Igniting Sustainable Place Based Innovation within Integrated Care

Background: The Norfolk Initiative for Coastal and Rural Health Equalities (NICHE) is one of six ‘Anchor Institutes’ , funded by NHS England (East of England). Based at the University of East Anglia, NICHE aims to co-create a healthy place to live and work, underpinned by collaborative and innovative approaches to building embedded research, improvement and innovation capacity whilst  maximising sustainable initiatives for the Integrated Care System (ICS).

Approach: NICHE is working across an ICS made-up of three ‘Place’ localities with a geography of coastal and rural communities. We aim through embedded, participatory approaches to engage people and communities, coproducing meaningful outcomes relevant to local, national and international contexts. NICHE’s approach draws upon key principles of Collaboration, Inclusion and active Participation (CIP). Our embedded funded programmes of learning, research and evaluation offer significant opportunities for ICS development.

NICHE core objectives are to:

1: Improve health inequalities across rural and coastal communities

2: Achieve workforce development and sustainable transformation

3: Enhance system collaboration and transformation through effective partnership working

4: Improve wellbeing and sustainable outcomes

These objectives are mapped to our four workstreams which are:

1: Workforce Intelligence Network (WIN)

2: Therapeutic Optimisation (THEO)

3: Workforce Optimisation

4: Evaluation

This presentation will focus on Workstream 3 (Workforce Optimisation) that is based within ‘Place’. We will present the programmes of embedded research, evaluation and learning activity that is impacting on the development of the ICS across the three Place based localities in Norfolk by drawing on the ‘voices’ of participant through embedded learning. Examples will be drawn from:

• Embedded NICHE Fellowships stretching across the lifespan of ageing
• ‘Kintsugi’ and ‘Mini Kintsugi’ Embedded Research and Programme Evaluations

 

Results and Emerging Themes: Evaluation of NICHE work is underway and will be fully reported towards the end of 2025. Within the first 18 months of Place funded embedded projects across the Norfolk and Waveney ICS the following themes are emerging:

1. a) Working with and through system complexity, by navigating changing, new and emergent ICS landscapes and structures.
2. b) Embedded Transformation requires new approaches to authentic collaboration and joint working.
3. c) Creative arts engagement, heritage and inclusion of historical aspects are all important and often overlooked assets when working in rural, coastal and isolated communities.
4. d) Co-produced, embedded programmes of work, enhances talent release and promotes local expertise which are highly effective strategies for cultural ICS transformation.
5. e) Cultural transformation cannot be rushed as new language, partnerships and interactions are formed. When based on the principles of CIP these can be built, based on trust, commitment and release of energy required to engage and sustain embedded transformation across complex, changing ICS’s.
6. f) Shared Values and beliefs are key to authentic relationships based on the key principles of reciprocity, shared power, trust and learning.

Implications: Whilst global health and social care challenges consist of similar themes across different countries, when working with coastal, rural and isolated communities it is imperative to engage local ICS partners, to curate cultural contextual wisdom across ‘Place’ with communities and people.