Precision Public Health
21st Century Public Health
On June 9th 2016 we had the privilege of speaking at the Royal Society for Public Health’s (RSPH) Conference on Health Trainers, and their highly respected “Well Communities” Programme. Opening the conference, RSPH CEO Shirley Kramer, talked passionately about “Precision Public Health” and later there was a piece on “Rings of Confidence”. Not only did Shirley’s message resonate strongly throughout the day, it continues to align powerfully with our values as public service innovators.
The conference was a stunning example of how language choice can create headroom for innovation in the face of the most entrenched systemic issues. For those of us who wish to see prevention as the normal mode of working for public services, it was, quite simply, inspirational.
Language for Positive Change
So the experience got us thinking about this question: “How does the language we use create or suppress opportunities for innovation in the wellbeing space?” We thought it would be interesting to ask around and compile a list of the terms and phrases Villagers thought were worth highlighting – or even challenge outright. Here’s what we found:-
1. Hard to Reach
In this day and age, there is simply no need to describe any target audience as hard to reach. We got away with it in the years leading up to the advent of the internet and social media. These days there is a multiplicity of tools widely available and in use by forward thinking services providers that make this kind of language instantly redundant. It’s time to tune-in; catch-up and go to the places frequented by these supposedly “hard to reach” people. You might be surprised what you see there.
2. Frail Elderly
These labels exemplify a family of phrases still doing the rounds in the public service arena. They are cited on this list because they set the standard for “How to isolate, stigmatise and dismiss someone you’re trying to engage” – in 2 easy words. So not just lazy – but potentially dangerous. These phases seem to suggest “You’re a problem and we’re trying to fix you”.
3. Troubled Individual
We encourage Villagers to think about this golden rule of System’s Thinking: “Never, ever be tempted to blame a person for a systemic problem!” It’s a slippery slope of head-over-heels distraction. It faces us away from the more important task of addressing the “causes of the causes” that emanate from deep within the system. In other, words, such language can easily mask the need to address underlying complexity.
4. Integrated Care
Can someone please explain what other kinds of care there can possibly be other than that which is joined-up around the needs and values of the people we serve? It’s like a delicatessen advertising “Fresh Sandwiches”. You wouldn’t dash inside and ask “have you got any stale ones?” Would you?
We prefer to think about a personalised framework of coordinated options that we refer to as a “Ring of Confidence”. Check our web-site (Our Model) if you’re interested in the details and, rest assured, we’ll be saying a lot more about this in future posts.
The problem with this phrase largely boils down to perceived widespread malpractice. Although well-intended, for a lot of Villagers, it has come to mean “I need to give the impression I’m working with you towards an outcome, but unfortunately I have a ready-made solution in mind, and what’s more I need you to eventually come to terms with it.”
6. Technology Led
We found this to be an interesting candidate for our list – not least because we are essentially a team of scientists. However, after many conversations, we think we may have discovered why this language irritates front line delivery teams. It seems that over the years public service professionals have endured a relentless torrent of top-down technology-led programmes, which have at best failed to scale and at worst reduced their capacity to delivery person to person care.
Our experience of using digital technology to enable up-scaling across multiple sectors tells us that in public services more than any other, it conversation-led not technology-led approaches that deliver the most sustainable impact. Hence our passion for story, conversation with real people in real places.