Passing a Movement Forward

Helen Davies-Cox

It was back in 2014 that I first came across an interview with the then new Chief Executive of NHS England ‘Simon Steven’s’. When asked about the challenges ahead for the health of the population and how the NHS needs to respond, he referred to the need to create a  “social movement for health’

This was both a curious and intriguing concept for my ‘NHS brain’ to consider, having had 29 years’ experience on the job.  Surely the NHS, ‘our National Treasure’, an institution held in international envy and esteem, an organism with its own set of peculiar cultures, sub-cultures and training, a monolith of gigantic proportions, couldn’t design and create a social movement.  For a start, the NHS is recognised as being risk averse and social movements by their very nature are uncontrollable, flexible and adaptable with few governance structures, the very opposite of how the NHS has been designed and developed. How on earth could the NHS become a social movement, generating social change from the ground?  

The challenge therein certainly got me thinking and at first it felt like an impossible ask, yet here I am today orchestrating a personalised care social movement based around peer-support, self-management education and health coaching.  A social movement that appears so incredible and amazing that people from all walks of life, near and far afield want to understand and emulate what we have done.  It is worth emphasising here, the most important two letter word in the last sentence you have just read ‘we’, it may seem a small point, however if you indulge me with your attention it will soon become apparent that although I am seen locally to be leading this programme, in fact it is the many, the people of Devon and increasingly the people of South West of England who are the ‘we’, I refer to, without whom our social movement ‘HOPE’ would merely be a figment of my possibility architect brain.

We are only too aware; having been an NHS England ‘Demonstrator site’ for Integrated Personal Commissioning and now an ‘Exemplar site’ for Personalised Care it can bring many demands and tribulations in the form of reporting and ‘feeding the beast’.  However what it also brought was an opportunity to draw down funded support from the Voluntary, Community and Social Enterprise (VCSE) sector.  One of the offers available in 2016/2017 was to work with Coventry University’s professor Andy Turner  Andy Turner is an innovator who created the HOPE programme.  Andy’s work at Coventry included evaluating several successful and popular self-management programs. By taking the best bits of these programs and synthesising them together within a positive psychology framework, he and his colleagues have created a program which they call Help to Overcome Problems Effectively or ‘HOPE’. HOPE is a six week programme that runs for 2 ½ hours a week and blends peer-support, self-management education and health coaching into a seemingly magical combination. It has become the catalyst that is bringing personalised care approaches to life across Devon and is now spreading further afield into the wider South West Region and gathering interest from across England.

Let me take you back a few steps…..”HOPE, why call it HOPE Andy?” I asked (Andy Turner’s following response is paraphrased).  “When we first developed the program we tested it out on several groups.  At weeks one and five, we ask the participants to each identify and write down three emotions that they are feeling.  We then create a word-cloud.  At week six we show them the before and after word-clouds to demonstrate how far they have come.  The one word that stood out time and time again in the second word cloud was ‘Hope’, so we decided to make an acronym out of it, Help to Overcome Problems Effectively. But it also simply means ‘Hope’ – the program seems to bring a real sense hope to people!” Trust academics to turn it into an acronym!

The possibility architect in me then started thinking………………… the system in which I was working, like many other systems, was experiencing significant pressures in terms of capacity and available finances.  This environment brings about challenges and also opportunities; after all it is often when our backs are to the wall as a species, that we are our most creative and innovative.  What if supported self-management in the guise of HOPE could be the thing that helps us to cement personalised care approaches across our system? Integrating primary, secondary, community and social care; mental and, physical health the voluntary sector and most importantly people with lived-experience, a truly holistic approach to creating the social movement for health that Simon Stevens challenged us to create in 2014?

If this is something that interests you; and you wish to orchestrate your own local or even national social movement for health, utilising personalised care as the chassis of choice, in the weeks to come we shall share with you our journey, the hill climbs, the pot-holes, the dead ends and the high speed stretches of road where there are no ‘National speed-limits’, only clear roads ahead and the wind in your hair, after all who doesn’t love to go topless! 

Published by change unlocked today

Helen Davies-Cox and Chris Edworthy are 'Architects of Extraordinary Change' , having over 60 years of experience in the NHS between them, leading and engaging in change projects throughout their careers. email:

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      1. Hi Helen, As I’ve never written a blog before; here’s my brief thoughts on social movement;
        Ever since I read People Watching by Desmond Morris many years ago, I’ve been interested in the social movement of people; – their behaviour and habits, their personalities and their quirks especially in groups. How people interact, consciously and unconsciously, shows us that we are by nature social animals.

        The challenge for Possibility Architects is how to harness this innate characteristic into a social movement for health!

        Liked by 1 person

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