How Shared Lives schemes are changing an 'all or nothing' approach to health and social care

Alex Fox OBE profile picture

26 September 2018

Alex Fox OBE
Chief Executive
Shared Lives Plus


Meg says, "My last hospital admission lasted four and a half years. I worked my hardest in therapy… found hope and became strong. It was time to leave hospital but no-one knew where I should go. I needed to feel part of something and genuinely cared for, away from a clinical setting. I didn't know how to live in the community as an adult. I was so scared."

As austerity bites deeper, our health and care system is increasingly 'all or nothing'. Too many people with mental ill health cannot get support in the community. But once outside of the community, the barriers to leaving the mental health system and returning to ordinary living, can also be higher. Meg had received successful medical care to recover from very significant and long term mental ill health, but clinicians did not have a plan for her to build a good life. Meg researched on the internet and found out about Shared Lives, which now supports 14,000 people across the UK, including hundreds with mental ill health.

Meg had received successful medical care to recover from very significant and long term mental ill health, but clinicians did not have a plan for her to build a good life. Meg researched on the internet and found out about Shared Lives, which now supports 14,000 people across the UK, including hundreds with mental ill health.

Alex Fox OBE    Chief Executive


Her local Shared Lives scheme introduced Meg to Hayley, an approved Shared Lives carer who had been carefully recruited and trained by the scheme. "Hayley taught me how to cook, shop and get around. She stood strong by my side, through mood swings, tears and frustration. We got through it. Now I work and I run a self harm support group in my town. I've been on adventures and made new friends. And in January, I moved into my own house."

Shared Lives is one of an emerging movement of community support approaches which focus as much on building community as support. These 'asset-based' approaches look for what people can do, or could do with the right help, not only for people's needs and problems. They try to see risk from the person's perspective, where living away from family and friends, or becoming isolated and lonely, might feel as significant as some risks which are more commonly assessed and pored over by medical services.

Shared Lives is one of an emerging movement of community support approaches which focus as much on building community as support.

Alex Fox OBE    Chief Executive


If we make people choose between formal medical support and informal social support, we may in effect ask them to choose between symptom reduction and real recovery. In my recent book, A new health and care system: escaping the invisible asylum, I argue that we need to build asset-based thinking into all long-term support services. To do that we need our services to measure their impact upon a person's wellbeing resilience, not just their mental health. This means being prepared to measure the negative impacts of our services as well as the positive ones, in order to get a more rounded picture of wellbeing impacts from the person's point of view. We need to challenge all of our support services to connect people wherever possible and to avoid disconnecting people. This will require new partnerships between the NHS and civil society, with charities not only seen as 'optional extra' providers, but as essential to co-designing a more effective system and services with communities, particularly those communities which are often overlooked.

I argue that we need to build asset-based thinking into all long-term support services. To do that we need our services to measure their impact upon a person's wellbeing resilience, not just their mental health.

Alex Fox OBE    Chief Executive


Our hard-pressed support services need more funding, but some of these changes can be achieved by using existing resources – including the resourcefulness of people, families and communities – differently. As Meg says, "More people need this chance. We need to see them as people with a future, instead of a risk."

 

Alex joins us on day one of our annual conference and exhibition this year to discuss who the NHS is for and to explore lessons from mental health services. To view the programme or to book your place visit the website.

About the author

Alex Fox OBE profile picture

Alex Fox OBE
Chief Executive

Alex is CEO of Shared Lives Plus, the UK network for shared lives and homeshare. He chairs the NHS England, Department of Health and Public Health England review of the voluntary, community and social enterprise sector, is vice chair of Think Local, Act Personal, and also sits on the NHSE empowering people and communities taskforce. He is an honorary senior fellow, Birmingham University, and trustee of the Social Care Institute for Excellence. Alex was awarded an OBE for services to social care.