Enhancing Wellbeing Report by Centre for Environmental Change and Human Resilience

School of the Environment, University of Dundee

Enhancing wellbeing: inclusive, community collaborative approaches to place making Centre for Environmental Change and Human Resilience (CECHR) and The Geddes Institute for Urban Research (Symposium 5) A report on the Symposium proceedings by Husam AlWaer, Ioan Fazey, Beverley Searle (University of Dundee), Eric Dawson (PAS/ Architecture and Design Scotland), and Ian Cooper (Eclipse Research Consultants) June 2015

Introduction The University of Dundee Centre for Environmental Change and Human Resilience and Geddes Institute for Urban Research held a Symposium with partners on 15 May 2015 on ‘Enhancing wellbeing: inclusive, community collaborative approaches to place making’ to develop wider public understanding of the contribution that community collaborative approaches to place making can make to well-being. This report summarises the key themes explored during the event which developed and built upon four earlier symposia. Summary reports are available for these events at: Masterplanning in current conditions; The Practice of Community Charrettes Design in the UK; Creating sustainable communities – better approaches to masterplanning practice; Professions, Place-Making and the Public. This report is organised in four sections: the first sets out the background to the event; the second summarises the key issues and questions raised by the speakers; the third explores the collected views of participants working together in groups; and the fourth reflects on these and draws conclusions. A video of the symposium is available at: https://youtu.be/OBIXvfcrBmo?list=PLydAjKLQIfcFbfHQgqfYxLTMNWY4XbFv1

1. Background Attitudes to well-being are beginning to change, both within government and society, with a shift away from the idea that a flourishing life is primarily connected to material prosperity towards one that positions well-being as a significant goal for public policy. This shift is being accompanied by a commitment to empower local communities, unlocking social capital and giving individuals greater voice in the processes of place making that determine the quality and direction of their lives. Together, these changes provide opportunities to secure healthier life styles, safeguard ecologicalintegrity, promote greater equity and support more resilient places in the low carbon future. UK and Scottish Governments have supported initiatives that champion new approaches to maximize the potential of the physical and social environment in supporting health, wellbeing and a high quality of life. Achieving this involves the public, professionals and other stakeholders working together to shape future plans for their area. Inclusive, collaborative and community approaches are used: to help stimulate discussion of place-based issues; to promote thinking about community values; and to allow consideration of the ways in which assets can be best utilised. The focus is on delivering long-term outcomes and on aligning the processes for place making and implementing well-being initiatives. There is an emergent acknowledgement that the need for well-being oriented outcomes should be outlined, promoted and accepted. This needs to be accompanied by examination of the underlying process if the use of community collaborative approaches are going to lead to quality of place outcomes and well being. The symposium explored how to fill the gap between the theory and practice of well-being and place-making. It considered how to embed and deliver sustainable outcomes within collaborative community-based approaches and address ‘hang-over’ effects whereby members of the community are left confused as to how their participation ‘follows through’ into the plan making process. It also questioned whether professional practice needs be transformed to deliver more effective well-being oriented outcomes.

This symposium was used as a platform to explore the relationship between communities, wellbeing and place making and the use of place-based empowerment to deliver well-being and quality of place outcomes. In so doing it sought to identify of what does and does not work in practice. The symposium was structured around the themes of place making for well-being, community collaborative-based approaches, and implementation roles and responsibilities. Key questions posed were: 1. Can community collaborative-based approaches help promote community well-being outcomes? If so, what processes are most suitable for achieving well-being oriented outcomes? And to what extent should process be seen as an end itself? And, if not, is well-being more correctly tackled directly in other ways, through more appropriate, more powerful, political processes? 2. What evidence is there of an emerging consensus, expressed through changes in professional practice, that community well-being outcomes requires more than just adding a few extra criteria to an already extensive list of project requirements? 3. What new knowledge and skills are needed within the core professions to champion place making for well-being, and within the collaborative community based approaches?

2. Summary of Speaker Presentations Delegates were welcomed to the university and the symposium by Beverley Searle and Husam AlWaer. A series of presentations were then delivered by speakers with a diverse range of expertise, including social sustainability, health and wellbeing, urban design, architecture and planning, Professor Ioan Fazey, University of Dundee: Processes and well-being – ‘finding common ground’. Mr Sandy Robinson, Scottish Government: Delivering wellbeing oriented outcomes - Knowledge / Dialogue / Place. Dr Rory Mitchell, NHS Health Scotland: ‘Good Places Better Health’. Professor Kevin Murray, Glasgow University: ‘The Collaborative Community Approaches – Learning from what has worked’ Mr. Eric Dawson of PAS (formerly Planning Aid Scotland): ‘inclusive, community collaborative approaches to place making’

Prof Ioan Fazey, University of Dundee, opened with a provocation on ‘Processes and well-being – finding common ground’ and noted that ‘wellbeing’ encompasses: economic dimension where money is important (income), sociological dimension including finding comfort from having food, water etc. and the psychological dimension relating to inequalities and self esteem (happiness, self esteem, ability to flourish, etc). Wellbeing is not just an end goal, however, it is also a process which has a long term horizon. That wellbeing is both an end goal and a process over time needs to recognised and balanced. This was illustrated in the 1960/70s ‘green revolution’ in India which used a mix of science, technology and pricing structures to reduce food importation and sustain the population. Although the outcome was ‘successful’ (grain imports reduced), a process intended to achieve ‘trickle down benefits’

resulted in increased poverty and landlessness of the poor and a dramatic increase in inequality! The way a process operates (how it is done) is important. Arnstein’s ladder of participation describes eight different stages of engagement, from manipulation to citizen control; it is only through higher levels of participation that greater learning is achieved which builds self belief and capacity. Criticisms of participation processes include:    

They privilege the public domain with some groups more likely than others to be heard; They support localism (local solutions to problems)– but this may not always be good (e.g. when a more ‘strategic approach’ may be required); power is often held by the facilitating organisations and they take decisions; They can raise expectations that can’t be easily met which is damaging and leads to mistrust.

