Report and accompanying case studies co-produced by Aberdeenshire Community Planning Partnership (CPP) and What Works Scotland, which offer descriptions and discussion of areas of emerging policy and practice as the CPP explores ‘putting Christie into action’ and opportunities arising from the Community Empowerment Act.

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Summary

This report and accompanying case studies offer descriptions and discussion of areas of emerging policy and practice as the Aberdeenshire Community Planning Partnership (CPP) explores ‘putting Christie into action’ and opportunities arising from the Community Empowerment (Scotland) Act 2015.

The report aims to help others involved in public services and policymaking understand more about what is happening, and why, in relation to this developing area of public service theory and practice.

1. Inquiring into ‘prevention’

The report follows several collaborative learning and action processes between CPP partners and What Works Scotland which illustrate the CPP’s ongoing work to develop multi-layered preventative partnership working and to consider what is being learned from this.

2. The developing context for policy and practice

The Christie Commission 2011 provides the rationale for this focus on the developing context for policy and practice. The Christie Commission argues for the need to prevent inequalities (wider social problems) to both create a fairer, more equitable society and reduce demand on public services in a time of constrained public spending. Partnership and participation are the key tools for achieving this.

A circular graphic with the following text in the centre: Barriers to change – there are a considerable number of challenges being identified as the CPP seeks to move to more preventative approaches. Nine arrows point out from this centre to the various barriers to change which have been identified. These are: • Political pressures: to retain existing services (status quo) that block change to prevention. • Administration of CPP budgets is complex: and therefore shifting to preventative spend too. • No working definition of preventive spend: need learning materials to develop this. • Public sector reacts to problems: not currently structured to tackle root causes. • Disinvestment (of funding) in services is challenging: benefits may be longer-term; communities may need convincing; and policy/contract commitments already exist. • Attributing outcomes to interventions is difficult: the services impacting may not be apparent, nor may those services investing in prevention actually benefit financially. • Community-led/asset-based approaches to prevention have a limited evidence base: this creates uncertainty where to invest and if inequalities between communities might widen. • Constraints on public spending: budgets are tightening, keeping the focus on resource management for statutory responsibilities, rather than shifting resources to prevention. • Data for strategic decision making is not always available or reliable: whilst reporting to Scottish Government can involve a plethora of ‘non-prevention’ priorities/targets. Below this circular graphic is the text: The CPP is exploring opportunities that would take forward culture change. Four arrows lead from this to four boxes below containing the following text: • Box 1 - Examples of local practice: include the Community Forums developed by Aberdeenshire Alcohol and Drugs Partnership (ADP), and the related transferring of financial decision-making (participatory budgeting); ‘community kitchen’ initiatives have been successful in supporting healthy eating and lifestyle choices with a range of service users. • Box 2 – A shared learning culture that can include: o Shared budgets and responsibilities – including accountability through the CPP. o Learning from ‘failure’: risk-taking and initial ‘mistakes’ are crucial elements in change. • Box 3 – The role of digital tools: for example, a website for young people and their parents developed by ADP; the role of tele-healthcare; digital assessment administered via one point. • Box 4 – Policy and practice opportunities: both health and social care integration and the Community Empowerment (Scotland) Act 2015 are creating opportunities for local partnership-working, working with communities, and the autonomy needed to generate local solutions.

Barriers to, and opportunities for, culture change. Click on the image to see a larger version

Early strategic thinking by Aberdeenshire CPP (October 2015) and a first Collaborative Learning Day (December 2015) organised by the CPP and What Works Scotland highlighted the challenges faced in developing relevant partnership, participation and prevention.

They pointed to the current challenge for the CPP of learning the ‘how’ of preventative partnership working. For instance, how to manage change, re-design services and support participation that can actually impact on local inequalities and other social problems. In effect, learning how to engage together on ‘wicked’ (complex) social problems.

3. Developing a clear focus on preventative partnership working

A second Collaborative Learning Day was organised by Aberdeenshire CPP, NHS Health Scotland and What Works Scotland (May 2016) to build on the emerging questions and challenges from the first.

