Over the summer, Catherine Max worked with Durham University to appraise the impact of the BIOPICCC research project conducted with local authorities to make older people’s care more resilient to climate change. She also asked whether and how political and economic change had affected their ability to act on the project’s recommendations. The areas researched were located in the South East, North and Midlands, and encompassed rural and coastal communities, and two tier and unitary authorities.
Evidence from psychology tells us that a person’s resilience lies in their ability to adapt to change, to weather life’s storms so to speak. Community resilience shares this characteristic, whether it’s social, economic or environmental changes we are facing – or, indeed, a combination of all three. Individual and community resilience are also both strongly supported by the social capital which arises from connectivity, be it through trust, networks or norms.
“Resilience strategies only work effectively if they are part of a holistic approach that connects citizens, communities and institutions across the public realm.” Resilience in practice (LGiU 2015)
Built Infrastructure for Older People’s Care in Conditions of Climate Change (BIOPICCC) was a three-year research project (2009-2012) which worked closely with local authorities in England to develop strategies to ensure infrastructures and systems supporting health and social care for older people are resilient to the harmful impacts of climate change, particularly extreme or severe weather events. Though the original research focused on older people’s care, it has proven relevant to a wider range of services and community resilience more generally. Indeed, the study provides useful insight into the importance of local adaptability and ownership for the successful development of resilience in localities.
It’s a rare privilege to be able to return to the sites of research three years on, so we were delighted to have the opportunity to re-engage with our local authority colleagues to investigate the impact of our work. Over the summer, we conducted interviews with participants who were involved in the original research or have subsequently made use of the BIOPICCC toolkit. These interviews examined past and present impact and considered the effects of changing political priorities, public spending cuts and health and social care restructuring. The interviews also created a space for participants to reflect on drivers of and barriers to action over a period of time.
We now have a snapshot of impact to date and this is helping assess how we might further strengthen and broaden impact across local authority areas and across health, care and environmental policy. A summary of the report will be published on the BIOPICCC web pages. In the meantime, this is some of what we found:
“BIOPICCC generates really good evidence to present to commissioners about what the community wants and why, their expectations, and how to deliver this.” (environmental services participant)
The BIOPICCC research has enabled participants to make a case to commissioners and other corporate decision-makers for action to improve resilience. Furthermore, the research recommendations and BIOPICCC toolkit are sufficiently flexible to enable this action to be tailored to local needs and circumstances. More generally, the research has raised awareness of climate change as a risk to care services and public health where it had not previously been taken into account. It has been used to support successful proposals for funding to assist in climate change adaptation initiatives, from both internal budgets and external sources such as the Big Lottery.
“The BIOPICCC research makes you think about how these things impact on you and your service.” (social care participant)
The research has also provided an ‘eye opener’ for stakeholders, helping them see their services from the users’ perspective and thus giving them a better understanding of how to respond to their needs. This is especially helpful where local authorities are moving to an outcomes-based and commissioning rather than delivery business model.
“Communities found it really useful to identify risks and share what services they wanted.”(environmental services participant)
BIOPICCC’s participatory mapping approaches and toolkit have proved to be adaptable to different geographical areas, organisational scales and issues (not just health and social care adaptation but community wellbeing) and have assisted in developing local plans, commissioning and delivery of services. The ‘organograms’ in the toolkit are useful for identifying and engaging with key stakeholders, which in turn has improved coordination and communication around resilience planning.
“The toolkit is definitely of benefit for community resilience.” (climate change participant)
The BIOPICCC approach has had a greater depth and longevity of impact among participants who used the toolkit autonomously rather than in the original case study sites. The ownership and drive demonstrated through its independent adoption allowed for using the toolkit in locally appropriate ways (which was a key aim of the toolkit design). For example, one severe weather plan was developed jointly by the local community and county council officers using BIOPICCC recommendations and resources. The geographically-based approach was also an effective way of bringing different stakeholders together on common ground. This approach is well aligned with local authority place-based approaches, highlighted as a ‘game-changer’ in Public Health England’s Annual Plan 2015/16.
“Urgent things tend to crowd out the important, non-urgent things.” (public health participant)
Inevitably, there have been some barriers to implementation. As ever, a crowded policy arena leads to changing and competing priorities. Capacity to implement ‘additional’ priorities is often limited, and this is compounded by ‘Austerity’, as is the scope to develop and monitor formal impact measures at a local level. Nevertheless, the finding about independent ownership of the toolkit is particularly encouraging, and was a key factor in our securing funding for further development and promotion of the toolkit with local stakeholders.
In January 2016, we are co-hosting a peer-peer learning event with Climate UK to spread our learning more widely and initiate the process of co-designing a refreshed toolkit to make it more current and user-friendly. For more details and to register to participate in Resilient health, care and wellbeing in a changing climate: lessons from research and local practice, click here.
Catherine Max is an independent consultant specialising in sustainable health and social care.
