Neighbourhoods for Wellbeing (N4W) : Modelling and embedding codesign as a mindset and a way of working from the get-go

Abstract

Introduction to Neighbourhoods for Wellbeing: Neighbourhoods for Wellbeing (N4W) is a codesign improvement project set within the geographical boundaries of South Eastern Sydney Local Health District (SESLHD), NSW, Australia. A partnership between SESLHD and Central Eastern Sydney Primary Health Network (CESPHN), Primary Care provider(s) and the people who live and/or access local health services, this project aims to improve and optimize how we engage as partners and draw on local assets in coproducing a future that values the determinants of good health and minimizes health loss. In N4W good health is not just about how we feel, but how we go about our everyday lives. It incorporates our physical, mental and social wellbeing. Our health and wellbeing can be influenced by many things, but generally depend on: • social determinants—the many, interrelated factors that influence our health • participatory action —the things we do to protect or improve our health or prevent health loss 1,2,3. Health loss is what contributes to ill health, injury, hospitalization or dying early. Globally, chronic conditions are the major reason for health loss. One in 2 (50%) of Australians have a chronic condition. The major causes of chronic conditions are known, and if these risk factors were eliminated, at least 80% of all heart disease, stroke and type 2 diabetes would be prevented; over 40% of cancer would be prevented 1,2. N4W builds on the foundations laid by the SESLHD 2015-18 Integrated Care Collaborative Action plan. Shifting focus from technical enablers and building a shared narrative between providers, N4W aims to strengthen the change leadership & social enterprise capabilities of primary care and to meaningfully engage with individuals and neighbourhoods as resources, influencers and change leaders in themselves 4,5,6,7. The boundaries of the neighbourhood in N4W includes the patient population who are enrolled or regularly visit a primary care general practice. A place-based approach ensures N4W focus is local and inclusive 3,8. Modelling and embedding codesign as a mindset and a way of working in all aspects of N4W has been the key organizing principle. Drawing on improvement and implementation science, a small-scale test of change approach involving iterative cycles of collaborative participatory action, was adopted 3,8. This approach allows for an adaptive approach in identifying enabling and inhibiting factors and for exploring the benefits and value of the approach from all perspectives. Brief for Participants: This workshop will provide details of our test of change framework and current status of the project. We will share our learnings and also key co-design tools and frameworks we have used in this and other projects to embed codesign from the very beginning. Participants will have the opportunity to test and contribute to at least one tool or framework in the workshop. Participants will be provided with materials at the end of session to help apply some of our learnings within their own environment.

Keywords

• codesign
• neighbourhoods
• wellbeing
• change
• primary care