A Chance to Change Scotland: Chance 2 Change Expert Reference Group with Lived Experience - report

This report accompanies the report of the Primary Care Health Inequalities Short Life Working Group (SLWG). It provides lived experience perspectives on health inequalities and inequity, and on how primary care can address these. C2C worked alongside the SLWG as an expert reference group.

1. Initial Ideas for Participation - Part 1

Structural Inequality.

  • "Agreement that the NHS should be 'best' where it is needed the most". Person-Centred theory has been in existence for years but is still just that a theory, in most practices. At Chance 2 Change (C2C), it's people-led, automatically making it a Person-Centred group, which benefits people by implementing active listening, building confidence and skills, which empowers people to make positive choices for themselves as well as challenge previous practice (e.g. GPs, healthcare professionals, mental health, etc.).
  • Policy recommendation – This can easily be achieved through community groups with links to GP practices – such as C2C.
  • Example question for C2C group:
    • If we were to build similar groups to C2C in other communities what would be required to make them as successful as this group?

Community Voice

  • Each individual at C2C has their own stories to tell where health professionals/organisations failed their needs which when broken down are not at all complex. C2C has proven that people from deprived areas can learn and promote positive wellbeing within the context of a Person-Centred approach.
  • Example questions for C2C group:
    • Think of a time when your health needs were not met? How could this have been better?
    • Has the group supported your needs? If yes, can we have some examples?

Sustainability & Leadership

  • I don't feel that this theme is for the group but do have some comments:
    • The paper talks about Clinical/medical expertise, which I have none of but the reason I feel C2C works is that I am an expert in growing up and living in a deprived area and all the issues and challenges that go alongside this.
    • An idea for a new model should be that academics need to collaborate equally with scheme experts and recognise each other's worth. I guess this is what you are trying to achieve by working with us.
    • Point 7 'Skills Curriculum' – this should be mandatory and we should have involvement from Relationship Scotland to enable professionals to develop skills that put people at ease, for instance 'non-judgemental' should not just be another theory but needs to be practiced. This should be for all front-line staff, not just clinical/medical (such as admin/reception).

Long Term Health Conditions

  • I have learned at C2C that language is important – I used to believe that 'recovery' was a term that should be used for addiction and long-term health conditions but I was wrong and have learned that in life we are all recovering from something, especially in the current Covid-19 climate. There is a range of challenges that C2C group members face such as addiction, Bi-polar, anxiety, poor mental health, stroke, etc. By bringing the group together and empowering them to realise that we are all recovering achieves a collective togetherness, which has proven to have a positive effect on long-term health conditions.
  • The paper states there should be 'greater responsibility on individuals to manage their own health'. This is true but people often do not understand what this means and require education and guidance.
  • Example questions for C2C group
  • Do you agree that you as an individual should take responsibility for your own health?
    • What things do you do to improve your own health?
    • Is it easier to make health improvements through a/the group than on your own?

Mental Health

  • It is fair to say that Mental Health is currently the weakest service provided by the NHS. I am part of the North West Mental Health and Suicide Prevention forum and I have very limited knowledge of services that I can signpost to. These services either do not work or have such long waiting times that suicide rates are further impacted.
  • The policy recommendation is that the 'Government invest in the infrastructure of kindness' – It's interesting to think what kindness looks like in this setting because it is currently the police that are first responders to a mental health crisis which either requires training or moving this responsibility away from the police.
  • Example questions for C2C group
    • How has Covid-19 and the restrictions impacted your mental health?
    • What support has been available to you during Covid-19?
    • How would you feel if you were suffering from poor mental health and the police arrived at your door?
    • Can you tell me ways in which health professionals and mental health workers can show kindness?

Digital Health Care

  • The whole world has gone digital and sadly we have an entire generation of people that do not understand technology. Since the Covid-19 pandemic, this is also a challenge that C2C is facing. What is currently in place to support education of digital technologies but also to ensure access to hardware for those people in financial difficulty? To support future decision making, could this be piloted at C2C, enabling the group to have the choice to communicate in this style but also highlight potential barriers in digital learning?
  • Example questions for C2C group
    • How would you feel about speaking to your doctor online?
    • Would this make you more or less anxious?
    • Putting the health stuff to one side - if we all had the confidence and knowledge to go online would we and would we speak to each other?


Email: katrina.cowie@gov.scot

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