Rethinking Our Health: starting with pain

Our latest update from Jo Crease, Programme Manager at Here, shares our progress on Rethinking Our Health, a community-led approach to improving support for people living with long term conditions.

Picking up from the co-design sessions at the start of summer, Jo explains where we’ve got to since then, what we’ve learned from communities about MSK pain, and what we’re going to test next.

Rethinking Our Health – so, what are we actually going to do?

Over the summer, people have quite reasonably been asking what Rethinking Our Health is actually going to look like in practice. What are we going to do, where, and with who?

I’ve spent much of the last six months saying: “We don’t know yet, because we haven’t asked the community yet – and that’s the whole point!”

Now we’re at a point where we have asked the community, and this is what happened next.

A reminder: what is Rethinking Our Health?

Rethinking Our Health is our shared programme with The King’s Fund to explore new ways of supporting people with long term conditions, starting from what communities say matters most.

How we’ve been working with communities and VCSE partners

Over the past few months, we’ve been in rooms with community members, VCSE organisations and partners, testing ideas together and challenging our own assumptions – rather than deciding solutions from the centre. After these sessions, all the collaborators came together to make sense of what we’d heard, compare insights and pull the learning into one shared picture.

Why we chose to start with pain

We all agreed we wanted to improve support for people with long term conditions – and we chose to start with “pain” as a way to talk with and support people who were struggling to get what they need.

But the priorities weren’t always the same.

Here and The King’s Fund were thinking about the longer-term challenges in how health and care needs to work in future. Our test site partners were focused on the immediate reality of people not being able to get what they need right now.

Once we recognised that difference, the question became: how do we create something that works for both?

We tried to square that circle by starting from the community’s point of view and seeing how that could lead towards more sustainable solutions for the NHS.  

What we learnt from truly listening to communities

As we tested ideas locally, a pattern emerged.

In spite of our best intentions, we were still coming across as “here’s something we’ve designed for you”, rather than “here’s how we want to build with you, starting from where you are right now”.

There was also a clear expectation that anything we offer had to genuinely solve problems people already face and not feel like yet another ask for people with busy lives and services that are already stretched.

We also learnt that creating new roles, like ‘Champions’, wouldn’t be welcome. People are already active in their communities, with their own motivations and networks. They don’t necessarily want another label or obligation – especially one created by public services rather than driven by what actually matters locally.

Community development organisations work because they start with what people already have: their strengths, motivations and contributions. They don’t impose new ones.

This feedback was honest and challenging, but it came from trust. We’ve worked hard to build that trust over the last six months, and because of that, partners were able to give this critique, and we were able to hear it – and act on it. And we know the work is stronger because of it.

Our response: a three-part community offer on early pain

People told us they wanted:

1. Trusted advice, early enough, local and accessible
2. A way to understand more about MSK pain
3. People working in the community being part of a solution together

Working with our test sites, we’ve refined the goal to build neighbourhood-level awareness, capacity and confidence to act on early pain. And we’re doing this through three interlinked elements that are, crucially, built on existing community assets and relationships.

1) Trusted advice, early enough, local and accessible

Community Health Drop-In
A weekly half-day drop-in hosted by a Community Development Worker, with a physio and a social prescriber. This is a space for advice, guidance, support with social factors and community connection.

2) A way to understand more about MSK pain

Community learning and peer support
Four modules covering: pain management, meditation, exercise and movement, and general health and wellbeing. We are using a train-the-trainer model so community workers can deliver these sessions in the longer term.

3) People working in the community being part of a solution together

Workforce learning offer
A CPD-accredited short training offer for people working in the community – primary care, VCSE, social care, libraries, food banks and volunteers – building confidence around early pain and health coaching and encouraging neighbourhood networks around pain.

What happens next

It’s still very much a work in progress – we need better names for the elements of the offer for a start (drop a comment with suggestions!).

We’re going live mid-November and running through to March in the first instance. The next update will share reflections from the first Community Health Drop-In. I’ll also be talking about how we plan to balance getting the data we need without overloading participants, and how we’ll involve community researchers in understanding people’s experiences of this work more deeply.

As always, let us know what you think – what questions do you have?

Drop us a line at collab@hereweare.org.uk

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