Such considerations were evident in the 1980s India Employment Assurance Scheme which aimed to empower poorer communities through a grass roots demand-led programme designed to enable self-selected poor to demand employment. Although poor people participated, in reality they were excluded through lack of knowledge and power. Poor people were more likely to be passive in meetings and the middlemen played down the demand led aspect and would not challenge others. Good intentions were undermined by prejudice, social exclusion and insecure livelihoods. What was required was a fundamental change in power relationships. The success of collaborative inclusive approaches depends on how participation is perceived: 1- if the process is a means to an end it is likely to misunderstand power relations – enhancing the efficiency of the process so as to get a better outcome such as a hospital but without challenging existing power relations; 2- if the process is an end in itself it is more likely to empower communities to make decisions and take control – empowering those involved to make better or different decisions – choosing a new school rather than a new hospital. This challenges the relationship between state and communities.

In Scotland we are seeing a shift. An example is the Scottish Borders Resilient Communities initiative that is seeking to make communities more resilient to climate change. What is important is that the council are stepping out of their local authority role and are working collaboratively with local communities to set a new agenda. Ioan concluded with a series of observations:  Is participation a process or a goal?  Is participation a means to an end or an end in itself?  How does empowerment contribute to wellbeing?  Can wider (e.g. environmental) goals be achieved through participation?  Is placemaking any different from other public policy processes?  How can empowerment be achieved in collaboration between local authorities and communities? Sandy Robinson of the Scottish Government spoke of a link between high-level strategic objectives and wellbeing by referring to the Scottish Government Programme for Government that focuses on prosperity (through Sustainable Economic Growth), fairness (reducing inequalies) and participation (passing power to people and communities). This invites a policy development approach that is:  Person centred – focussed on enhancing quality of life  Asset based – services, people, built fabric, natural environment  Focussed on Co-production – involving people in the design of services A strong link between placemaking and wellbeing is clear from the influence that the physical environment has on lifestyle patterns and in particular on people’s propensity to be active in their daily lives. Physical inactivity is the fourth leading risk factor for global mortality and evidence suggests that 20% of the population walk for 20 minutes or more only once a year, or never. Estimates put the cost of obesity to Scotland in 2030 at up to £3 billion. In negative circumstances, potential assets can become deficits where the poor quality of an environment can contribute to deprivation, stigmatise communities and inhibit growth and investment. Experiential considerations are important and, in addition to physical activity, evidence suggest that how you feel as an individual matters to health outcomes. Research has shown that a sense of coherence and an ability to make sense of the world is extremely important. Antonowski described that people’s ability

to relate to their environments needs to be comprehensible, manageable and meaningful; their world needs to make sense. A lack of control and meaning can lead to an increase in chrionic stress, which is linked to early mortality. This research been promoted by Sir Harry Burns, the former Scottish Government Chief Medical Officer, when speaking about ‘salutogenesis’ as a need to create conditions that enable people to live in a healthy way. This suggest an opportunity for processes that encourage co-production of the design and delivery of services - where people have influence over decisions that affect their lives - to contribute to positive health outcomes. Sandy described the Scottish Government charrette programme that promotes interactive design workshops where the public work with design teams to make decisions together and generate a masterplan. Charrettes were described not as a consultation process that involves design, but rather as an active design process that is consultative. Traditional consultation processes, where plans, often developed in relative isolation, are presented for comment, can lead to a negative reactions from communities. The negative impact of ‘silo working’, where individual policy, legal or regulation issues are considered in isolation also has the potential to degrade the quality of proposals. A focus on collaboration and integrated working practices can allow decision making to be better informed and focussed on the quality of the overall outcome and impact of a development. In this way, the charrette process is not about asking people what they want, but about asking people what they know; it is not about the collection of facts, but the application of knowledge and the building of relationships. The charrette process involves setting up an on-site design studios where a specialist design team engages with the community, public agencies and the development sector over a short number of days. The focus is on identifying the real and potential assets of a place and harnessing the knowledge of local communities. The charrette process is typically comprised of site walking tours; community and stakeholder workshops to identify issues; design sessions with attendees encouraged to contribute ideas to emerging proposals; the presentation of ideas and feedback from the community and; refinement of proposals through a cycle of iterative working. Charrettes are focussed on producing graphic material, particularly sketches and 3D visualisations that are accessible to communities. . Through the intensive collaborative working process, charrettes can also create new networks and relationships, involve local people in delivering outcomes, and potentially link community planning processes with spatial planning. A focus is on the design process as a mechanism to involve communities at an early stage in the development of plans and to harness important local knowledge. Importantly, design is not the output; it is the process. Criticism of charrettes is sometimes levelled at the potential for the process to raise community expectations and fail to deliver on the consensus generated through the process. There remains a need to focus on the delivery of charrette outcomes and to make this happen there is a need for effective collaboration across the public and private sectors and opportunities for communities to be

directly involved in taking projects forward. Improving the design process can produce healthier places but is the process of bringing people together to design their place important too? Are we missing the potential of collaborative processes to creating healthy environments? Sandy finished by quoting Michelangelo: “the greatest danger is not that we aim too high and miss... but that we aim too low and reach it”.

