Focusing more on people and less on strategy

Over the years I’ve been working in social inclusion in Birmingham, I’ve seen many strategies announced in the name of innovation. But inequalities persist; people still need help.

strategiesAbove our heads, the governments change, the policies change and the language changes. New reports are produced and new boards are set up to respond. Everything needs a “radical new approach”. But when you look into the details of any of these strategies, the point is the same: inequalities need reducing.

Even the specifics remain: to reduce smoking, reduce obesity, increase physical activity, live a healthy lifestyle and prevent people becoming ill.

Instead of focusing on the constants, however, each new strategy seems to require starting all over again. I find it immensely frustrating.

Take mapping exercises. Every time a new strategy is announced and a new group of people are put together to respond, they seem to start with a mapping exercise. Over and over again the deprived areas of the city are drawn and redrawn. I’ve seen them marked in different colours; as circles, as tube maps. By wards and by constituencies. Named as “spearhead areas”, or “super output areas”. Given “hubs” and “spokes”. But the poorest people haven’t moved! We all know where the work needs to focus, but it seems more important to illustrate that information in a hundred different ways instead of just getting down and tackling it.

Gateway is focused; Gateway is consistent

All of these stop and start strategies – and their mapping exercises – distract from the real point: that poorer people live riskier lives, have higher rates of infant death, early death from heart disease and a poorer quality of life in older age.

When Gateway started, we listened to people. We started from where they were, we involved them. We helped people with the things that put them at higher risk: smoking, diet, lifestyle, poverty, economic activity, chaotic lives. And – despite a million new reforms and reviews – this hasn’t changed.

We have always set out to reduce inequalities in learning, employment and health and we have been doing this consistently now for seven years. In that time we have worked with over 20,000 people in Birmingham and have helped reduce risks that lead to inequalities.

Because of Gateway:

  • People have lost 4000 stone
  • Nearly 200 long-term unemployed people are now in long-term jobs
  • Over 1000 qualifications have been gained
  • People are smoking 1.85 million fewer cigarettes

We haven’t changed – even though strategies have changed – and this means that we can focus on people who need us. Consistency counts. We use our skills and experience to spend our time supporting people. We are lean and efficient; our data is clear and links to outcomes.

New strategies from above always look to the future, but they fail to capture the past. As I’ve said before on this blog, innovation isn’t always needed – it’s development, refinement and evolution that helps good services become great.

But in the political world, one thing stops and another thing starts. And when everything has to start again – and again and again – millions of pounds worth of skills, systems, training, experience and support are lost.

What a waste.

Making things simple

This video from the Kings Fund explains in simple terms how the latest NHS organisations work and fit together. It’s no wonder we’re confused.

And meanwhile… Gateway continues to address the problems directly and consistently.

5 comments

  1. alun severn says:

    Vicki, I can understand your frustration. Mapping, ‘reassessing’ the problem, ‘baselining’ — in a sense they all have the potential to be displacement activities: the things we do instead of actually doing….

    Sven Lindqvist, the Swedish writer and thinker, has said:
    “You already know enough. So do I. It is not knowledge we lack. What is missing is the courage to understand what we know and to draw conclusions.”

    It’s hard to put it better…

    But having said that, it’s even harder — I think anyway — to imagine that this situation is amenable to change.

  2. Anne Cummins says:

    I agree that constantly re-visiting “maps” and “where we are now” can be frustrating and cause delay’s in reach people who need support.
    If we are to build upon what we already know we need to ensure that the “maps” held by allied organizations are understood collectively. Otherwise we will continue to find piecemeal fragmented services, competition between experienced service providers and lose the benefits of working collaboratively for the good of those who most need support.

  3. Rosemarie Simpson says:

    Vicki, I couldn’t agree more. If we were to add together all the money spent on the ‘mapping exercises’, innovative ideas, strategies, policies, etc, etc, it would no doubt be eye watering. Alas, this apparent need to come up with a myriad of reports, strategies, policies to address the issues instead of really looking at and dealing with the problems that prople face, which as you say, have not fundamentally changed seems to be all pervasive.
    Gateway cuts to the chase through focussing on people, finding solutions and capturing and applying the things that work. It’s a pity the Government doesn’t do the same.

  4. Kate Gordon says:

    @ Alun – not to mention an element of job protection as well. Surely one of the worst (best?) examples of what Vicki is talking about is The State of The Third Sector report. On a scale of 1-10 waste of time/money/paper/ink, surely that must rate at least 9?

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