The presentations provided the following material for later discussions on the day across the following topics:

  • The evidence base: reducing health inequalities, improving population health, preventative spend:
    • Points to upstream, system-wide approaches, e.g. fiscal, regulatory, legislative and whole population health (public health) as likely most effective in reducing health inequalities.
    • Potential savings are most likely achieved in the longer-term rather than the shorter-term
  • Preventative spend: shifting to preventative spend is challenging. Options include:
    • Disinvestment – moving spending from existing (reactive) services to preventative approaches, e.g. through pooling budgets to generate more effective coordination.
    • Public accounting procedures – changing the focus from the current financial year to longer-term, e.g. use of predictive analytics and rewarding services that take a longer-term view.
    • External investments – alternative sources of finance (public, social, private) that can support transitions and ‘double-running’ of preventative approaches and reactive services.
A graphic consisting of three boxes. The first contains an image of three hands on top of each other. It is titled “Developing effective multi-layered partnership-working focused on prevention”. This box contains the following points: • Finding ways to improve collaboration and communication across complex partnerships: investing in longer-term discussions so that organisations, services and communities can understand and monitor progress; and spot new opportunities, synergies and ‘co-incidental outcomes’. • Culture change across partnerships needed to implement ‘prevention’: unpacking what prevention means in detail across a partnership to develop shared outcomes and monitoring; learning with and from communities and the third / community sectors; and recognising the role of human resources. • Building a learning approach: related to changing culture and learning from the evidence; allowing space for learning; recognising that in seeking new approaches some will ‘fail’ – at least initially – but will support development of preventative approaches. The box below this contains a picture of two silhouettes with the tops of their heads open and cogs and wheels coming between them. It is titled “Deepening shared understandings of ‘prevention’ and preventing inequalities. This box contains the following points: • Recognising evidence has a crucial role to play: the prevention evidence-base can help with crucial decisions about where to invest and disinvest, but that this is a challenging area without easy answers; recognising too that community intelligence is invaluable, e.g. priorities and monitoring. • The challenge of getting preventative spend to ‘work’: recognising the range of tensions faced here; overcoming budget silos and the lack of pooling of resources; shifting away from unhelpful competition for resources; recognising that savings may not be in the short-term. • Being realistic about the constraints and speed of change: preventing inequalities suggests a longer-term, complex process of change – with potential for some shorter-term gains; realism is required and there are constraints on what local actions can achieve given wider economic and policy contexts. • Common understanding of and commitment to ‘prevention’ across all partners: working together toward strategies that provide shared understandings; what are the priorities, who does what and is responsible for ‘taking it forward’; how to unlock the necessary resources; and how can Local Outcomes Improvement Plans (LOIP) help? The final box below this contains an image of a lightbulb. It is titled “Seeking committed and creative approaches to preventing inequalities”. It contains the following points: • The politics of sustaining a focus on the prevention of inequalities: alongside national policy and politics, there’s the politics of organisations and partnerships; elected members, their local accountability and political party commitments; and communities and their networks – political bravery and political capital is required. • Community capacity building and community sector development: developing local community assets and drawing on ‘community intelligence’; supporting the development of local community organisations and groups; participatory budgeting can help, and the Rural Partnerships and Aberdeenshire Voluntary Action. • The need for flexibility, imagination and ‘entrepreneurial’ approaches: related to learning, but emphasising the need to support more flexible, risk-taking organisations – particularly those from the third and community sectors including social enterprise.

Three emerging areas of challenge

  • The CPP’s focus: on upstream, ‘whole population’ public health strategies and its Local Outcome Improvement Plan (LOIP) provides the opportunities for building preventative partnership working.

Three emerging areas of challenge arising from discussions at the Learning Day then provided the focus for further inquiry on the development of this form of partnership working:

  1. How to support effective, multi-layered partnership working?
  2. How to deepen understanding of the realities of ‘prevention’ and preventing inequalities?
  3. How to generate committed, creative approaches?

 

4. Learning from policy and practice case studies about preventative partnership working

Two case studies provide material for discussing the development of such partnerships.

Case Study 1: A Changing Relationship with Alcohol

This case study describes early development work on a LOIP priority: changing Aberdeenshire’s relationship with alcohol. This was led by Aberdeenshire Alcohol and Drugs Partnership working with its CPP partners.

