Deep Value: We know it works.

Community Links delivers a wide range of practical services in east London. One principle underpins them all: We believe it is not only possible for one human being to make a real and lasting difference to another, it is often, in the most difficult circumstances the only thing that ever does. Continue reading Deep Value: We know it works.

Nurses need to urgently engage in this debate- relational welfare

A human approach to welfare with bureaucracy taking a back seat is to be hugely encouraged. Working in a hospice I regularly see professionals going the extra mile to ensure a patient’s last requests and wishes are carried out. There are, of course, huge challenges within the NHS to allow a personal touch to break through. Within a hospice setting a cross section of society make up the patient numbers. Your nursing expertise deals not with one type of person or problem or communication method. This makes the work varied and the problems faced not all of a similar type. The needs of people within the wealthy, information laden middle classes present as much of a challenge as those whose needs are overwhelmed by poverty. In a busy NHS hospital ward which I worked on recently, communication with all the patients was a problem due to language difficulties, cultural boundaries or confusion. Changing shift patterns within nursing have promoted a different type of continuity of care. You may work with one patient for 12 hours but the chances of looking after them again could be remote. For staff this means building quick relationships, for patients it means relentless questions on a daily basis. Computer systems ensure accuracy of data and information sharing – but come at the cost of increased time spent at a computer rather than a bedside. Nurses have been slammed in the press recently – uncaring, too technical, no compassion. This is a distorted view of a profession that has always been able to react to the individual and see that person as a part of a wider family and community, and indeed acts as a referral agent to many other health professionals. Nurses need to urgently engage in this debate about relational welfare and be part of an exciting change to the way care is structured.

-Hospice Nurse

‘The idea of RELATIONal welfare is like music to my ears’

As a psychotherapist, the idea of RELATIONal welfare is like music to my ears. Relationship is at the core of the human condition – a welfare state that is built around this principle has the potential to really transform people’s lives.

Having worked in an adolescent NHS psychiatric unit, I have witnessed first-hand the despair and hopelessness of adolescents with mental health issues. What was most upsetting, was the number of re-admissions on the unit. A significant percentage of the residents were on their second or third admission, and not much had changed for them / within them between stays at the unit. In my view this was because there was nothing outside the unit to ‘hold’ them; no container for their confusion, their suffering, their despair, their rage. No one person outside a mental health unit that could bare their suffering. If Participle can offer a one-to-one functional ’Relationship’ to those in need, a person who can mentor, guide, offer practical, emotional and sustainable support then it is offering hope and the real possibility for change.

As Alain de Botton has said, “Imagine if the need for therapeutic dialogue was as honoured and recognised as the need for a haircut or a go on an exercise machine. Imagine if seeing a therapist wasn’t a strange and still rather embarrassing pursuit. Imagine if one could be guaranteed a certain level of service.”… Is this the challenge of the creation of a Relational Welfare State? – to provide a ‘certain level of service’ that understands the therapeutic, life-enhancing, life-changing value of Relationship? If so, I am ready and up for it.

Cathy Bor is a psychotherapist.

Participle- Shaping the future

Having worked in Local Government, it is striking to see the waste and inefficiencies that exist within the structure of departments and services engaged in the spending of public money. Bit of a ‘hard-hitting’ statement but you can only begin to make a difference if you are prepared to take a fresh approach to what is required and what will work more effectively.

Today, Central Government still provides the national performance framework of how Local Government is measured with Chief Executives vying each year to demonstrate that their Local Authority is measured as ‘excellent’, having good cash receipts as well at the end of the financial year.

Well what’s wrong with this approach as it certainly provides a ‘safe pair of hands’ when dealing with the public purse and the provision of public services. After-all, many staff are life time members of their Local Authority and they have always delivered public services in the same way and why should they change the recipe of what works!

But you have to ask the question ‘who does it work for?’ You have to admit that this tried and tested structure does work because the books balance at the end of the year and of course the ‘spin doctors’ of Central Government rub their hands with delight at the positive media hype that the austerity measures are working. But is this the right measure?

But if were to ask the local community whether this is the right measure, the answer I suspect, will be totally different. I would therefore argue that fundamental change is required to reposition Local Government from the providers of local services to the facilitators of local services. Quite simply, there is a large and talented world that exists externally to Local Authorities made up of the local community and private industry with a far greater capacity for innovation and design having the right skills and critical modern day thinking that can deliver services far better and for a lot less cost.