Dr Rory Mitchell, NHS Scotland, referred to the 1948 World Health Organisation’s definition of Health and Wellbeing as ‘a state of complete physical mental and social wellbeing and not merely absence of disease or infirmity’. This advocates a more proactive dynamic approach to wellbeing. He stressed Scotland’s challenge in confronting the stark contrast between the most and least deprived communities. For example, there is evidence of health inequality on a spatial basis as illustrated on a ‘tubemap’ of Glasgow where male life expectancy rises as you travel between areas. There is also evidence that children living in areas of disadvantage have poorer health. Health inequalities arise from a causal chain resulting from an unequal distribution of power, money and resources. These in turn influence the shape of the physical environment and the ability to be participate in decision making. Issues of ‘place’ expose massive inequality and a need to focus on and work with communities. This links with Community Empowerment, and the Christie Commission review.

The development of a Place Standard (jointly led by Scottish Government, NHS Scotland and Architecture and Design Scotland) is a tangible example of how this challenge is being addressed. The project came from the Good Places Better Health, and the Creating Places policy documents, and is intended to provide a framework to structure conversations and support communities to work with others to deliver high quality places.

The standard seeks to capture peoples’ experiences of place covering a range of issues such as walkability, attractiveness, etc. A set of 14 themes has been identified, framed as questions and the responses are recorded in a spider diagram. Example questions: Am I able to participate in making my neighbourhood as good as it can be? Does my neighbourhood have a positive identity? The place standard is currently out to consultation. It is anticipated that there will be multiple conversations about the same place over time. These can be summarised in a spider diagram that provides a visual assessment of a place and shows how peoples’ views change over time. The diagrams are quick to create and can give an impression of where priorities for change might lie. Rory’s conclusions included:  Enhancing wellbeing and tackling health inequalities are part of the same agenda  Community collaboration has an important role to play, as part of an integrated approach to action on the causal chain leading to health inequalities  Inclusion and representativeness are key factors  An ongoing process of learning and sharing is required to maximise the impact of actions that communities and professionals take together  The Place Standard for Scotland provides a major opportunity to push this agenda forward. Professor Kevin Murray, Glasgow University / Kevin Murray Associates, presented on ‘Collaborative Community Approaches – Learning from what has worked’ and noted that health and wellbeing is a longstanding part of a philosophy of town planning which emanated from public health improvements. The way towns have been planned has changed with different approaches to housing – from tenements, to high rise flats, to today’s estates. As density is reduced, areas lose local facilities such as schools and shops. We find this not only in Scotland but elsewhere in Europe too, for example Paris. Antonowski – put forward the term ‘salutogeneis’ as an approach to supporting health and wellbeing through developing coping strategies. He argued that certain characteristics contribute to people’s sense of wellbeing, namely comprehensibility, manageability and meaningfulness. This can be applied to place making; both plans and the process of creating them. Without dialogue it is difficult to build an engaged, informed society.

Dialogue and discourse are important to build an engaged and informed society. Society is becoming more complex (e.g. eldery / demographics) and tends to operate in policy and delivery silos (budgets) that see things in different ways. In current practice a range of different techniques are being used that include (inspired by Carl Jung) active imagination collaborative approaches to placemaking. Kevin made reference to the Maslow hierarchy of needs as a way of understanding the differences between communities. Frieberg in Germany have now mainstreamed eco approaches; However, eco greens have now become NIMBYs. Carl Jung techniques – employing active imagination – utilise tools which encourage adults to play and collaborate. Allowing individuals to take different roles and seeing different perspectives. Scotland is taking a progressive approach generally, influenced by key people but a default position is often taken to planning and design. How adequate is this response? 1. There needs to be a clear vision and goals and this can be generated in different ways, perhaps the simplest of which is by using post its to gather ideas. The key to this approach however, is who turns up. Efforts need to be made to reach out to those who do not attend, to encourage them to tell their stories. 2. Review and testing. This includes business and development review, as well as community, often through the use of interactive workshops. Different groups can come up with different perspectives. 3. Delivery, consensus around what has to happen next. The need for Communities to appreciate the wider perspective is addressed through different stages: (1) Listening; (2) Testing / buy-in; (3) Endorsement; (4) Advocate / promote. This is informed by a clear vision and goals. Storytelling is an important part of the narrative development that reviews and tests ideas against diverse functions of a community. It is also important to focus on delivery: who does what?