These graphics illustrate  the wide range of issues, concerns and ideas that were generated for supporting the development of multi-layered preventative partnership working. (Click on the images to see larger versions).

Case Study 2: Community Capacity-building for Health and Wellbeing

This describes on-going development work on a strategic approach to community capacity-building for health and wellbeing led by Aberdeenshire HSCP and working with its CPP partners.

These images show the initial mapping of community approaches and community capacity-building. (Click on the images to see larger versions).

Emerging learning

The What Works Scotland commentary highlights the emerging learning from this early work:

Safe spaces for dialogue and deliberation are crucial

Both case studies illustrate how facilitated collaborative learning and action processes can provide a ‘safe’ context for shared dialogue on preventative partnership that builds understanding across diverse partners. There is potential to extend this into sustained externally-facilitated deliberation that supports an increasingly diverse range of public service and community partners in: considering evidence; exchanging reasons, emotions and values; and making informed, shared actions and plans  (see, for instance Public Dialogue and Deliberation: A Communication Perspective for Public Engagement Practitioners, Oliver Escobar, 2011).

Deepening knowledge of  ‘what works’

Working towards upstream, whole population and system-wide changes most likely to prevent inequalities (see Best preventative investments for Scotland – what the evidence and experts say – PDF, Neil Craig, 2014) is challenging for CPPs, particularly given their local focus on social problems often sustained by wider social and economic forces. Further, given the differing objectives of individual partner organisations there is the need to invest significant time in building relationships and shared understandings to support complex working. Access to suitable expert knowledge to support CPP partners in understanding the complexities of the evidence on prevention, partnerships and preventative spend would be invaluable.

Investing in preventative spend

Exploring opportunities to shift toward preventative spend was visible in smaller ways in the case studies as a focus on the role of community sector organisations that can coordinate local activity. This is a ‘new’ area of policy and practice and the opportunities outlined above (see 3. Developing a clear focus on preventative partnership working) suggest how policy and practice could develop to support preventative spend but these are not specifically illustrated in these case studies. The focus on the community sector within these two examples could, however, be developed further to support community enterprise and ownership that can generate (trading) income to invest in local economic and social development. The local community anchor organisation model offers one such route for this; the community-wealth model, with its mix of larger public bodies and smaller cooperatives, another.

Local democracy building

This is now a sustained national policy focus e.g. the Christie Commission,  the Local Governance Review, the proposed Local Democracy Bill. Both case studies seek to explore the roles of community organisations, not only to generate local activity, but to support local dialogue, learning and build informed local commitment that engages with change. Such capacity could be harnessed to build local understanding and activity seeking to preventing inequalities.

Further reflections

Further reflections from policymakers and practitioners in this report consider:

  • the importance of support for local decision-makers in using evidence
  • the potential of local work (LOIP) on child poverty
  • the need to build significant community infrastructure in low-income communities

Download the publications

Get the case studies from the full report as separate publications:

More details

Authors: Aberdeenshire Community Planning Partnership (CPP) partners and What Works Scotland

Type of publication: Collaborative research report

Publication date: March 2018

Related resources

Mapping the frontiers of collaborative governance

In this blog post James Henderson and Nick Bland from What Works Scotland discuss public service reform and how multi-layered preventative partnerships might address inequalities, drawing on the inquiry work for the report Inquiring into Multi-layered, Preventative Partnership.

Changing alcohol culture: developing our LOIP priority and what we’ve learnt about partnership working

Changing Aberdeenshire’s relationship with alcohol is a Local Outcomes Improvement Plan (LOIP) priority for Aberdeenshire Community Planning Partnership. In this blog post, Wayne Gault, Lead Officer with the Aberdeenshire Alcohol and Drug Partnership, reflects on how the Partnership approached the priority, what they have learnt from the experience, and what it means for practice.

Aberdeenshire photoAberdeenshire case site

Discover more about the collaborative inquiry work in Aberdeenshire, which has focused on two broad themes: community capacity-building for health and wellbeing; and using evidence across local and central community planning.

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