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Bad health in poor communities is often linked to social factors, like anti-social behaviour and poor access to good food.C2, short for Connecting Communities, was developed by ex community nurse Hazel Stuteley with the Health Complexity Group at Exeter University. It is an evidence-based, multi-agency programme, which delivers learning and skills needed to support residents in disadvantaged neighbourhoods to lead and sustain transformational change and to become self-managing. There is a C2 network linking resident leaders and service providers, to support and share innovations between more than twenty widely differing communities, who are all achieving measurable outcomes in health and social well being. It was the runner up for our Innovations Award 2011. |
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Year established |
1998 | |
Number of staff |
Paid Staff (FT equivalent)12, Volunteers 50 | |
Number of users |
Approx 5,000 | |
Is there a charge to users? |
No. | |
What makes your project sustainable? |
Sustainability has been maintained across all sites as they are demonstrably cost-effective and resident led. Funders generally happy to support such self-managing, well organised community initiatives. The community partnerships are encouraged to set up companies whose profits go back into the community. These include gardening services, house clearance and decoration etc. | |
Demographics |
C2 works with communities that tend to be the most disadvantaged, which have often received little investment from statutory agencies. These communities suffer the highest prevalence of chronic disease, with mortality figures indicating that they die on average 10- 15 years sooner than those living in more affluent areas. It is of particular note that C2 has been commissioned in large seaside towns ( Margate, Ramsgate, Skegness, Plymouth, Southend) which suffer higher than the national average levels of disadvantage. | |
Innovation |
• C2 supports communities to lead change and improvements for themselves and become self- managing. They take responsibility for their health, neighbourhood and work as equals with service providers who also want the same thing. Residents want a better place to live, service providers want a better place to work. C2 sets up neighbourhood partnerships and has a consistent track record of improving levels of ASB, crime and disorder, poor health, youth issues, teenage pregnancy, low educational attainment. In other words, the causes of poor health behaviours leading to LTCs.• C2, through their inter-community network encourages exchange visits for residents and service providers, and also develops resident leaders and young people (TR 14ers community dance team) as teachers. C2 develops residents to lead their partnership committees, and provides ‘in house’ bespoke courses on the skills needed to do this.• C2 holds regular web-based education events for all the communities that they support.• At times the communities that we work with go through difficult patches. The residents are strong enough to ride these storms with support from the C2 team and service providers. The important issue is to learn from these hard times, and also share the learning.
• Complexity science is C2’s theoretical framework, used to understand and deliver transformation. It works, every time!
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Patient-centred, whole person preventative approach |
The focus of C2 is on health creation. Bringing healing to troubled communities is at the heart of the C2 approach and we have achieved many measurable health outcomes over many years. The approach is a multi agency ‘whole community’ rather than individual approach. We listen and act upon community priorities (see attached 7 step framework ‘From isolation to transformation’), which leads to large-scale health and lasting improvement. C2 is NOT a project but is designed to deliver a permanent culture shift across the spectrum of service delivery by embedding the values of enablement, listening, connectivity, compassion and trust from ‘high level to street level’.Empowering residents on a large scale gives them a feeling of hope and being able to influence the direction of their lives. Sir Harry Burns, the Chief Medical Officer of Scotland provides compelling research indicating that it is hopelessness and powerlessness that leads to such high levels of chronic disease and premature death. This is the reality for vast swathes of our population and we believe, and have proved, that is it entirely preventable and treatable. | |
Evidence informed/audit and evaluation |
Health and community needs and aspiration assessments are part of the underpinning of the C2 programme. A retrospective 2yr research programme was also undertaken by Exeter University to determine key success factors in the multi award winning Beacon Project (led by Hazel Stuteley), which informed C2 course content. (Community Regeneration Evaluating Sustaining & Transferring C.R.E.S.T. Wyatt & Durie, University of Exeter, 2004) Download the report here.External evaluation has been carried out in all 3 Cornish sites and is available at wwww.healthcomplexity.net as well as 3 other sites when C2 was commissioned as practice framework by Dept Health funded Health Empowerment Leverage Project (HELP 2010/11) as an economic evaluation and business case (SROI of 3.8:1) see attached. www.healthempowerment.co.ukC2 has an ongoing relationship with researchers in the Health Complexity Group at the University of Exeter medical School. This enables a dynamic cycle of ‘research into practice’. In each community, we use a ‘connectivity assessment’ tool and ongoing qualitative data collection including dvd footage and ‘before/after’ photos to track progress. C2 also has a network of universities who are evaluating local communities who have worked with the C2 team. These include St Andrews, Staffordshire, Norwich and Kent. Attached are the HELP report ‘ Empowering Commun ities for Health, a business case and practice framework 2011’ and CMO Scotland Annual Report ‘Time for Change’ 2009 citing Beacon Project and C2. |
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Multi-disciplinary collaboration, and professional communication |
C2 offers a ‘2 community approach’ – connecting the community of residents to the community of service providers. It is the community of service providers who often have the most trouble in re-defining the nature of relationship with residents – switching from ‘doing to’ to ‘working with and supporting’. However, the professionals who do embrace the power shift from ‘power over’ to ‘power with’ find greatly enhanced career satisfaction.In particular C2 has enjoyed excellent and productive working relationships with the Police and Fire Service. Both have proved extremely pivotal in bringing about transformative outcomes and health improvement on many C2 sites. We would particularly mention officers within Devon and Cornwall Police, the Violence Reduction Unit Glasgow, and Margate Task Force, without whom C2 could not have consistently delivered the outcomes with residents that have been achieved in last 20 years.The C2 7 steps to community approach works with both simultaneously, gradually building trust and new relationships. Both in fact, are equally in need of being enabled, connected and listened to. Our consistent experience is that only when the community of service providers changes its behaviours to embrace those values will the community of residents change their behaviours. As a minimum requirement the 7 step approach must work with providers from health, local authority, education and the police, alongside residents. Any other services like Fire and Youth services are an added bonus. | |
User comments |
“So pleased with the way things are shaping up, we really are on a roll and the skills that have already come out are fabulous. Sure there are plenty more waiting to emerge so am very confident that this new group will climb many mountains.”“ We know our people in this neck of the woods and there is much positive energy oozing in Cliftonville with some wonderful people emerging who have not had the opportunity before.” “The key people who run the street scheme and resident groups are even stepping back already to allow the new energy to come through. I think they are quietly grateful to have other people who are willing and eager to become proactive.”“Thank you, for such an incredible knowledge exchange. The past few days, have been a truly ‘stand up and pay attention’ experience. I know we can now follow through in Coventry!” ‘’You have shown us, not only the C2 principles in theory, but how to ‘sprinkle stardust’ and spread the ‘magic moments’. The compassion and sincerity you showed the whole team, was truly an inspiration for us both.” http://tedxexeter.com/2013/06/05/hazel-stuteley-from-isolation-to-transformation/ http://tedxexeter.com/2013/06/05/shanna-dawes-and-the-tr14ers-performance/ | |
Contact details |
C2 Connecting Communities University of Exeter Medical School St Lukes Campus Exeter EX1 2LUt: 01392 264916 w: www.healthcomplexity.net e: Suzanne Hughes s.hughes@exeter.ac.uk |
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Changing the conversation about health