Kevin referred to 5 case studies that have used charrette type models: 1. Glasgow City Vision – working with different groups using diverse techniques, one technique explored what the ‘colour’ of the city might be, and captured feedback in visual ways, e.g. through a wordle. 2. Grandhome – community nervousness about loss of green fields / belt for housing was explored through a process of drawing; this ‘form of therapy’ used design as a dialogue tool; a continuing intelligence process to understand what the future might look like. 3. Port Dundas – a lack of an existing community invited the use of role play to question what people might want. The process explored the potential of what might be (contrasting a

former canal with a white water canoe centre facility) moving from now/existing to what might be (future sustainable uses and a positive identity), sometimes through a series of temporary uses. Through progressive discussion and review the final outcome was not a detailed masterplan but a framework of ideas. 4. Woodside, Firhill, Hamiltonhill charrette involved artists to capture cross community engagement, and children’s views about possible futures for that section of the canal. 5. Aberdeen city centre masterplan involved a number of stages including: Workshops; Youth engagement; Exhibitions; Outreach activity; Feedback questionnaires. Workshops generated the highest level of knowledge and support; city talks were the next highest; exhibitions were next; and online feedback prompted lower levels (and more critical) feedback and support. So two way flows or knowledge are very important. In conclusion, collaborative design helps to achieve health and wellbeing through a form of therapy that helps to deal with coping with change as managed evolution. 1. 2. 3. 4. 5. 6.

Better health and wellbeing Better mix of perspectives, activity, uses Safety and wellbeing Engaged, representative society Long-term placemaking Form of therapeutic intelligence

Mr. Eric Dawson of PAS (formerly Planning Aid Scotland) noted that ‘inclusive, community collaborative approaches to place making’ lies at the heart of what PAS does, evident in strategic aims:

This is particularly important in a Scottish context that seeks alignment of spatial planning, community planning and community empowerment, where ‘place’ is central to making policy ambitions meaningful. As an independent, impartial organisation supported by a network of volunteers PAS promotes ‘inclusive, community collaborative approaches’ through providing advice, education, training, and place facilitation. PAS’s role in inclusive placemaking was illustrated through a variety of projects and activities, including:

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 

Youth engagement across ages and contexts (IMBY / primary school age; YEP / secondary school age; Young Placemakers / school to university graduates; European Youth Exchange programmes; and specific projects: e.g. Place Work Folk brought together young and elderly groups to learn about their place) Meaningfully engaging seldom heard communities in decision making processes; e.g. working with gypsy travellers The SP=EED programme (successful planning = effective engagement and delivery) which recognises different forms of engagement (informing, consulting, partnership) and identifies 8 criteria for effective engagement (transparency & integrity; co-ordination; information; appropriateness; responsiveness; inclusiveness; monitoring & evaluation; and learning & sharing) Community led placemaking activities (e.g. Isle of Rum) The Charretteplus programme works with communities to develop an action plan and link spatial and community planning (e.g. Levenmouth, Dunblane)

These types of activities need to be embedded as part of ‘the norm’ to engage communities in collaborative participative placemaking that considers longer term outcomes and builds social capital. In a Q+A session Chaired by Dr Beverley Searle the presenters considered a range of discussion points including:  Frustrations people experience around being able to participate (e.g. how to initiate participation? accessing funding, etc)  The need to develop capacities to follow through to delivery; aligning ‘silo’ budgets; skill sets  A need to shift power relationships; achieving fair and just outcomes; unlocking social capital  Scotland’s unique opportunity (and urgent need?) to make this happen  Linear and non-linear processes and techniques; backcasting: where do you want to be? How do we get there?  How to measure wellbeing – quantitative/objective and qualitative/experiential measures  There is too much policy! Stop reinventing the wheel; link with others already engaged in these areas (e.g. community learning/education programmes)  The link with and role for academia/research – knowledge from practice  The challenge of working between ‘bottom-up’ / local drivers and wider strategic aims e.g. environmental justice – informing decision making processes; short-term v longer term issues  The importance of building trust  A contested area: can’t force consensus – agree themes and principles about outcomes  A need for cross professional/discipline working; bring things together; see bigger picture + work at fine detail level; hands-on learning; more CPD; shared learning.

Section 3: Group discussions Following lunch, a facilitated discussion in breakout groups led by Dr Ian Cooper of Eclipse Research, Dr Husam Al Waer and Professor Ioan Fazey considered responses to three prompts and gathered feedback in a final plenary session. Participants in the Wellbeing Symposium were asked to discuss three previously circulated questions, in eight small, mixed groups: 1. 2. 3.

What is happening now? (What is the current state of play in delivering wellbeing?) What needs improving (in how wellbeing is being delivered)? What do you want to happen next (to improve how wellbeing is being delivered)?

In their title for the symposium, the organisers gave prominence to six issues –wellbeing, inclusion, community, collaboration, place making and approach. Overall, in their group discussions, participants did not completely reflect these emphases. Instead they gave primary attention to just two of these: ‘wellbeing’ and ‘community’. Figure 1 combines all of the eight groups’ responses, across all three questions, shown as a Tag Crowd (Tagcrowd.com). What the large number of issues recorded here illustrates is the wide range of perspectives and opinions expressed during the group discussions, presumably reflecting the diverse backgrounds of those who took part in the symposium (see Section 4). Over-arching concerns Figure 1 shows the over-arching concerns that lay behind the participants’ responses to all the three questions posed (archived in Appendix 1). Gauged by frequency of mention, they shared a clear set of priorities: first, wellbeing followed by community; then a secondary emphasis on the social, local, people, (short/long) term, along with approach and (what) works. In turn, behind these most frequently mentioned issues stand a secondary set of concerns about better and different delivery, improving engagement, integration and links, and policy, resources, health and outcomes.

