Sara discusses how truly listening and acting on what we hear is the only way that true and real change can be made.

We’ve all had conversations where we realise someone isn’t listening. They might be nodding, but their attention is elsewhere. Compare that with someone being fully present – attentive, asking questions, letting you finish. The difference is striking. One leaves you feeling dismissed, the other feeling understood, even nourished.

Too often in health and social care people’s voices are treated as background noise or data to identify a ‘problem’. Consultations are held, assessments happen, decisions made, but a gap remains between listening and acting.

Our healthcare model often centres on a medical approach – identifying an illness or impairment then focusing on treating the ‘problem’. This overlooks the role people play in their own health. In contrast, a social model emphasises the impact of social, economic, relational, and environmental factors.

In September, the ALLIANCE hosts Self Management Week. Self management is rooted in a social model; understanding health as a continual journey. With the right support, tools and compassion, people can harness their strengths, motivation, and creativity to live well.

We know when communities aren’t involved in decisions which affect them it causes issues. Policies can look good on paper yet fail to connect with the realities of people affected. There often feels like a lot of nodding, not enough listening.

That thought has stayed with me as the ALLIANCE, alongside over 200 third sector health and social care organisations across Scotland, sent an open letter to the First Minister. The letter is about investment; calling for proper resources, funding, and a plan for recovery. But at its heart, it’s about voice – calling for organisations and communities to have a proper seat at the table, ensuring voices are heard. Without this, Scotland risks building strategies that don’t consider lived experience and services that don’t meet needs.

This year’s Self Management Week we are asking people to consider “what I need to lead”. People are the experts in their own lives. They know what matters most in managing their wellbeing, yet too often their voices aren’t heard.

When we really listen, everything changes. Services stop being something done to people and become something shaped with them. Self management isn’t about going it alone, but being heard, respected, and supported in ways that work for you. Whatever the answer, it begins with the same question: what do you need to lead?

As I reflect on the letter and the theme of Self Management Week, one thing is clear; listening matters, but real change happens when we act on what we hear.

We can create a Scotland where every voice counts, where everyone can lead their own health and wellbeing, and where the third sector’s voice is respected. Only together will we create the change our communities deserve.

This opinion was first published as a column by Sara Redmond in the September edition of TFN.

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