DIY Health, Bromley by Bow - Transformation Partners in Health and Care

National: London Borough of Tower Hamlets, United Kingdom

Geography type: Urban

Population covered: Estimated local population 0-18 years in Tower Hamlets: 71,600 (2017). In 2001 the population of Bromley by Bow was 11,581 of which 30% were under the age of 16.

Professional group/type of organisation involved e.g. acute, CAMHS, voluntary sector, primary care

This service was provided within primary and community care with group sessions being facilitated by a health visitor (HV) and adult learning specialist. DIY Health aims to work horizontally across a range of stakeholders including local people, primary care, HV Services, Children’s Centres and community and voluntary sector organisations.

Details of initiative

Parents of children under the age of 5 were frequently re-attending St Andrew’s Health Centre (one of three surgeries run by Bromley by Bow Health Partnership) for support with managing self-limiting childhood problems. Group learning sessions were developed aimed at empowering the parents with knowledge, confidence and skills to manage minor ailments at home. Support from local Children’s Centres ensured that parents were able to attend the sessions in the absence of childcare arrangements for children under 5.

The initial phase of the project involved asking local parents of children under the age of 5 about managing children’s health at home. Six core topics identified locally included: cold and flu, diarrhoea and vomiting, fever, feeding, eczema, and ear pain.

DIY Health employs a co-produced methodology in which parents and families are involved in the design, delivery and evaluation of the service. The core content of each of the sessions is based on parent experiences and stories. This model was originally funded as a six-month pilot as part of the Tower Hamlets CCG Innovation Bursary Fund. The purpose of a multi-disciplinary team approach was partly to facilitate DIY Health being shared across a wide range of external organisations to generate interest around different ways of delivering health education. One of these organisations was with the Children and Young People Programme Board at UCL Partners (UCLP). The innovative method of delivery led to a collaboration between the participating organisations to upscale and evaluate the original DIY Health model pilot, with a rigorous academic steer from UCLP underpinned by funding from the North East London Foundation Trust.

Type of integration (vertical, horizontal, population)

Horizontal

Outcomes achieved

The second phase of the pilot project was evaluated in partnership with the Anna Freud Centre and colleagues from the University of Sheffield. Qualitative analysis showed an increase in knowledge, confidence and skills to manage a wide range of health issues for all parents involved, and high levels of co-production throughout the programmes.

Challenges, successes, lessons learned and advice

Work with stakeholders, including local people, from the beginning to define, articulate and design a program that addresses a need
Be flexible and open to problem solving in the sessions
Ensure that all those involved share the same project ethos and values
Measure what matters – do not place all the emphasis on reducing service use. Increases in resilience, confidence and skills are just as important
If you want to measure health service use, do so across the health service (ED, primary care, HV) to get a true picture of what is happening for parents. Economic evaluation should include measures such as quality adjusted life years and social return on investment measures.
Co-production takes time – for local people to develop as facilitators themselves or be involved in community organising. Be prepared for this to happen outside the lifetime of structured sessions. More longer-term funding will support this and should be considered when applications for funding are made.