Figure 1. The overall priorities given to issues as reported by the discussion groups

Question 1. What is the current state of play in delivering wellbeing

Figure 2 shows the eight groups’ combined responses to this question, as a Tag Crowd. Here there are fewer frequently mentioned issues than shown in Figure 1 and those that were most frequently mentioned differ only slightly, with equal emphasis being given to planning and health. Stringing these emphasised issues together suggests that participants think what is currently Figure 2. The priority given to issues in response Question 1 happening is: There is, as far as local community well-being is concerned, a lack of links between sectors in the delivery of health, social care and planning, and between policy and projects. There needs to be a Focus on different (forms of) delivery that work. This interpretation is reflected in what individual groups reported back as their key issues during the feedback session. One group called, for instance, for “joined up decision-making about urban spatial planning and lifestyles” while another reported a “lack of coherence and understand across different sectors (structural deficiencies) along with lack of exemplary projects on the ground”. One group pointed to beyond planning to “preventative and proactive work by NHS and another to the Scottish Government’s GIRFEC policy (Getting it Right for Every Child) and “its common understanding and priorities”, see (http://www.gov.scot/Topics/People /Young-People/gettingitright). One of the groups reported that there was good alignment between policies in Scotland “informed by good principles, moving in the same direction but often not integrated”. Another group summarised its discussion as “A lot happening but not connected, policy lost as trickle down, ‘contrary to what it is professing’ … And Bits and Bobs [but with] little evidence to show delivery of long lasting wellbeing”. While another added “To target well-being you have to tackle INEQUALITY” – a theme echoed on multiple occasions by groups at various times in their discussions (see Appendix 1).

Question 2. What needs improving in how wellbeing is being delivered? In comparison to Figure 2, the responses to question 2 (Figure 3) suggests a change in emphasis. In relation to what now needs to be improved, participants wanted more attention to the delivery of community engagement. Stringing the issues emphasised in this figure together suggests that what participants were seeking is: A stronger focus on communities themselves and the integration of people into longer term processes for the delivery of wellbeing. Figure 3. The priority given to issues in response Question 2

This interpretation is reflected in what individual groups reported back as their key issues during the feedback session. One group asked for “Need for a common understanding of wellbeing, identifying the real problems in the community through longitudinal analysis”. Another wanted “Improving delivery: reaching out to different groups in their own language and media for better (inclusive) solutions “, while another sought “Longer term, collaborative approaches (linked to secure funding) to make community involvement and wellbeing promotion part of everyone’s business.” And another called for an “Integrated approach – organisation, programme and information”. One of the eight groups summarised its discussion of Question 2 by calling for a “Redistribution of access to resources and organisation of democracy: smaller communities and democratic organisation sizes” linked to “Freedom to express aspirational ideas and thinking”. Question 3. What do you want to happen next to improve the delivery of wellbeing? A comparison of the cloud representations for Question 3 (Figure 4) with those for Questions 1 and 2 is revealing. Whilst Figures 2 and 3 suggest that there was a reasonable level of agreement about the current state of the art of delivering wellbeing and about what needs to improve, Figure 4 indicates that there was less agreement about what needs to be done next. Perhaps this too reflects the diverse background and perspectives of those who took part in the symposium. As a result, stringing together the issues emphasised in this figure coherently is much more difficult. Multiple interpretations are possible. What follows is only one possible version: Community wellbeing requires a local action-based approach that requires improved evidence, knowledge and resources. Community capacity building, investment and measurement of outcomes Figure 4. The priority given to issues in response Question 3 will also be needed. There is support for this interpretation in what groups reported back as their key issues in the feedback session. One group prioritised “Translating policies into measurable actions – improved wellbeing by private and public actors at local level.” Another pointed to “Dedicated resources in place (non-elected place-making champion) to ensure an emphasis on people living and working in same place: collective wellbeing arising from shared vested interest.” While others called for “Knowledge into Action – developing and sharing evidence base across the wider system”, “Local investment – community capacity building, social enterprise and breaking down barriers”, and “Integration of approaches at lower levels – consistency, resources, leadership”. One of the eight

groups summarised its discussion by asking for “Land management changes to capture value” along with “Qualitative approaches to measure the quality of places – what matters to people?”, and a plea for “Consultation not an outcome – not falling off a cliff at the end – but a continuous process”.

