Dr Jennifer McLean is Public Health Programme Manager at the Glasgow Centre for Population Health.
Asset-based approaches are, first and foremost, about people, and over the last 10 years Scotland has come a long way in sharing, illustrating and embedding the values of this way of working within our public services and creating community-based, holistic and person-centred approaches for improving health and wellbeing. Although much progress has been made, they remain far from the way we do things within our services. At their heart asset-based approaches are about valuing the skills, strengths and successes of individuals and communities, recognising the importance of achieving a balance between service delivery and community building, as well as meeting people’s needs and nurturing their strengths and resources (McLean, Mitchell & McNeice, 2017). They are context specific and are about people and relationships in a place and time.
Evidence supports a growing consensus that asset-based approaches are a vital part of a progressive step towards improving outcomes for people and communities (Foot, 2012; Burns, 2013; Rippon & Hopkins, 2015) but undertaking this work is complex, time- and resource-intensive and often countercultural to how many public service organisations currently operate. However, they are now firmly located in Scotland’s policy and legislative ambitions for the future (Scottish Parliament, 2010, 2014, 2015), where the moral, ethical and legal case for working in this way is clear, a way which recognises the contribution that inclusive, safe, empowered and resilient communities can make to improved wellbeing (Scottish Government, 2018).
In practice, the values and principles of asset-based approaches respect and elevate the insights and experiences of people – those who have the sharpest focus on what matters most in their lives and in their communities. By fully understanding a person and the context of their lives, it is possible to see how they can benefit from the assets and resources of their local community. People have the knowledge and insights to know what will help them and their communities. They understand what they can do to improve their life choices and circumstances, but also what is beyond their reach and where they require help and support. For local councils and the NHS, these solutions are not always clear, or even a priority. To bring a focus on these community-led solutions requires large organisations to operate in a different way: to involve people more, to take risks, to transfer power and to enable and facilitate rather than provide, and to place a focus on unlocking the potential of people, places and organisations to work more effectively together. They must genuinely engage with people and communities, listen and act accordingly (SCDC, 2016).
However, it must also be recognised that health services and local councils have multiple priorities and demands upon their limited resources. They are procurers and providers of services and major employers. As organisations they hold significant power, a fundamental cause of inequalities which has an important impact on peoples’ circumstances and on their health. These organisations can operate in ways that use this power to make decisions on behalf of people and communities, using their ‘power over’ them, or they can recognise that their power is often an obstacle and take steps to reach out, using their roles, capacity and resource and share their ‘power with’ people and communities to build on assets and strengths. They require a real shift in power between public sector bodies, professional staff and individuals and communities. But enabling this shift and working in an asset-based way, does not ‘just happen’, ‘nor are they a DIY approach to improving health and wellbeing’ (Garven, McLean & Pattoni, 2016). To create safe, supportive places that enable individuals and communities to take more control over their health and life and what is important to them, requires long-term investment, of both time and money, and structural and legislative change to how public services work. “An asset-based solution isn’t necessarily quick or cheap. People don’t fulfil their potential just because others proclaim them to have – or be – assets”. (Duncan cited in Tamber, 2019)
But what progress are we making in this area and what does practice look like? Working in an asset-based way is not easily definable and may take many forms, as demonstrated from our research at the Glasgow Centre for Population Health. Across a range of settings (McLean & McNeice, 2012; McLean, Mitchell & McNeice, 2017), we have found asset-based approaches to be largely practice-based, experiential and sometimes instinctive, a relationship-based way of working which appreciates the connections, contributions and participation of people.
Our early research explored the lived realities of asset-based working in community-based projects and offered a valuable insight into the practical experiences of those working most closely with communities (McLean & McNeice, 2012). Against a backdrop of a wide range of engagement mechanisms, a number of projects went beyond delivery of a defined project remit to engage with and respond to the identified priorities and concerns of the local community. These projects were seen to inspire and empower local people to take ownership of the issues they experienced and supported them to develop action in response. This participation and involvement helped to increase individual confidence, develop skills, and build community connections to enable a stronger role, voice and influence in local decision-making. Further research in this field focused on highlighting the practice of public services aspiring to address complex social issues in a more holistic manner than has traditionally been taken (McLean, Mitchell & McNeice, 2017). This research gained an insight into several services which were open and responsive to the needs and concerns of local communities, alongside the delivery of a central function. In these cases, the service often in partnership with others including the community and voluntary sector, played a wider role in local capacity building, focused on mobilising the expertise of the community and the development of more stable cohesive communities through a range of opportunities and events.
