making and has to work across systems.
The recent publication from PHE is clear that ‘Local public health leaders are in a strong position to scale up community-centred approaches across local systems. Effective place-based working across sectors and in partnership with communities can improve health outcomes and meet other local priorities’ and that taking a whole systems approach to tackling the wider determinants and supporting community approaches. Hence ‘Building healthy, resilient, connected and empowered communities is a public health priority shared across many sectors.
A whole system response is needed to maximise impact and improve the health of the poorest fastest. This involves scaling a range of community-centred approaches, addressing community level determinants and working at all levels of a system’ (Community-centred public health: Taking a whole system approach).
As Wilkins, reflecting on her experience in Oldham, says, ‘the principles and values of strength-based working shape everything that we are trying to achieve. It is not an approach we simply select for certain projects. It is a fundamental shift in how we think about what we do, and how we design and deliver services and support’
What the Wigan deal and our other practice examples exemplify is the importance of clarity of political purpose; having ambition and working to scale; and of leadership – both at the top to drive the vision forward but very importantly at all levels so that staff are enabled to work differently and citizens feel empowered to get involved.
None of this is easy in financially challenging times and an asset-based approach should not be seen as a replacement for properly funded services which are adequate to meet needs and address inequalities. Asset-based approaches do however offer a way of achieving much greater engagement and real power sharing across diverse communities.