Section 4: Individual responses During the symposium, participants were requested to respond to three questions posed in a proforma provided in their delegates pack. 1. Is there evidence that, in practice, collaborative community-based approaches do help to promote community well-being outcomes? 2. What evidence is there of an emerging consensus, evident from changes in professional practice, about the process needed to deliver wellbeing outcomes? 3. Do you think new professional knowledge and skills are needed for delivering place-making for wellbeing, using collaborative community-based approaches? Participants were requested to answer these questions drawing on their own experience and on the presentations made at the symposium during the morning session. Forty five symposium participants completed and returned the pro-forma. Combined responses as shown in Figure 5 (see Appendix 2). Most of the issues illustrated in Figure 5 were also raised during the group discussions, see Section 3, Figure 1. But there were new priorities signalled by these individual responses, shown highlighted above in yellow. This suggests that one shared concern at the symposium, expressed through the individual responses, was about the skills required to deliver wellbeing. This interpretation is borne out by what individuals said (see below and Appendix 2). And, compared to the responses generated in the group discussions, overall greater emphasis was placed in the individual responses on evidence and health, and on professionals themselves. A third (n=15) of participants chose not to disclose their occupation. Almost as many (n=13) who did, identified themselves as planners. Half as many (n=6) were Figure 5. Issues raised from pro-formas (n = 45, frequency threshold = >5) academics. Three held healthrelated posts, two each worked in the third sector, in heritage, or as surveyors or consultants. Taken in aggregate, those who didn’t disclose their occupations put less stress on community in their individual responses (see Figure 6). In addition, they emphasised only a fairly limited number of issues which illustrate a shared a concern about evidence of what works in approaches where people collaborate on wellbeing.

Figure 6. Issues raised from pro-formas; non-disclosure of occupation (n = 15, frequency threshold = >3)

In aggregate, academics displayed even fewer shared concerns, pointing surprisingly not to evidence but to the skills required if people are to be involved community-based processes (Figure 7).

Figure 7. Issues raised from pro-formas; academics (n = 6, frequency threshold = >3)

In aggregate, planners showed much less consensus than other occupational groups, emphasising instead a much wider range of frequently mentioned concerns (see Figure 8). Like the academics, they placed most emphasis on skills and on understanding, and then on themselves as development professionals delivering changes in wellbeing through charrettes. Only three of the participants identified themselves as holding health-related posts although it is clear from the attendance list and from the types of comments made (see Appendix 2) – that some of those who did not disclose their occupations also worked in the health sector. Figure 9 indicates that the three participants who did identify themselves as working in the health sector shared a concern focused on the evidence available about community collaboration on health. Figure 8. Issues raised from pro-formas; planners (n = 13, frequency threshold = >3)

Figure 9. Issues raised from pro-formas; health sector (n = 3, frequency threshold = >3)

Question 1. Is there evidence that, in practice, collaborative community-based approaches do help to promote community wellbeing outcomes? (Table 1) Yes

Yes and No

Don’t know

Yes but

No response

Table 1.

A large majority of the participants thought that there is evidence that collaborative communitybased approaches do help to promote community well-being outcomes. More than four fifths of them (n=39) responded positively to this question. But a third of these (n=13) sought to qualify this by making ‘Yes but ….’ or ‘Yes and No’ statements. Only a tiny minority (n=3) thought that there was no evidence that this was happening and a similarly small minority (n=4) didn’t know. However, few of the participants gave concrete examples of what they took to be the nature of this evidence. Most either cited generic processes – community engagement, partnership working, inclusive participation or joined up policy making/implementation – or offered their own formulations for what they thought should be happening, e.g: “Need to engage with seldom heard groups …. Need to develop ways to ensure community inclusion. (Informal gatherings, need to informalise process to break down barriers.”

“Collaborative approaches always seek to know what people know and want. So the outcomes of [a] process based on these approaches ‘should’ meet the aspirations of people, in spatial planning, planning and designing places. Asking and reviewing what people thought will ‘theoretically’ end up with a design that people will feel happy to live in and that will enhance their wellbeing.” Where participants were more concrete, they tended to point to particular policy initiatives: • Good Places, Better Health • the Place Standard • Creating Places, • Getting it Right for Every Child • Community Learning in Health and Social Care • Health and Social Care Partnerships • Healthy Sustainable Neighbourhood Model • Healthy Community Collaborators in Perth and Kinross • Equally Well in Dundee. Significantly, each of these initiatives was identified by only one participant – signposting that those who attended the symposium appeared not to have come with a pre-exisiting ‘shared’ evidence base for wellbeing initiatives. Some participants also draw attention to charrettes, both in themselves and to their consequences, e.g.: “Charrette reports are leading to community planning [which] is becoming real statutory planning. Heilston Charter followed by charrette is now SPG in Local Plan.” But, in all of their allusions above to evidence about the promotion of wellbeing outcomes, there was a lack of references to place-specific (back-end) evaluations demonstrating what any of these initiatives have actually delivered in practice. Figure 10 shows all of the participants’ responses to Question 1. This would appear to suggest a simple story. Charrettes emerge as the main shared source of evidence that local people are being collaboratively engaged in the planning of health and wellbeing. Figure 10. Issues raised in response to Q1 (n = 45, frequency threshold = >5)

Given the range of initiatives cited above by individual participants, this shared story is may be accurate but it fails to capture the wide spread of initiatives identified – because each of these was only cited by one participant. As intended, the symposium played a role in sharing these. As one participant noted, referring back to those who spoke during the symposium’s morning session: “There are examples from practice and research in health and in planning that wellbeing can be improved if people affected are involved in the solutions” even if chapter and verse for hard evidence for this happening in Scotland was not presented. Other participants were more sceptical, e.g.: “Little evidence of delivery of long lasting wellbeing – bits and bobs going on”

