Innovation: Neighbourhood Coach (Social GP) programme
Netherlands
AAI Domain: Independent, healthy and secure living (physical safety, independent living, access to health services)
There is strong evidence that how long and well people will live is influenced by the social conditions into which people are born, grow and live over the whole of their life course. Those people who experience relative individual and household deprivation and experience the numerous facets of social exclusion often live in neighbourhoods that are also relatively deprived.
There have been countless urban regeneration initiatives in the Netherlands and other EU member states but the problems of relative deprivation, social exclusion and resulting health inequalities still means that some people lead shorter and less healthy lives than their more affluent fellow citizens. In affluent states with highly developed systems of welfare provision there are still persistent problems of social exclusion that prevent equitable active ageing to occur despite significant levels of social expenditure.
An innovative approach to improving how well people live over the life course that went beyond the traditional approaches of improving the physical infrastructure or seeking to create a more resilient social environment is the Neighbourhood Coach (or Social GP) model that has been operating in Velve-Lindenhof neighbourhood of the Dutch city of Enschede since 2009. Velve-Lindenhof was identified as one of the 40 most deprived areas in the Netherlands in 2008 and as part of a national initiative to address social exclusion and urban regeneration.
These areas were assigned extra resources to develop innovative solutions to seemingly intractable problems of urban deprivation and the effects that this had on the health and well-being of people in these local areas. The solution, adopted for approximately 600 residents of all ages in Velve-Lindenhof, consisted of a home visits programme involving teams of social workers, police officers and employment officers to try to detect emerging problems by engaging with local residents.
An agreement was also made by local social welfare and public service organisations to provide a more integrated approach to the people and place of Velve-Lindenhof. This combination of factors underpinned the development of Neighbourhood Coaches who aim to supersede the array of professionals that people often have to deal with (or not if they slip through the safety net) and who can be highly paternalistic and may even create dependency.
The ethos of Neighbourhood Coaches is ‘one professional, one plan of action, one system’ and was based on working collaboratively with people and empowering them to be independent and take charge of their lives. The 25 organisations that provided a range of public services – housing, health, social welfare, employment and so on – agreed to empower the Neighbourhood Coaches to take decisions while they maintained formal powers and responsibilities.
A more open and participative local political context assisted in making this intervention more acceptable and the four coaches came from different local service organisations rather than being employees of the municipality. The coaches could call on specialist professionals if needed but they developed plans with individual and small area strategies for localities while calling on resources from a multiplicity of agencies.
The programme was process evaluated by researchers who found that most participants viewed the intervention in a favourable fashion and showed indications of promise. Neighbourhood Coaches can play an important role in personalising wider urban regeneration programmes so that they make a difference to people’s lives by working with the people living in the area.
In relation to active ageing, the Neighbourhood Coaches programme provides opportunities for independent living and physical safety in a locality which was affected by crime and fear of crime. It also provided improved access to health and other services that should contribute to people in the neighbourhood, empowering them to improve their own situation and that of the locality.
This pilot project covered just a small area and enjoyed the benefits of additional resources to make a difference to the quality of life of people and the social quality of the area by developing ideas and solutions together. Whether it has sustained effects and can be used on a larger scale, as it has subsequently across Enschede although with fewer resources, has yet to be determined but it does provide a promising model.