Empowering Communities: UEA's Anchor Institute Role in Fostering ‘Curated Communities’ as part of an ICS

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 research, improvement and innovation capacity through embedded research, education and evaluation focussed on maximising sustainable initiatives for the Integrated Care System (ICS). There are no other models of Anchor Institutes that we know of working in this way, so an evaluation of activity and outcomes is underway to monitor and measure impact.

Approach: NICHE is working across an ICS with a geography of coastal, rural and isolated communities. Curated Communities is achieved through seeking to engage those who live and work in the ICS, coproducing meaningful outcomes relevant to local, national and international communities. NICHE inclusive approach draws upon key principles of Collaboration, Inclusion and active Participation (CIP). Our embedded programmes and funded research and evaluation offers improvements to the economic, health and social sustainability agendas, all of which form part of our Anchor Institute status.NICHE core objectives are to: : Improve health inequalities across rural and coastal communities2: Achieve workforce development and sustainable transformation3: Enhance system collaboration and transformation through effective partnership working4: Improve wellbeing and sustainable outcomes These objectives are mapped to our four workstreams which are: : Workforce Intelligence Network (WIN)2: Therapeutic Optimisation (THEO)3: Workforce Optimisation4: EvaluationAn integrated and inclusive governance structure includes a series of operational and strategic groups, who provide strategic oversight alongside local insights to ensure work is effectively using best evidence relevant to a wide group of people and partners across health and social care. Our commitment to shared governance is further reflected through a series of shared learning opportunities, (open to all) to maximise learning uptake across all workstreams and activity. Offering an open forum ensures learning is shared and transparent, maximising potential for innovation uptake and dissemination for all. Other communication with ICS partners is via a website, alternate monthly newsletter and an annual conference. Opportunities for international joint working, collaboration and learning are also emerging drawing on themes that have a shared synergy with our own.

Results and Emerging Themes: Evaluation of NICHE work is underway and will be fully reported in 2025. Within the first 8 months the following themes linked to curated communities are emerging:a) Caring for the workforce, through addressing wellbeing as a central aspect of workforce sustainability.b) Transformation requires new, flexible workforce roles - the importance of mentoring, coaching and effective supervision has a significant role in retaining staff.c) Creative arts engagement, heritage sites and inclusion of historical aspects are all important and often overlooked assets when working in rural, coastal and isolated communities.d) Co-produced, embedded packages as bespoke programmes of work, enhances and release talent and promotes local expertise are highly effective strategies for cultural transformation.e) Cultural transformation takes time, and 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

Implications: Whilst global health and social care challenges consist of similar in themes across different countries, when working with coastal, rural and isolated communities it is imperative to engage with local ICS partners, to curate cultural contextual wisdom across communities with people. Only then can traditional approaches be challenged effectively to initiate and sustain change for good.