“Evidence from case studies e.g. charrettes. But this evidence seems fairly limited, e.g. no long term studies to demonstrate continued success, i.e. are places which have been the subject of charrettes popular, healthy? And do the local communities remain engaged in the process of change” “Collecting evidence is problematic – different stakeholders value and give credence to different kinds of evidence – whose voices are heard?” Or they pointed to obstacles: “Practical examples deliver results, positive outcomes for communities, break down silos and encourages co-production but resource intensive nature limits delivery.” “Exemplar local initiative demonstrating what can work well, how and why but don’t get mainstreamed very well for a variety of reasons.’ And just few responded negatively: “No, working on single service agendas.” “Poor links between collaboration on wellbeing…. Evidence is patchy - as is effective practice.” “Very little empirical evaluation or evidence ‘at scale’ exemplified or emphasized this morning. If empowerment = entitlement, then demand exceeds, c.f. NHS.” Question 2: What evidence is there of an emerging consensus, evident from changes in professional practice, about the process needed to deliver well-being outcomes? (Table 2) Yes

Don’t know

Yes but

No response

Table 2

Figure 11. Issues raised in response to Question 2 (n = 45, frequency threshold = >5)

As Table 2 and Figure 11 indicate, there was also general agreement amongst the participants about whether there is an emerging consensus about the process(es) needed to deliver wellbeing outcome. Once again, four fifths of them (n=37) thought that there was. But two fifths of these (n=15) expressed reservations about this. As before, the ‘evidence’ offered tended to take the form of expressions of aspirations rather than concrete examples, e.g.: “Needs to be joined up policy making and policy implementation. Also needs to be more balanced bottom up approach.” “Collaborative processes, community empowerment and long term objectives are key. Need feedback loops, evolution of processes and consideration of on-going management.” “Everyone needs a clearer understanding of outcomes and outputs. Acknowledgement that this is not an easy one size fits all process.” “Getting people involved in the design process shaping their places from scratch to completion and [the] professional role is to facilitate such work ….” “Need a collaborative, holistic approach delivered at community level.” Other participants were more sceptical about whether professional practice has really changed, e.g.:

“Are there real changes in professional practice? There are some good examples but there is no consistency across Scotland …. Leadership is key to push wellbeing up [the] local authority corporate agenda and political agenda.” “Qualified. Structures continue to impede horizontal co-operation, albeit that often professionals have open attitude if limited grasp of the expertise held by those in parallel organisations.” “Enlightened stakeholders get it, politicians who have experienced the technique see the benefits but resources for expansion are not following good practice.” A few expressed more negative opinions, citing a ‘silo mentality’ or largely un-reformed underpinnings: “Quite the opposite. An industry in itself. Self-serving.” “Different people/institutions with different viewpoints. No systematic approach.” “Only that ‘things should be participatory’ – not questioning fundamental structures of power and inequitable distribution of resources which would be vital to change.” Question 3. Do you think new professional knowledge and skills are needed for delivering placemaking for well-being, using collaborative community-based approaches? (Table 3) Yes

Yes and No

Don’t know

Yes but

No response

Table 3

Figure 12. Issues raised in response to Question 3 (n = 45, frequency threshold = >5)

As Table 3 indicates, almost nine out of ten participants (n=40) thought that new knowledge and skills are needed. And only a small minority of these (n=7) placed any reservation upon their positive response. Few (just 4 of them) thought that there was not a need for new knowledge and skills. As Figure 12 reveals, in aggregate, participants placed more emphasis on skills rather than on knowledge here. Participants placed a strong emphasis on the need for improved sharing across all those involved, e.g.: “Yes, need all stakeholders working together learning and sharing skills, e.g. public health and planning, health and social care. Engaging local professional groups and the public in the process.” “Possibly need a shared language so everyone is working towards the same thing/using similar approaches and communities should also know this. May be need to build knowledge/skills/ confidence with partners who could be involved around co-production.” “The difference lies between the professions. There is a need to share both understanding and skills as no one individual or profession can do it all.” The need for improved community engagement skills was also a repeated refrain: “More skills in engaging communities. Particularly in encouraging facilitators to be more accessible and sensitive rather than attempting to teach communities how to understand and use their technocratic language.” “Ability to common speak, ability to listen and not sell, ability to think creatively, ability to grasp the big picture.”

But others questioned this emphasis on ‘new’ professional skills and knowledge, e.g.: “ A major issue is harnessing skills that we have, across professions and silos.” “It’s more about developing existing skills to take account of the changing environments.” “The skills already exist in certain staff groups e.g. CLD – needs to be spread to a much wider range of professionals.” “Not new knowledge and skills, just make sure the existing ones get transferred.” “We need to be able to talk and listen. At times professional knowledge and skills can block this – ‘I have training. I know best’.” “There’s plenty of professional experts and lots of local knowledge. It’s how it all works together that needs improvement.” And some pointed to improving the skills of community members instead, e.g.: “Community members need opportunities of training in critical questioning, activism, democracy” while others pointed in a different direction – towards leadership: “What is needed is better leadership in how we can use better what we already have and develop better outcomes through this.” Another (smaller) group called for the adoption of a more critical attitude towards wellbeing through analysis, measurement and improved evaluation, e.g.: “How to root these procedures in empirical evaluation at scale to compare models – not to espouse them.” “We need to understand better the healthcare data and interpret this into clear, deliverable, measurable and achievable policies and actions.” “More long term evaluation of good practices and processes. Evaluation of processes that have been able to deliver successfully.”

