The future of ‘healthy places’ — Developing futures strategies

Is it possible for a group of colleagues to get together, develop a vision of what we want our future to look like AND then actually develop strategies to work towards it?

That’s what we had a stab at in November 2016.

The plan was to lock a couple dozen colleagues in a room for the day at the Bournemouth Town Hall with Mike Jackson from Shaping Tomorrow leading the sessions. And that’s just what we did.

Participants were drawn from several organisations both within our health and care system and from outside, table below. I’ve also listed all of the ‘roles’ that colleagues held at that time (roles are not linked to organisations in the table below) to provide an indication of the range of perspectives we had available to us on the day.

Roles of Participants Dorset Health and Care System

1.     Head of Environment

2.     Coast & Countryside Service Manager

3.     Head of Parks Development

4.     Sector Growth Manager – Creative & Digital

5.     Executive Director, Environment and Economy

6.     Policy Development Manager, Economic Development and

7.     Strategic Director Sustainability

8.     Head of Transportation Services

9.     Community Planning and Development Manager

10.   Dorset AONB Manager

11.   Director of Public Health

12.   Public Health Consultant

13.   Public Health Consultant (Health Protection)

14.   Public Health Consultant (Intelligence)

15.   Head of Programme (Health Protection)

16.   Head of Programme (Research and Intelligence)

17.   Deputy Director of Public Health

1.       North Dorset District Council, West Dorset District           Council, Weymouth & Portland Borough Council

2.       Dorset County Council

3.       Bournemouth Borough Council

4.       Borough of Poole

5.       Public Health Dorset

6.       Dorset AONB

 

 

 

 

External Organisations

18.   Head of Health Intelligence

19.   Head of Extreme Events and Health Protection

20.   Principal Environmental Public Health Scientist

21.   Senior Fellow, Knowledge Exchange

22.   Senior Research Fellow

23.   Professor of Public Health & Wellbeing

7.     Public Health England

8.     Public Health Services, Jersey

9.     The University of Winchester

10.   Bournemouth University

11.   University of Exeter Medical School

 

Group learning

We first had an overview presentation by Mike Jackson and he provided us with the ‘raw future insights’ produced for this meeting by the Shaping Tomorrow horizon scanning software and talked us through the approach to considering these.

We had about 500 futures insights (Healthy Places Futures Workshop) to work with. The objective was not critical assessment of these insights, because we would have no way of knowing whether these were going to impact Dorset greatly or whether they would even happen. The point was to play a low-tech version of the ‘big data’ game – lots of little insights from many perspectives to which a general direction of travel could be gleaned.

A few examples:

Each group (we broke up into five groups) was tasked with considering futures insights in five of the following 24 topic areas:

  1. Transportation
  2. Education
  3. Technology
  4. Travel
  5. Urban
  6. Work
  7. Environment
  8. Food
  9. Health
  10. Homes
  11. Aging
  12. Alcohol and smoking
  13. Collaboration
  14. Cycling
  15. Public space
  16. Retail
  17. Streets
  18. Traffic
  19. Isolation
  20. Obesity
  21. Pollution
  22. Poverty
  23. Crime
  24. Public safety

What we came up with

We worked in groups to both articulate what we wanted for the future and discuss, in the context of our 500 or so futures insights, how we might get there.

We all want to live in a place with as little pollution as possible, where it is easy to eat healthily, stay fit, socialise, contribute to society and generally enjoy life. We didn’t spend a lot of our time hammering out what this means in practice, because this is rather subjective – rather we focussed on the perceived challenges to achieving this.

Each group worked up some strategies, things that they and their organisations could do to meet the challenges identified by the futures insights. These were then fixed to the walls and each participant was given 10 ‘sticky dots’ that they could use, in any way they wanted, as votes against the various strategies.

I’ve ranked our topic based strategies from the day, below, and you can see how many votes were cast for each of these by the participants. What you can also see in the far-right column is a ‘look back’ exercise conducted by a couple of us recently to see whether Public Health Dorset are working towards any of the identified strategies. I was a little surprised (and raise your hand if you’ve done one of these exercises and then left it in the room afterwards, never to revisit it?) that we were working on most of the identified issues in some shape of form.

