Dragon’s Den: Raising Social Capital As A Means to Tackle Inequalities

Getting Started – Vote 1

How much do you know about social capital in a health context? (select one only)

Press ‘1’ – Nothing

Press ‘2’ – A little

Press ‘3’ – A reasonable understanding

Press ‘4’ – A good understanding

Getting Started – Result 1

Male life expectancy: Scotland & other Western European Countries, 1851-2005Source: Human Mortality Database

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Male life expectancy: Scotland & other Western European Countries, 1851-2005Source: Human Mortality Database

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Scotland in Europe

Life expectancy trend by deprivation

Estimates of male life expectancy, least and most deprived Carstairs quintiles, 1981/85 - 1998/2002 (areas fixed to their deprivation quintile in 1981)

Greater Glasgow Source: calculated from GROS death registrations and Census data (1981, 1991, 2001)

72.2

76.2

65.364.8 64.4

69.4

71.2

73.373.9

60

65

70

75

80

85

1981-1985 1988-1992 1998-2002

Es

tim

ate

d li

fe e

xp

ec

tan

cy

at

bir

th

Males -Dep Quin 1 (least deprived)

Males - Dep Quin 5 (most deprived)

Scotland Males

The contrasting experience of Scotland’s communities-70 -60 -50 -40 -30 -20 -10 0 10 20 30 40 50 60 70

-70 -60 -50 -40 -30 -20 -10 0 10 20 30 40 50 60 70

How should we respond?

Individuals and communities have deficiencies & needs

Individuals and communities have skills & resources

Features of asset-based working• Identifies and supports protective factors, such as

• Individual level: resilience, self-esteem, sense of purpose, commitment to learning

• Community level: supportive networks, intergenerational solidarity, community cohesion

• Approaches involve• Doing with rather than doing to (shifts in power, engagement and

control; different decision-making processes)• Seeing people and communities with needs as part of the solution

not the problem• Placing a premium on skills for resilience, relationships, and

sustainable improvements• Building mutually supportive networks

A bit about social capital

• Bonding capital – links with similar people, similar outlooks and values, strong ties, good for “Getting by”

• Bridging capital – links with people with different outlooks and values, weak ties, good for “Getting on”

• Linking capital – links with people and structures that make decisions that affect your life and community. Good when distance between is short. Best when community are involved in decision making.

Different areas of focus offer different opportunities

• Bonding capital – good for day-to-day psychological support, “bouncing back” from crisis

• Bridging capital – good for knowing about and taking advantage of new opportunities (e.g. jobs), and for adapting to changing circumstances

• Linking capital – good for creating an empowering environment; co-production and interests being heard and acted upon.

The policy context

• Integral to a shift towards prevention and health creation

• Supports the continued move to partnership and integration

• Reflected in the Scottish Approach to public service reform

• Fundamental to the success of reshaping services, personalisation, and investment in community-based service delivery

• …yet there are many inherent challenges

Contemporary challenges

• Increasingly atomised and individualised lifestyles• Personal networks and associations becoming less

grounded in geographic place• Separation of networks between affluent and deprived

individuals/ communities creates barriers to opportunity and social solidarity

• Workforce practices and expectations

Dragon’s Den - ContextCommunity ‘X’:• Discrete estate on the periphery of Big Town• Population of 5,000• In top 5% of the Scottish Index of Multiple Deprivation since the

Index began in 2004• Recently undergone a process of physical regeneration resulting

in marked improvements in housing stock quality• Life expectancy is low• Rates of hospital admissions, drug and alcohol problems and

Disability Living Allowance (DLA) claimants are high• Usual activity supported but no significant impact seen

Dragon’s Den – Your brief as a ‘Dragon’

You’re a Senior Public Sector Manager:

• One of your key objectives for the next two years is to identify an approach that has the potential of improving outcomes for people living in ‘X’ in long-term

• Approach must be capable of delivering sustainable change• Approach must also help to reduce NHS spend associated with the

community in longer-term• Total budget for the two years is £200k• Five parties are pitching for some or all of this budget, but you are only

going to hear one today whose aim is to raise social capital• Reflecting on what Carol has said, listen to the pitch and decide if you are

going to invest

“You what?”

Raising Social Capital – Aims

• Aim 1 - By doing things together and helping each other, individuals build new trusting relationships; helping to enhance their view of themselves and the community they live in.

• Aim 2 - Individuals and communities are more resilient and have greater capacity to address the challenges they face.

Raising Social Capital – Approach

• Individual and community engagement and asset-mapping

• Getting activities started

• Nurturing individuals and groups

• Reflection

Raising Social Capital– What’s Different?

• A focus on local people’s assets & building their capacity

• Community-led, not about external agendas

• Worker autonomy to adapt project to local context

• Flexible funding to turn ideas into action quickly

• Workers value and respect participants

Raising Social Capital

Any questions before we vote?

Dragon’s Den – Vote 2

Are you persuaded enough by the proposed approach to Raising Social Capital to invest in it?

Press ‘1’ for ‘Yes’

Press ‘2’ for ‘No’

Dragon’s Den – Result 2

Dragon’s Den Revisited – Your brief

You’re a Senior Manager in the Public Sector:

• Same brief as before, but the project you have just heard about (‘Raising Social Capital’) is a real programme called Link Up and has been operating in ten communities for the past 2 years

• You’re going to be given an overview of the impact of the Link Up programme in those communities

• Based on what you hear, you will be asked again to decide if you are going to invest

Link Up Impact – Social Connections

Link Up Impact – Transformational Outcomes

7,376 social connections between people that might otherwise not have met

487 volunteering and helping others in their community

79 previously isolated but now engaging

102 attained skills/competency based/qualification/award

82 expressing desire to work

26 employed

72 attained food hygiene qualification

27 reduced alcohol consumption

66 re-engaged with formal decision-making structures

Incr

easi

ng s

elf-e

ffica

cy (

and r

esi

lien

ce?)

21 reduced tobacco consumption

13 reduced drugs consumption

15 reduced some form of daily medication

Link Up Impact – Tales from Muirhouse

Bingo

TRIM

Community Shop

Old Butcher’s Shop

Open Cafe

A’s story

Sep 2012

Sep 2013

B’s story

Dragon’s Den – Vote 3

Based on what you now know about the impact of the existing Link Up programme – would you invest in the Raising Social Capital project for community X?

Press ‘1’ for ‘Yes’

Press ‘2’ for ‘No’

Dragon’s Den – Result 3

Potential barriers to Raising Social Capital

• Insufficient evidence-base

• Strategy & policy (including associated targets) not aligned

• Standards and practices inhibit raising social capital

• Organisational culture does not value social capital

• Workforce development does not support raising of social capital

Barriers – What do you think? (Vote 4)

Based on your experience, what do you think is the most significant barrier to raising social capital? (only select one)

Press ‘1’ - Insufficient evidence-base

Press ‘2’ - Strategy & policy not aligned

Press ‘3’ – Standards and practices inhibit raising social capital

Press ‘4’ – Organisational culture does not value social capital

Press ‘5’ – Workforce development does not support raising of social capital

Barriers – Result 4

Reducing inequalities and creating health – The importance of social capital

In conclusion

Evaluation – Vote 5

Do you understand better now the potential of increased social capital to improve outcomes for individuals and communities?

Press ‘1’ for ‘Yes’

Press ‘2’ for ‘No’