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Nesta is partnering with Macmillan Cancer Support and the British Heart Foundation to reimagine the way help is given across our health and wellbeing systems.

Our vision is for everyone to get Good Help – help that looks beyond people’s health conditions, understands what matters to each person, strengthens social connections and support, and builds opportunities for people to feel more confident and in control of their health and wellbeing.

Why are we doing this?

Everyone relies on help from public services and other sources of support to manage their health and live well. But how that help is given makes a huge difference to people.

A vast body of social and behavioural research – spanning several decades – tells us that if we build the following eight approaches into the way that we help one another, then people are more likely to make positive changes in their lives (developed with UCL Centre for Behaviour Change):

  1. Social connection. People have opportunities to build new relationships and take part in social activities to improve their health and wellbeing.
  2. Skills and learning. People have access to opportunities where they can learn new skills which help them feel more equipped and confident to reach their goals.
  3. Enabling environments. People’s physical environments are set up in a way that makes it easier for them to work on their health and wellbeing goals.
  4. Working on what matters. People take an active role in deciding what is important to them and planning what goals they want to work towards.
  5. Tracking change. People track their health and wellbeing in a way that is engaging and easy. This helps people to stay motivated, understand patterns of behaviour, reflect on their progress and adapt plans accordingly.
  6. Having the right information at the right time. People can access accurate health information in amounts that help them to feel (as far as possible) in control of their health and wellbeing.
  7. Celebrating success. People are motivated by rewards (social and practical) that celebrate the journey they’ve taken to reach their health and wellbeing goals.
  8. Managing setbacks. People understand that setbacks are normal and by making time to plan for them, people feel more in control and confident that they can continue to work on or adapt their goals during any setback.

Despite research that demonstrates the importance of these eight approaches and many examples of good practice, use of Good Help in practice is far from universal. Previous policy attempts to change the practice of ‘help’ at scale (NICE 2014; Public Health England 2018; Make Every Contact Count), have not achieved widespread adoption. We think there are a number of different reasons for this: implementation plans are often overly prescriptive, limiting their relevance to local contexts; evidence is often presented in lengthy and inaccessible formats; and the busy healthcare environments do not support practitioners to innovate in their practice.

We have talked to practitioners and people with lived experience who have told us about their experiences of Bad Help – in which healthcare services encourage ‘fixes’ for problems – telling people what is best for them, and focusing exclusively on the medical aspects of health. In scenarios where health services hold most of the knowledge and power, people can become dependent on them for ‘solutions’, rather than being supported to use their own knowledge, agency and purpose to determine approaches that work best for them. This is one of the fundamental differences between ‘good’ and ‘bad’ help.

What we are doing?

We want to work with communities, voluntary sector organisations, healthcare services and practitioners to really understand what Good Help looks like in practice, and how the ‘active ingredients’ can be built into all touch points between people and sources of help, to ensure those interactions have a positive impact on people’s behaviour.

Building on our 2018 report Good Help and Bad Help, we are working in partnership with UCL’s Centre for Behaviour Change to review the scientific literature and practice-based evidence to better understand what Good Help looks like in behavioural terms, and what conditions are needed to embed it. Dartington Service Design Lab will also support us to translate the evidence into clear, compelling and accessible resources.

We have formed a co-design group made up of people affected by cancer and heart disease, VCSE and public sector practitioners, and academics, to test our core assumptions and evidence as it emerges. This process of co-designing is a vital part of the programme and will continue both on a local and national level as the programme develops.

Our ultimate aim is to carry out a series of real-world experiments to test new ways of applying and embedding this evidence into the practice of health systems that are supporting people with cancer and/or heart and circulatory disease, in multiple areas across the UK. We hope to commence this work by the summer of 2020.

The partnership

Working with Macmillan Cancer Support and the British Heart Foundation offers a unique opportunity to build on their insights, influence and networks, and to help bridge interests so that people with multi-morbidities are also better supported by services, the voluntary sector and their communities.

The Good Help Award

Following the release of the Good Help and Bad Help report in February 2018 we launched The Good Help Award to discover more examples of ‘good help’ projects that are already happening across the country. You can read more about the award and the overall winners.

Project partners

Team

Christina Cornwell

Christina Cornwell

Christina Cornwell

Director, Health Lab

As Director, Christina leads Nesta’s work helping to develop and grow innovations that create new relationships, networks and technologies that improve health and well being.

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Esther Flanagan

Esther Flanagan

Esther Flanagan

Senior Programme Manager, Social Health

Esther joined the Health Lab in January 2017 and is working in the social health team on a range of projects.

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Tara Hackett

Tara Hackett

Tara Hackett

Assistant Programme Manager, Nesta Health Lab

Tara joined Nesta in January 2018 and is working in the social health team on a range of projects.

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Robert Jamieson

Robert Jamieson

Robert Jamieson

Assistant Programme Manager, People Powered Results

Robert is an Assistant Programme Manager for People Powered Results in Nesta's Health Lab.

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