Bromley by Bow Centre and Social Prescribing

The essentials of our model

Canary Wharf

Olympic Stadium

Bromley by Bow

Where are we?

This is Charles Booth

He was a social researcher

In 1889 he created a poverty map of east London

One of the hotspots of deprivation was Bromley by Bow

It still is

Charles Booth’s poverty map 1898

Lowest class

Very poor

Poor

Mixed

Fairly comfortable

Middle class. Well-to-do

Upper-middle and Upper classes. Wealthy

Index of Multiple Deprivation 2010

Dimensions of deprivation:

Income deprivation, employment deprivation, health deprivation and disability, education, skills and training deprivation, barriers to housing and services, living environment deprivation,crime.

Today 28% of Londoners live in poverty, with 40% of children living in poverty.

Tower Hamlets is the 7th most deprived local authority area out of 326 local authority districts in England.

16 out of 17 of its wards are amongst the 20% most deprived in the country with 12 wards in the 10% most deprived wards.

almost 50% of children in tower hamlets live in poverty.

The Marmot Review 2010Professor Michael Marmot

Social determinants of health

Marmot Review Priorities

•Every child needs the best start in life •People to need to be able to maximise their capabilities

•People need to feel in control over their lives

•Having a good and fair job is vital

•Everyone needs a healthy standard of living

•People need to live in homes and communities that promote health and are sustainable and stable

•There needs to be effective, accessible and sufficient clinical provision in communities

Tower Hamlets Reality

•At age 5 only 50% of children have a good level of cognitive development

•Attainment at Key Stage 5 it is 4th lowest in London

•Unemployment: 33% above London average. High proportion of residents work in low paying sectors

•20% of households have income <£15,000.

•50% of Tower Hamlets children are in poverty

•Second highest population density in London. 35% of the borough’s households are overcrowded

•10% of the population eat 5 portions of fruit or vegetables a day; 30% exercise to the recommended level ; 42 fast food outlets per secondary school

the wider determinants of health, including behaviour, have a greater influence on health outcomes than genetics and healthcare combined

the effects of the determinants of health are cumulative over the life course, and interventions need to respond to this

70% of our community are amongst the 20% most deprived in England

Behaviour: the 4 healthy lifestyle factors in Tower HamletsClustering within individuals, aggregation within communities

For those living in social housing

In Tower Hamlets 40% of residents live in social housing, in Bromley by Bow, almost 60%.

• Chance of being a current smoker is 1½ times higher

• Chance of having a BMI of 30+ is 1.4 times higher

• Chance of being physically active 3 times a week is 20% lower

• Chance of drinking 2+ units a day is 40% higher

Exercise 30% of adults

exercise 5 times a week

Healthy eating

10% of adults eat 5 portions of

vegetables and fruit a day

Smoking 27% of adults smoke, higher

than the London average

Alcohol 50% of adults drink

alcohol, 43% of them excessively

The effects of the social determinants of health…..on healthMap shows high risk of diabetes, 15-17% (darker shaded areas)

2nd highest rates of premature death in the UK from circulatory disease, cancer and respiratory disease (conditions which constitute 75% of all premature deaths)

10% of adults diagnosed with depression (4th highest in London), 7th highest level of mental health hospital admissions in London

13% of children in reception year are obese (6th highest UK), 25% of 10-11 year olds are obese (9th highest UK)

1 year survival rate for cancer amongst the lowest 10% in the UK

where have we landed?

Socio-economic status is a major determinant of life expectancy and disability-free life expectancy

70% of the Tower Hamlets population are located in the most deprived quintile of this diagram

Borough A

Tower Hamlets

Welcome to the Bromley by Bow Centre

so what’s at the Centre?

Bromley by Bow Centreindependent charity c£4m turnover, c150 staff, operating on 23 sites around 2,000 clients per weeklearning centre – daycare centre – social welfare provider creative arts centre - integrated health programmes – employment programmes – debt advice Plus ‘Beyond Business’ - incubated 57 social businesses in 10 years, 42 still trading. Turnover in excess of £4 million and created over 320 jobs

GP Partnership – Primary Care4 sites with 37,000 patients and turnover c£6m – including a 7 day per week 8am – 8pm Walk-in Centre. 110 staff.

Plus Bow Childcare and Poplar Harca and FoodCycle and Bromley by Bow Church on site

Health CentreGeneral Practice, Community Health ServicesSocial Prescribing Supports access to all Centre services

Social EnterpriseSupports establishment of new social enterprises, creates service provision and employment.

Employment ServiceCareers advice. Extensive employer relationships, work experience placements, and support in applying for jobs.

Health and social careHealthy lifestyles promotion, weight management, mental health projects, social care brokerage, carers support, disability sports. Social Prescribing Receives referrals and supports those referred

Connection ZoneA warm welcome with engagement staff, tea and coffee. A place to meet, make friends and build social networks. Group activities, internet café with digital inclusion support, homework club, informal learning and family learning. Time Banking, Community Grants for small projects. Welfare, Debt, Legal

Advice, Financial Capability Social welfare and legal advice on benefits, housing, debt. Money management and fuel poverty programmes. Promotion of Credit Union.

Social Care and arts spaceSocial care, inclusive arts space and programmes, including for elders and carers. Artists’ studios.

Vocational LearningA range of learning options for young people and adults, including traineeships and apprenticeships

Café Provides training and volunteering opportunities

Growing spaces Social and therapeutic horticulture, food growing

Park and playgroundManaged by the Centre. Recreational space, children’s playground, sporting events, summer fairs

Church / Nursery Childcare provision, community celebration space

Children’s Centre activities Activities for parents and children

elders’ programme

Integrated service model and social prescribing

General Practice

Carers support

Children’s Centres

Schools

Faith organisations

Resident groups

Health Trainer

s

Mental Health Project

sCare

brokerage

Social Care

Domiciliary Care

Literacy numeracy

Digital Inclusio

n English courses

Family Learning

Activity groups

Time Bank

Social Welfare Advice

Legal Advice

Financial Capability

Energy Advice

Apprentice-ships

Traineeships

Youth Training

Employment

Youth Employmen

t

Social Enterprise incubation

Home Store

Socia

l

Pre

scri

bin

g

Refe

rral R

efe

rral

Refe

rral

Safer Neighbour-hood Team

Employers

CorporatePartners

Credit Union

Housing providers

Social Enterprises

Food Bank

Regeneration agencies

Local Authorities

Health and Wellbeing Boards

Commission-ers

Ministries

Public Services

Service Providers

Service provider networksDown to

EarthPartnerships, networks and policy

Services to improve the social determinants of health

Services that directly support health and social care, often Public Health Programmes

Primary care and community health services

Expert Patients & Self Care Weight

Management

Inclusive Sport

Doctor: ‘Listen……’

‘your patient…..’

Empathy, attention, time, responsibility, ownership

Patient: ‘telling…..’

Education, communication, advocacy, confidence

“Listen to your patient, he is telling you the diagnosis”

Social determinants of health also act through the doctor-patient relationship

timebank coffee afternoons

planet asthma

arts and health programme

be focusedour mission is to enable people to be well and live life to the full in a vibrant community

Dan Hopewell

Director of Knowledge and Innovation - Bromley by Bow Centre

Website www.bbbc.org.ukEmail dan.hopewell@bbbc.org.ukTwitter @HopewellDan

@bromley_by_bow