Transforming health and social care 10 years on

Written by: Audrey Birt, Associate Director, the ALLIANCE
holding a sparkler

Associate Director Audrey Birt shares her experience of seeing first hand the Self Managements Fund's impact on individuals across Scotland.

Can it really be almost ten years of the Self Management Fund? In many ways it feels a very short time since we sat in my office in Sauchiehall Street, put the final touches to Gaun Yersel and secured the fund for the first time.

As anyone who visited that office will remember it was rare to work in that office without the musical accompaniment of a Glasgow busker. So perhaps it was some musical inspiration that helped us come up with the controversial name of the strategy or maybe just the fact that we knew if we did things as they were always done, nothing would change. But we also understood that nothing would improve if there wasn’t an investment made in self management. And the government deserve great credit for understanding that a strategy written from the perspective of lived experience by us, that also had funding had a significant opportunity to truly change things. And I do think the fund has made a difference to many people over these last ten years.

Often people tell me that the investment of the fund has changed either their lives or those they in turn support. Recent work with neurological conditions took me all over the country and, more than once, people told me of the impact of the fund on their lives. From support for people with MS to buddy schemes for those with ME, I heard of its impact. These occasions leave me so grateful for the opportunity the fund has offered so many and for being able to have played a role in its inception. I once described the fund as lighting a 1000 fires and when I see that truth in action it’s especially rewarding.

So, what has made the difference? I’m an Associate Director now with the Academy, a Programme of the ALLIANCE focussed on transforming health and social care. Following a think tank of public sector leaders we developed the Five Provocations to enable the transformation of services in health and social care. Looking at the fund through that lens helps us to understand the success to date. Through the fund we emphasise humanity in the process; we reward courageous leadership in the projects we fund; we shift the focus from targets to outcomes; we nurture the projects to ensure longer term learning and benefits; and perhaps most importantly we cede power to the organisations and communities closest to where the difference is made. Our work has shown us that all those aspects are vital to ensure successful transformation and improvement of services.

But is all of that enough? In reality, the fund has not increased in this time and we could allocate it many times over. Too many times we see successful work flounder once they lose the funding as local funds are diverted to maintain the status quo in existing public services. If the fund is to be truly transformative, then the wider system has to be honestly open to investing in successful work, wherever it sits.

So, these years have taught me two things; when people in positions of power cede that control of power then real and lasting change can happen and when you accompany that with funding you can really improve people’s lives. Let’s approach the next ten years with boldness, vision of a better future and of course humanity.