For me, working in Local Government is very frustrating because there is a great reluctance to change. But with a background in change management and organisational best value reviews, this comes as no surprise! But Local Authorities will always stay the same until such times as the Chief Executives are prepared to push at the boundary fence to bring about more effective change. To some, this is called ‘rocking the boat’ and to the enlighten few, it is called ‘leadership’

A few have already started to do so and in these cases, Participle are spearheading the way in working with the local community and delivering services that truly make the difference. Having had the opportunity to look at Participle and it’s values, I am very impressed with how they deliver their enterprise solutions, which are bang on the money from the communities point of view.

Going forward, Central Government has recently announced even more public sector cuts to come and this will mean the loss of even more services that local people have come to depend on. The time for change has never been so real with companies such as Participle, more than fit for purpose to bring about much needed innovation and change.

Richard Wingett

A ‘One Nation’ Integration Policy

Whether we’re looking at ethnicity, class or age, the UK has an integration problem.   Our country is unnecessarily divided.  We can see it when we visit our schools, we can see it when we walk round our neighbourhoods, we can see it when we look at our friends.

For too long our bar for building a integrated society has been too low.  As long as there are no riots or violence we have assumed it’s all ok.  As long as everyone speaks some English.  As long as we can queue up together.  This is not integration, it is tolerance.  And it is a tolerance that has accepted the unacceptable.  It has accepted one of the most segregated school systems in the rich world. A system so segregated that my three year old daughter will prepare for life in a diverse country by spending seven hours a day, five days a week for 11 years in a building full of people broadly her age, her ethnicity and her parents’ income bracket. It has accepted a care system that corals the elderly together or isolates them at home. And it has accepted a housing policy that locates rich and poor households in separate enclaves.

This division matters.  It matters if you care about social mobility for relationships and networks are key to social mobility.  However, at present half of our poorest children are educated together in just 20% of our schools.  It matters if you care about unemployment.  80% of jobs are never advertised but passed through word of mouth.  However half of unemployed Brits spend most of their time with others who are out of work.  It matters if you care about social care.  Loneliness makes the elderly more likely to suffer mental and physical illness.  However, 5 million senior citizens are so disconnected from society that they describe the television as their main companion. And it matters if you care about far-right or faith-based extremism.  Having a friend of different faiths makes you less susceptible to extremism.  However only 12% of non-Muslims have a Muslim friend.

It is time to admit that our present approach has failed. In fact, it has failed many of the young people my charity has worked with.  It failed Ahara – an Asian girl from Birmingham – who at 16 had “never had a white friend”. It failed Dami who never considered university as he did not have a friend who had applied. It failed Louise who crossed roads to avoid groups of black youngsters as she thought they were all in gangs.

And it has also failed our country.  For a segregated country is a low trust country.  And we have become a low trust country; British citizens under 55 have lower trust of their neighbours than any people in Europe.  This should seriously worry us for it is high-trust countries that flourish in the global race.   Individuals are happier – meaning lower mental health expenditure, communities are more cohesive and less fearful of crime – meaning lower policing costs – and economies grow faster with a more interconnected labour market.

So what do we do about it?  An effective relational approach to integration must have two main thrusts.

Firstly, it must seek to desegregate our public services – with a particular focus on education which is uniquely social.  Our schools, apprenticeship programmes and universities must be places where young people from all walks of life gather.  This means finding ways to incentivise all schools to reach their entire community.   The right to operate as a free school or academy might come with a requirement to reserve a set number of places for those on free school meals.  Or an Ofsted rating or provision of charitable status might require schools to show they are reaching all sections of a community.  For universities, the right to charge higher fees might be tied more closely to receiving applications from all sections of society.  For apprentices, providers might be required to do much more to ensure that they are seen as an option for all young people not just the least academic.

Secondly, it must seek to support and encourage the social entrepreneurs who will build the new 21st Century institutions.   Lottery funding should be set aside to support the initial start-up of creative and scalable ways of connecting people.  Institutions like The Big Lunch –which now brings together many tens of thousands each year – were born in exactly this way.  Support must also be prioritised for young fast-growing institutions including the National Citizen Service.  Through it, charities like my own have connected thousands of people across income, ethnicity and generational lines.  It is through the National Citizen Service that Ahara made a white friend, Dami decided to apply to university and Louise overcame her fear

For too long a truly relational approach to integration policy has been left in the shade, eclipsed by discussions of immigration, race relations and security.  It is time to put relationships at the heart of the approach and bring UK citizens together again.

Jon Yates is Strategy and Development Director at The Challenge Network.