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Posted by Mark Ravenhall on 11/10/2017 - 12:15

HOW COULD ADULT LEARNING HAVE A GREATER IMPACT ON OUR HEALTH?

As we have seen, there’s a wealth of evidence out there that adult learning has a positive impact on our health and well-being.  Such learning may be full-time or part-time.  It may be short-term or long-term, targeted or general.  It may be formal, or non-formal, or informal - or more along this continuum. 

So what are the best ways of taking this agenda forward?  Here are some areas for discussion:

 

1. Prescriptions for learning

Prescribing learning is not a new idea[1].  It sits within the concept of social prescribing, where health professionals refer people to leisure, learning, work and community services in order to help improve health and well-being.  However, its implementation is dependent upon a number of factors such as the availability of accessible adult education locally; knowledge of provision by health care professionals; information, advice and ongoing support for learners as well as access to wider services relating to, for example, housing or debt.  With the devolution of adult education funding to localities there is the opportunity to use prescriptions for learning as part of an integrated health, skills and employment offer. A recent report from the Work Foundation (2017) suggested:

A gainfully employed population will incur less health costs and social prescription can provide the means of achieving this.[2]

The Work Foundation report on Social Prescribing (2017) focused on the impact of this process on work. A long list of social prescriptions included: community education, arts, creativity, learning and exercise, self-help groups; reading groups; volunteering; sign-posting Information and Guidance; knit and natter clubs; supported learning and employment; sports of many kinds including gym, swimming, walking group and dancing and learning new skills.  All of these activities sit comfortably within the description of adult learning in all its diversity.  The report stated: ‘We found considerable potential for social prescribing to help clients to gain work, as part of the larger goal of improving health and wellbeing.’

A similar report, evaluating the Social Prescribing Initiative in Doncaster[3] indicated that, using the Doncaster Outcome Tool which embraced health, social connectedness and financial well-being, the Health-related Quality of Life increased by 48%.  Additionally, converting the Quality Adjusted Life Years (QALY), across the programme into finance, the value of the benefits gained amounted to £1.8m; the NHS uses a £20k threshold whereas the QALY threshold for Social Prescribing emerged as £2k.  The project cost £180k and offered 588 interventions at an average cost of £306.  For every £1 spent supporting vulnerable people, produced £10 return in benefits of better health.  Social Prescribing appears to be both beneficial and highly cost-effective.

 

2. An integrated, multidisciplinary approach

We have seen through our case study examples in Bromley by Bow and Rochdale that an approach that integrates learning across multi-disciplinary teams provides a model for replication.  This would require a rethink of services, at the local level, and some element of professional development for leaders and front-line staff.

A well-developed approach to integrated services is the Bromley By Bow Centre, a charity, where the focus is on offering services to vulnerable people, facing multiple challenges, based on three features of: accessibility; integrated services and long, slow journeys.  The Centre adopts a theory of change model with 5 basic steps: making connections; initial support; developing skills and confidence; preparing for work and moving on.  The programme of services are grouped under six headings: a) Community Connections, including language, digital inclusion, the arts and family learning; b) My Life, which focuses on health and incorporates social prescribing; day care, health and weight management and health advocacy; c) Advice including practical and financial needs of housing, rent, utilities and energy; d) Local People, Local Jobs: an employment service with a strong focus on young people with careers services; employability; job brokerage; women into work and enterprise; e) Capital Skills, upskilling the local community including health and social care; business administration; customer service; retail, leisure and hospitality services; f) Beyond Business which launches and nurtures new social enterprises.  The success of the centre’s integrated service delivery model is recognised locally, across the UK and internationally.

 

3. A person-centred curriculum

The most impactful adult learning interventions are those co-designed with learners to enhance the capabilities they already have.  This asset-based approach relates the learning outcome to issues that are relevant to the learner’s own life.  In terms of health and well-being, this might involve healthy eating classes, or an anti-bullying seminar, or targeted English lessons designed to help non-native speakers access and navigate the health service effectively. 

 

Have you seen the Health Capabilities as part of the Citizens' Curriuclum Approach?  See: http://www.learningandwork.org.uk/wp-content/uploads/2017/01/Health-Capa...

 

ARE THESE THE RIGHT SOLUTIONS?

 

WHAT ARE YOUR IDEAS?


[1] James, K. (2001).  Prescribing Learning: a guide to good practice in learning and health, NIACE, Leicester, UK.

[3]  Sheffield Hallam University, 2016, Evaluation of Doncaster Social Prescribing Service: understanding outcomes and impact: http://www.syha.co.uk/wp-content/uploads/2017/01/Evaluation-of-Doncaster-Social-Prescribing-Service-Final-Report-.pdf (accessed 12.09.17)