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April 23, 2024

Community health and care ecosystems

The plans to establish a National Care Service, despite hitting some significant bumps along the way in the form of widespread opposition from trade unions and local government to the perceived power grab by Scottish Government Ministers, continue to gather pace. And despite all the evidence that consistently highlights 80-90% of good health outcomes arise from factors outside of our formal health and care systems, the proposals make no mention whatsoever of how community based health and care ecosystems will be part of the new Service. LGIU highlights some good examples from England, Wales and USA. 


Sid Hayward, LGIU

Every week, we highlight inspiration and innovation from local government worldwide. In this article, we’re focusing on how local government can help create and strengthen the care ecosystems in their communities. You’ll find best practice from Wales, England, and the USA, along with plenty of practical policy and resources.

USA: Collaboration to improve the mental health of children with complex health and social needs
In 2021, four organisations based in San Diego, California, began working collaboratively to help families with children who are chronically ill or who have complex social needs. An ecosystem of care was developed to expand San Diego’s Rady Children’s Hospital’s network of social and behavioural health providers. The ecosystem saw the newly form team, which also comprised a YMCA, local non-profits and a prescription program, shift their focus from a medical perspective to a community-focused approach. The ecosystem is set to expand to support children aged under 19 who are incarcerated, with the providers having gained the tools and capacity to identify new community partners to meet their needs.
Camden Coalition

England: Non-intrusive remote monitoring pilot frees up funding and social practitioners’ time
A pilot launched in tandem between Reading Borough Council and software firm Lilli has seen new proactive and non-intrusive remote monitoring technology rolled out to give people with care needs greater independence at home. The pilot gives frontline social care practitioners new data and insights to support their decision making, in turn improving care outcomes for people across Reading. Daily behaviours such as home temperature, movement, eating habits and nighttime activity are monitored to get a better picture of an individual’s wellbeing.
AT Today

USA: Multi-generational housing keeps care front and centre
Bay State Commons Cohousing is a condominium project constructed in Malden Massachusetts, where care is incorporated into every element. The multifamily development’s design places an emphasis on child care, community engagement and neighbour support, with features including a glass door separating the community kitchen and the playroom and kitchen windows overlooking the community courtyard. Elsewhere, other accommodations are targeted at older residents, with grounds graded for accessibility and facilities for live-in carers.

Wales: ‘Shared Lives’ scheme connects vulnerable adults with would-be carers
Powys County Council operates a service where vulnerable people are helped to live independent and thriving lives by people with time, support and a space in their homes to offer. The Shared Lives scheme sees local people opt to be recruited, assessed and trainers as carers for people who can no longer live independently without support. Shared Lives Carers offer long-term homes, short breaks or sessional support for people in need, working with people in need to help them develop their independence and offering a sense of community.
Powys County Council

Report: Care Ecosystem Toolkit
This report introduces the care ecosystem and provides an evidence-based framework to promote optimal dementia care outcomes by addressing patients’ social determinants of health. It provides tools and case examples, highlighting challenges and strategies for healthcare teams to implement effective dementia care tailored to patients’ unique needs across all levels of the ecosystem.

Report: What does the concept of an ecosystem offer to social care? A narrative review of the ecosystem literature
The report reviews existing literature on creating care ecosystems, proposes potential measurement approaches, and discusses the increasing role of digital technology when considering the interplay between a person and the health environment.

Report: People, Place, Health Constructing a Health and Care Ecosystem for Wales
As this report published by ARUP argues, 80-90% of good health comes from factors outside of our health and care systems, ensuring these systems cannot be distinct from our day-to-day lives. It argues that public planning and decision making must consider the wider impacts of health. It details five steps to create a more effective health and care ecosystem which supports our places, communities, environment and economy.

Webinar: Building ecosystems of care with justice-involved populations
This Camden Coalition webinar examines the health and wellbeing barriers people who have interacted with the legal system face. It covers two case studies in York, PA and Spartanburg, SC, that worked to meet the needs of justice-involved people. These two communities developed and strengthened ecosystems of care through partnerships centred on behavioural health, community voices, and organisational relationships.