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10 Years of Improving Health in Communities

Can it really be 10 years since Health Exchange started?  It’s been a challenging and exhilarating journey – and one that looks set to continue as the need for health information and innovative solutions to health challenges becomes more pressing with NHS resources stretched further each year.

Starting out

Although the plaque displayed on my office wall says Health Exchange was launched in 2006, in reality the journey started two years earlier.

In 2004, the Director of Public Health, the Chief Librarian and the Vice Chair of the Heart of Birmingham Primary Care Trust met to discuss an idea which they had provisionally named Health Exchange. They knew that they wanted Health Exchange to be a different way of delivering public health, particularly health promotion, by being rooted in the communities that it served. They felt that the word ‘exchange’ was critical, reflecting the role that conversation plays in starting a behaviour change journey.  They also knew that individuals from the communities most in need of behaviour change in relation to healthy lifestyle choices were best placed to help ‘people like us’ to start, manage and sustain those choices.

From there a pathway was planned to set Health Exchange up as an independent third sector organisation. While we sorted out the technical difficulties inevitably associated with externalising a body from a public service, we started building the Health Exchange ‘brand’ and its model of working.

Forging key relationships

We recognised that Health Exchange needed to be a great third sector partner, committed to working with and through existing organisations and strengthening their capacity to support the wellbeing of the communities they served. We also recognised that libraries would have a key role to play in supporting the ‘health exchange process’, because people who go to libraries are already committed to learning and this was a solid foundation on which to build sustainable behaviour change.

Health Exchange was officially launched by Councillor Ray Hassall on 5 July 2006 at our fifth floor base in Birmingham’s Central Library. Our challenge was twofold and immediate: we had to prove that we were a great third sector partner; and we had to rebuild our links into the NHS, and particularly the community health programs.

By working out through initially 20 community organisations and six libraries we started the process of building a robust network of friends and partners across the communities of the heart of Birmingham. By the end of the year over a hundred organisations were working with us regularly to deliver programmes of support into the communities they served.

Working alongside the NHS

The relationship with the NHS should have been straightforward; we had been working as colleagues across the same desks within the Primary Care Trust!  However, as a new organisation we had to undertake a major relationship rebuilding programme in order to ensure that our clients were able to access the best services from Health Exchange, its community partners and the wider NHS family working together. The fact that we have continued to grow, now work extensively across the West Midlands and are also part of two national NHS delivery programmes suggests that we were successful in this aspiration!

Fitting in to a changing landscape

The last 10 years has seen some of the biggest changes in the NHS, social care and wider health economy that our society has ever experienced: the implementation of the CCG programme under Andrew Lansley as the Health Secretary saw GPs taking a much more central role in the planning of the health economy for their area, commissioning the widest range of services from prevention and early intervention through primary care, self-management and the whole of the acute provision; the addition of commissioning support units as technical support services for commissioning processes, coupled with marketing and communications – then their gradual merger and shrinkage; the transfer of public health commissioning from CCGs into local authorities, coinciding with the greatest shrinkage of local authority funding and increasing challenges of an ageing population impacting on housing, health and social care; the growth of GP federations, primary community partnerships and acute–primary partnerships, bringing together new networks of providers who also had key commissioning roles; vanguards, demonstrators and a whole plethora of rapid piloting programmes for wide scale implementation. Health Exchange has not only survived these changes, but has thrived as part of the new landscape.

Growth and diversification

The emphasis that Health Exchange places on evidence and the collection and interrogation of data to improve intelligence in service delivery and aid commissioning has contributed to the continuing success and growth of the business. We have held on to our core principles and the original vision of the founders, delivering our services through ‘people like us’ working in the community, within reach of the clients that they serve. We have enabled individuals to take control of their health and wellbeing by accessing the widest range of appropriate personalised provision to facilitate their journey to sustainable behaviour change.

During its early years Health Exchange had a turnover of around £1 million and 23 staff.  In 2016- 17 it looks as though our turnover will be between £3m and £3.5m and the staff team has grown to almost 90.  We have diversified the services we offer to include a rich provision in mental health support and services to support independence and wellbeing amongst older people. We’ve grown into a significant West Midlands third sector provider with a range of specialist services delivered nationally and internationally.

An exciting future

Whilst I sit here reflecting on our journey, I am taking time out from the busy ‘day job’ of ensuring that the business is delivering for its current clients, creating social value – through job opportunities, reach into communities, targeting of the most vulnerable individuals and business creation – and managing the launch of new programmes and pilots, like Living Well Taking Control which is now part of the national NHS Diabetes Prevention Programme. These are exciting times – we, as a society, need to set our goals and aspirations for health and social care and work out how to make services sustainable.  We need to understand how to educate and support people in making healthier lifestyle choices so that we can focus clinical resources on the diseases and conditions which are not lifestyle-related and prevent those which are lifestyle-related from occurring. I, for one, am looking forward to seeing what the next 10 years brings!




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