I do not claim that we used this workshop output to model our work programme, but it did serve as a talking point for quite some time. Regardless, we are using the learning from this workshop.

I’m not going to go through these proposed strategies in detail, except to say that I didn’t predict the top ranked strategy, before doing the exercise. Shame on me? Clearly, I have pragmatic clear-thinking colleagues all around me. Thank goodness for that!

We need to do a lot of things to ensure a future of healthy places – and the most important strategy is to align population health priorities with political priorities. What I take this to mean is that we, in public health and local government, need to listen more to the concerns of our population if we are to have a hope of engaging them in the co-development of public health strategies. These strategies really do need to be developed together – no one group can bring about a desired “healthy places” future for everyone.

It’s no longer sufficient to only have a great evidence-base and deep public health knowledge, to work together in a meaningful way, we need to understand system issues that might not immediately appear to be public health issues.

And when we understand what those system issues are and how they related to our population, we need to be prepared to spend some time telling that story. Having the ‘answer’ isn’t enough anymore (if it ever way). Go figure.

Rank Focus Proposed Strategy Votes

Public Health Dorset

(as at Jan 2018)

1 Political priorities Find a way to align population health priorities with political priorities 24
  • System working approach
  • Narrative capacity building with BU Media Faculty
2 Natural Environments Maximise opportunities from natural environments in local spaces through evaluating health impacts 16
  • Healthy places programme
  • System working approach
  • Public health programme evaluation effort
3

Active Travel

 

Increase focus on active travel opportunities as a key element of all travel planning 13
  • System working approach
  • Quantifying accessibility to greenspace project
4 Volunteer resource Older population is a rich source of skill and experience that could become a major volunteer resource 12
  • System working approach
  • Prevention at scale – aging well programme
  • Locality working programme
  • Health Champions Project
4 Sustainable building strategy Develop a sustainable building strategy (Healthy green developments in partnership) 12
  • Healthy places programme
  • Spatial planning development project
  • System working approach
6 Volunteering resource Develop a program of community health champions 10
  • System working approach
  • Health Champions Project
7 Transport Policy Develop smarter ways of working between professionals and the public 10
  • System working approach

 

7

Cycle Infrastructure

 

Concerted backing for infrastructure development for cycling – we need to make the economic case for health and wellbeing 10
  • Cost-benefit modelling
  • System working approach
9 Spatial planning: Engagement We need to develop a more ‘powerful voice’ for the public’s health on strategic spatial planning committees 9
  • System working approach
  • Narrative capacity building with BU Media Faculty
9 Spatial planning: Framework Develop a new strategic framework for enhancing the urban environments of public spaces 9
  • Spatial planning development project
9

Poverty

 

Invest time and effort on strategic effort towards building community cohesion/culture 9
  • Prevention at scale locality working programme
  • System working approach
  • Narrative capacity building with BU Media Faculty

Where to next?

Get in touch if you’d like more information about how we ran these sessions or what exactly Public Health are doing (right column, above).

We intend to repeat this exercise in November 2018 with an even larger group of colleagues (hopefully we’ll get wider range of colleagues to participate as well) from across the Dorset health and care system with a view to repeating and updating this exercise. We also hope to identify what our partner organisations might have been working on over the last two years that addresses some of the identified challenges. I am looking forward to finding out about that.

This futures blog

This blog is about ‘healthy places’ and what our possible ‘futures’ could be given current trends and momentum within society, the economic and political systems, and the environment. I use the plural ‘futures’ intentionally, because our future is not pre-determined (I hope), we can and should work towards the future we want. This blog aims to generate discussion (maybe even some debate) around ‘Healthy places futures’ in the hope that if we all put our minds to it, a collective vision may emerge, which would inform any strategy we might put in place to get us to our preferred future. We’ll be leaning on heavily on futuring tools found on our Shaping Tomorrow hosted website:  phd.shapingtomorrow.com.

The future is already here — it’s just not very evenly distributed (William Gibson 1993).

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