National: London Borough of Tower Hamlets, United Kingdom
Geography type: Urban
Professional group/type of organisation involved e.g. acute, CAMHS, voluntary sector, primary care
This service was provided within primary and community care with group sessions being facilitated by a health visitor (HV) and adult learning specialist. DIY Health aims to work horizontally across a range of stakeholders including local people, primary care, HV Services, Children’s Centres and community and voluntary sector organisations.
Details of initiative
Parents of children under the age of 5 were frequently re-attending St Andrew’s Health Centre (one of three surgeries run by Bromley by Bow Health Partnership) for support with managing self-limiting childhood problems. Group learning sessions were developed aimed at empowering the parents with knowledge, confidence and skills to manage minor ailments at home. Support from local Children’s Centres ensured that parents were able to attend the sessions in the absence of childcare arrangements for children under 5.
The initial phase of the project involved asking local parents of children under the age of 5 about managing children’s health at home. Six core topics identified locally included: cold and flu, diarrhoea and vomiting, fever, feeding, eczema, and ear pain.
DIY Health employs a co-produced methodology in which parents and families are involved in the design, delivery and evaluation of the service. The core content of each of the sessions is based on parent experiences and stories. This model was originally funded as a six-month pilot as part of the Tower Hamlets CCG Innovation Bursary Fund. The purpose of a multi-disciplinary team approach was partly to facilitate DIY Health being shared across a wide range of external organisations to generate interest around different ways of delivering health education. One of these organisations was with the Children and Young People Programme Board at UCL Partners (UCLP). The innovative method of delivery led to a collaboration between the participating organisations to upscale and evaluate the original DIY Health model pilot, with a rigorous academic steer from UCLP underpinned by funding from the North East London Foundation Trust.
Type of integration (vertical, horizontal, population)
The second phase of the pilot project was evaluated in partnership with the Anna Freud Centre and colleagues from the University of Sheffield. Qualitative analysis showed an increase in knowledge, confidence and skills to manage a wide range of health issues for all parents involved, and high levels of co-production throughout the programmes.
Challenges, successes, lessons learned and advice
- Work with stakeholders, including local people, from the beginning to define, articulate and design a program that addresses a need
- Be flexible and open to problem solving in the sessions
- Ensure that all those involved share the same project ethos and values
- Measure what matters – do not place all the emphasis on reducing service use. Increases in resilience, confidence and skills are just as important
- If you want to measure health service use, do so across the health service (ED, primary care, HV) to get a true picture of what is happening for parents. Economic evaluation should include measures such as quality adjusted life years and social return on investment measures.
- Co-production takes time – for local people to develop as facilitators themselves or be involved in community organising. Be prepared for this to happen outside the lifetime of structured sessions. More longer-term funding will support this and should be considered when applications for funding are made.
Cost benefit information
Preliminary quantitative results showed a reduction in GP attendances for parents who attended DIY Health sessions.