These examples of projects, services and communities have over time been able to create the conditions where they could place a focus on co-creating appropriate community-led responses to addressing local priorities with local people, priorities which were often not in the sight of large public organisations. It is evident that mobilised and empowered communities recognise what it takes to work in an asset-based way, but they may not use the same terminology to describe it. Language can create a divide, but if we really listen, work with people where they are and identify common ground, much can be achieved, individually and collectively.
In Scotland considerable progress has been made, reflective of the supportive and receptive policy landscape, to support community-led action, opportunities for participation, citizen involvement in decision-making and a significant move towards more community-based services. A number of examples of large-scale community-led initiatives and programmes are now evident. Supported by funding from national and local government, community groups and organisations from across Scotland have taken and continue to take action on issues that are important to them and which is leading to positive change in and for that community. Our community-led action research programme Animating Assets (GCPH & SCDC, 2015) supported real-time learning from real-time situations in the context of local issues, identified by local people and practitioners. This programme reinforced the significance of building trust, relationships and engagement across agencies for collective action and sustainable positive change.
Significant further national developments have also been made in Scotland to enable local people to have a direct say in how public funds are used to address local needs. The Scottish Government and all local authorities have made a commitment to work together to ensure that at least 1 per cent of council budgets are subject to Participatory Budgeting by 2021. PB, Community Choices or Community Budgeting, as it is also known, is recognised internationally as a method which, when used alongside other models of community engagement and empowerment, forms a wider strategic approach to advancing and strengthening representative and participatory democracy in local decision-making (Harkins & Egan, 2012). PB offers a practical mechanism to mobilise community assets and to promote community empowerment, shifting power from the state to individuals and communities (GCPH, 2012). Moreover, the emerging establishment of citizen juries which value the knowledge and personal experience of people to support decision-making about the issues that affect their lives and communities, is regarded as a further mechanism to strengthen citizen engagement and participatory democracy.
Good progress has been made, but many challenges remain to mainstream asset-based approaches rather than them being regarded as the “the community bit around the edges” (Gamsu, 2015). Public service reform in Scotland offers an exciting opportunity to re-frame the relationship between the state and the citizen, and the service provider and people supported by services. However, we must also reframe our existing perspectives to recognise that our ‘big systems’ (our NHS, or local authorities) are not inanimate organisations and that people are the essence of all such systems. We must always remember that the ‘people’ and ‘communities’ we talk and write about are also us.
To adopt an asset-based approach is to build on strengths and hope. In Scotland there is much to be hopeful about – national conversations are taking place on how to achieve a fairer, healthier and a more socially just Scotland. Further opportunities and mechanisms to support democratic participation are also gaining commitment and momentum, and more legislation supporting further individual and community empowerment is in the pipeline.
Asset-based working means working differently – in true co-production with people and communities. Real change however, must be accompanied by investment and commitment to moving resources to people who use services, to communities and to frontline staff. A focus on continuing to strengthen the research base, as well as the status of the evidence is also vital.
The Covid-19 pandemic is an exceptional event that continues to have a major impact on families and communities across the UK. As we are seeing, the existing inequalities within society also continue to be exacerbated. Those who had least to start with, those already experiencing poverty and disadvantage, are being the hardest hit. Those with greater resources are in a better place to endure the ongoing challenges the crisis presents.
In communities across Scotland and the UK, many organisations were already responding to community need, providing support to try and redress the balance that inequalities bring. As the coronavirus situation developed, these community organisations quickly adapted and changed how they delivered their services and support to their communities, especially their most vulnerable citizens. We have seen communities respond to the crisis in their own unique ways by recognising what is needed locally and organising around the knowledge and skills they have to meet those needs and concerns. The Scottish Government also immediately stepped up with a £350 million fund for communities, demonstrating their recognition and commitment to communities at this time in knowing what works best locally to support welfare and wellbeing.
The role and significance of community-focused activity and asset-based approaches has never been more important or relevant, especially as we start to move into the recovery phase and try to ‘build back better’. The lockdown situation and the ongoing restrictions have created many challenges for individuals and families. However, by drawing on friendships and networks for support in creative and innovative ways, identifying what is working well, accessing a range of different resources and by sharing kindness and compassion and feeling a richer sense of community spirit, they have all helped us to manage these unusual circumstances.
Never before has the power of people and communities been clearer. Learning from the stories of community action and where the state has given communities more opportunity to shape the response, I hope can encourage, inspire and lead to longer-lasting change and a new relationship between public and community and voluntary sector organisations. It is clear that community responses will play a vital role in rebuilding and responding to the new challenges that lie ahead.
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NHS Health Scotland: Fundamental causes