Asset-based approaches - valuing strengths and associations
“One of the great strengths of this country is that we have an NHS that – at its best - is ‘of the people, by the people and for the people’. Yet sometimes the health service has been prone to operating a ‘factory’ model of care and repair, with limited engagement with the wider community, a short-sighted approach to partnerships, and underdeveloped advocacy and action on the broader influencers of health and well-being.” (Five Year Forward View, 2014: 9)
Citizens and communities have been described as the “renewable energy” of the NHS, but what does it really mean to harness this?
In the renewable energy business, the trick was first to realise the value of sunlight, wind, tides, waves and geothermal heat as energy sources, and then to harness these in cost-effective ways. In health, we need to first realise the value of people and communities, and then build the business case for cost-effective approaches.
Beyond starting with the strengths of people and communities (rather than their needs), asset-based approaches share four other key characteristics. In this blog, we’re setting out each of these four key characteristics, alongside examples from our work to illustrate how these might play out in practice.
Asset-based approaches are community-based. They work in the space in which networks come together and shared interests are negotiated and acted on.
New Roots, a partnership of social enterprises committed to improving the lives of people with dementia and their carers in Salford, hosted with Healthwatch Salford a dementia discovery day. 110 participants, including people living with dementia, their carers, care professionals and other stakeholders came together for lively discussions around three themes:
- discover – what is happening with people with dementia and their carers
- dream – what people with dementia would like in an ideal world
- design – how the suggested changes can be implemented
By drawing on strengths, this approach is leading to new thinking about the quality of life of people with dementia from their perspective, starting with ‘my world’ (my life and relationships), then ‘our world’ (wider community) and finally ‘your world’ (health and social care).
Asset-based approaches are relationship-based. They create the conditions for reciprocity, mutuality and solidarity.
In Eccles, Unlimited Potential is currently testing how local people and practice staff can work together in equal partnership to solve issues of common concern, and make improvements to primary care. We have done this first by identifying priority issues – access to primary care and increasing demand – and then supporting both local people and general practices to run practical tests of change.
Eccles Together in Health is using improvement methods with plan-do-study-act (PDSA) cycles. Tests include storytelling to improve take-up of the minor ailments scheme, careful wording of text messaging to reduce missed appointments, and asthma parties as a fun way to improve children’s use of inhalers.
Asset-based approaches are citizen-led. They empower individuals and communities to take control of their lives.
In Salford, Unlimited Potential identified with local people that fathers are a hugely underutilised resource for children’s wellbeing. We ran an exploratory project to find new ways to improve the wellbeing of disadvantaged fathers and to understand whether this can improve their children’s well-being. Using a ‘positive deviance’ approach, the project was co-produced with a ‘Council of Dadz’ (now Salford Dadz - Little Hulton). They have created male-friendly spaces where positive role models talk openly ‘shoulder to shoulder’ and also fun dad-child activities that enable bonding.
Fathers report a greater sense of positive identity, increased social connectedness and moves towards or into meaningful employment. Children reflect better relationships with their fathers, with consequent improvements in their own behaviour and well-being. With greater shared parenting, mothers relate significantly improved family relationships and, for some, a much more positive view of men.
Unlimited Potential is now testing whether the successes of fathers and children in Little Hulton in changing their lives can be sustained, deepened and replicated elsewhere. This has started in a second locality, Winton, with a Men Behaving Dadly competition.
Asset-based approaches promote social justice and equality. They enable everyone to have access to the assets they need to flourish.
Within the Community Assets workstream of the Salford Together integrated care programme, a programme of tech and tea sessions is continuing to run, aimed at helping older people gain a better understanding around new technology and the benefits it can provide. In many cases, people already owned tablets and other technology, but had little or no knowledge how to use them. Local volunteers support them to explore their interests in social settings.
With increasing demand for health and social care by professionals, but ever limited budgets, we need new resources. If we are prepared to look differently, we can see they have been in front of us all the time – our fellow citizens and communities.