PPL Perspectives

'Power to the people, right on' - what do we mean by health as a social movement?

19 February 2018

Hannah Dayah, Analyst

Hannah reflects on a talk she attended at the RSA entitled ‘Health as a Social Movement’ back in 2016 and its relevance now in 2018.

Health as a ‘Social Movement’ is not a new concept.

Social patterns in health have been studied for decades and are of interest to both commissioners and providers. Well-known examples include the GM Cancer Vanguard model and the Breast Cancer Awareness campaign.

A social movement is a group action focused on a specific political or social issue such as climate change or health care. The collective group act through creating, resisting or reversing change. Social movements are ‘messy’ – they are unpredictable and vary in size and direction, making them difficult to harness.

I was interested to hear the panel’s views on the practical applications of social movements: how they will help to shift power to citizens, improve well-being and reduce demand on finite NHS resources.

But is the movement happening?

As part of the Five-Year Forward View, NHS England is progressing a three-year programme to support social movements, incorporating ‘trial and error’ methods in its determination of ‘what works’.

Let’s look at some examples:

1. A ‘People Powered’ approach - empowering patient groups to manage their healthcare

‘The Right Prescription: A Call to Action’. This case study looks at how the social movement Dementia Action Alliance tackled inappropriate prescribing of antipsychotic medication to patients diagnosed with dementia. Within three years the Alliance managed to reduce the amount of unnecessary antipsychotic medication prescribed by 52%! This was achieved through medicine optimisation on an individual patient basis.

2. The ‘Hierarchical’ approach – incorporating social movement groups in to the official structure.

An example of this approach was undertaken in a Worcester based NHS Trust. Their hierarchical system includes a ‘rebel’ group. This sub-group acts in parallel with the strategists and developers on projects but proposes ideas with an underlying ‘social movement’ purpose, highlighting non-system based ideas. Executives have been delighted with their approach and in the confidence they have created. The team still exists and are currently bringing ideas to further regional Trusts.

The panel debated the hierarchical approach and whether there is potential for the NHS to institutionalise social movements, incorporating them into their managerial frameworks and decision-making criteria. It is thought that the hierarchical approach allows the unrestricted ideas created from the social movement group to act in harmony within the rigorous structure of the NHS; it allows for controlled change that is still more rapid and refreshing than often seen today.

How can we use social movements to deliver change on the ground?

Much can be learned from examples of communities that are mobilising effectively for better health and social care. This may pave the way for existing cumbersome models of care to be replaced by logical and efficient pathways. By enhancing systems in this way, healthcare could be more accessible and encouraged at earlier stages, with the additional benefit of freeing up time and resources.

The key message I took from this discussion was the need to integrate social movements with health care in an organic fashion. There is strong evidence to suggest that this may be the way forward in creating a truly integrated and sustainable NHS. As using social movements in healthcare is fairly new and unused, effort should be spent in a widespread trial of this idea.

Get in touch with us at info@PPLconsulting.co.uk to find out more and continue the discussion! Or tweet us @hannahdayah or @PPLthinks.