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[2 of 4] Remote Services Futures - Designing Services With Communities [Amy Nimegeer]
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[2 of 4] Remote Services Futures - Designing Services With Communities [Amy Nimegeer]


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The future for rural health services is the topic for the first in the new series of free public lectures at UHI, the prospective University of the Highlands and Islands. …

The future for rural health services is the topic for the first in the new series of free public lectures at UHI, the prospective University of the Highlands and Islands.

Professor Jane Farmer, UHI co-director of the Inverness-based Centre for Rural Health, is joined at the lectern next week by two of her researchers, Amy Nimegeer and Artur Steinerowski. The centre has carried out two years of concentrated research with rural communities in the region about their health services.

Amy has been working on a project looking at ways to involve communities in planning services, while Artur is looking at the role of social enterprises in community sustainability and working on the centre’s O4O (Older for Older) scheme. In collaboration with local people, the O4O team is devising initiatives to enable elderly people to live happily and healthily in remote and rural areas.

Professor Farmer said: "Our research has shown what rural communities want from health services and how that might be provided. We also speak about the changes required from managers, professions and community members themselves - and how everyone may have to think and act in much more radical ways to have services provided in the future."

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  • One of the ways that policy makers have advocated dealing with some of these challenges is by involving remote and rural communities in the design of future services. However, service providers and communities do not always have the same priorities or view services in the same way. I am going to talk about Remote Service Futures, a two year project…
  • As part of RSF we wanted to find out what it is that rural communities think themselves about the strengths and opportunities that their services have, as well as the potential threats and weaknesses. We then wanted to combine that with the service provider point of view and look at ways of combining these two viewpoints
  • Combines these two viewpoints: stage one gather info from service provider, stage 2 from community members, stage 3 give community options WITH service providers, stage four community plans along with present service providers
  • Transcript

    • 1. Remote Service Futures: Designing Services with communities Amy Nimegeer Centre for Rural Health UHI Millennium Institute [email_address]
    • 2. Remote Service Futures Project (RSF)
      • A two year project, looking at finding best practice for engaging remote communities in community level service design
      • Four communities in the project, two mainland and two islands
      • As part of the project, looked at the services communities already have, what they think is good about them and what could be better, combined this with clinical data
    • 3.
      • Common strengths and opportunities (assets)
      • Common weaknesses and threats (challenges)
      • What service providers say rural communities need
      • When change occurs
      • Better service design
    • 4. Common community assets Community spirit, people look out for each other People resourceful, adaptable Low crime, beautiful scenery, safe place to raise children Potential for growth with more online working Personalised, continuous, preventative care from local practitioners Local practitioners = social assets Local practitioners flexible, resourceful, think and act ‘out of the box’ Air ambulance responsive, connects community in an emergency
    • 5. Common community challenges Lack of affordable housing, can make it hard to attract practitioners Fears for security in emergency due to remoteness / weather Current practitioner about to retire, concern about replacing them Older people have to leave community if needs become too great Confusion about current service provision, who does what, who to call and when Poor access to patient transport to outpatient facilities Current practitioner provides ‘above and beyond’ services, fear this service will be lost For practitioners providing 24/7 service, concern they may be insufficiently supported, stress and isolation
    • 6. Service Providers say… “ Anticipatory” care and primary health care Aging populations: more complex, chronic disease, more need for social care (COPD, high blood pressure, obesity depression) Quick emergency response and transfer
    • 7. The disconnect…
      • Teams vs. generalists
      • Aggregated clinical data vs. narratives of experience
      • Chronic conditions vs. emergencies
      • Mutuality vs. the welfare state
      • BUDGET!
    • 8. When change occurs..
      • Sometimes it is accepted, but…
      • Often a ‘one size fits all’ model
      • Urban models squeezed in to rural areas
      • ‘ Informal’ work can be lost
    • 9. Some reactions to change…
    • 10. Remote Service Futures
    • 11. RSF conclusions: how could design be improved?
      • Design services with community BEFORE crisis arises (anticipatory design)
      • More community ownership of process
      • Sharing budget and profiling information
      • Acknowledge informal work
      • Persistence, creativity and feedback!
      • Mechanisms for community to get involved, actively supporting them to develop capacity