Additional comments Space was provided at the end of the pro-forma for participants to add their own comments. More than half (24) of the participants took this opportunity. Eleven of them made positive comments, often about the symposium itself and the opportunities it presented for cross-discipline learning: “A very interesting symposium, well beyond my usual area of interest, which has demonstrated the value of cross-fertilisation of ideas when organisations/services approach the task of achieving change through a redesign process.’ “Very enjoyable session. Appreciate the opportunity to engage with folk from other organisations/professional backgrounds.” “Useful models for translation to my own sector – reflecting the benefit of cross-sector collaboration.” Few (3) were openly critical: “Same old, same old – no new thinking, just polishing the old techniques. Time for a paradigm shift.” “Enthusiasm does not equal expertise.” But others offered more neutral comments, asking, for instance, for future events to be more inclusive – either in terms of the voices heard or how participants engaged, e.g.: “Ask more practitioners from local authorities to present their work – lots of good work happening but not being recognised.”

“Representatives of lesser-known community groups could contribute vital perspective and are often left out.” “We all need to learn to listen and be prepared to step back from our own agendas.”

Emergent conclusions and recommendations This symposium set out to develop wider public understanding, by encouraging discussion across a range of disciplines and domains - not least planning, health and social care - about the contribution that community collaborative approaches to place-making can make to wellbeing. This report summarises the key themes that emerged at the symposium. The organisers’ starting point was an acknowledgement that attitudes to wellbeing are changing, both within government and society, away from the idea that a flourishing life is primarily connected to material prosperity and towards one that positions wellbeing as a significant goal for public policy. Like other planning issues such as master-planning, the use of charrettes, and the importance of place-making covered by previous symposia – this interest in wellbeing is being accompanied by commitments to empower local communities, unlock social capital, and give individuals greater voice in the processes of placemaking that determine the quality and direction of their lives. Scotland is seen - at least in terms of policy formulation and pilot initiatives – as well placed to respond to these aspirations. This starting point was well reflected in the presentations made by the wide range of experts who spoke during the morning session.

Presenters’ collated position statements • • • • • • •

•

• • • •

•

participation can be both a goal and a process, both a means to an end and an end in itself enhancing wellbeing and tackling health inequalities have to be treated as part of the same agenda. community collaboration has an important role to play, as part of an integrated approach to action on the causal chain leading to these inequalities collaborative design, for example in the form of charrettes, helps to achieve health and wellbeing through a form of therapy that helps to deal with coping with change as managed evolution the Charretteplus programme works with communities to develop an action plan and link spatial and community planning it is important to focus on delivery: who does what - inclusion and representativeness are key factors meaningful engagement means enrolling seldom heard groups – such as bringing together the young and elderly groups to learn about their place, engaging gypsy travellers in decision making processes; communities’ need for a wider perspective can be addressed through different stages: listening; testing / buy-in; endorsement; advocacy/promotion – informed by a clear vision and goals the SP=EED programme, for instance, recognises different forms of engagement (informing, consulting, partnership) and identifies 8 criteria for effective engagement (transparency & integrity; co-ordination; information; appropriateness; responsiveness; inclusiveness; monitoring & evaluation; and learning & sharing) storytelling is an important part of the narrative development that reviews and tests ideas against diverse functions of a community continuous learning and sharing is required to maximise the impact of actions that communities and professionals take together evidence is required about how empowerment can contribute to wellbeing. Along with achieving wider (environmental) goals worked examples are needed of how empowerment can be achieved in collaboration between local authorities and communities Scotland’s Place Standard provides a major opportunity to push this agenda forward

There is a strong overarching alignment across these position statements and this is echoed in what symposium participants subsequently said both in their discussion groups and through their individual response forms. In the afternoon session, three questions were asked of the symposium participants to help them to explore how Scotland can achieve its currently stated aspirations. Question 1. Question 2 Question 3

What is happening now? (What is the current state of play in delivering wellbeing?) What needs improving (in how wellbeing is being delivered)? What needs to happen next (to improve the delivery of wellbeing)?

A clear underlying narrative thread links the responses that participants gave to these three questions. Through their group discussions, participants indicated their shared concerns and

priorities. They were primarily concerned with community wellbeing, calling for both short and long term approaches to improving wellbeing that involve local people based on ‘what works’. They wanted to see improved community engagement in different forms of delivery that linked, preferably integrated, planning policy and resources with achieving health outcomes. Their responses to Question 1 indicated that, as far as local community wellbeing is concerned, they saw a lack of links at present between the sectors involved in health, social care and planning, and between policy and projects. Improvements were sought here by focussing on different forms of delivery that are known to work. In response to Question 2, they wanted a stronger focus on communities themselves being integrated into the long-term processes being used for the delivery of wellbeing. This is because, as their responses to Question 3 indicated, they believed that community wellbeing requires an inclusive action-based approach based on improved evidence, knowledge and resources. To do this effectively, they think, will require more community capacity building, investment and measurement of outcomes. Participants’ individual responses to a further three questions show some indication of divergence in relation to their sectoral origins. Question 4. Is there evidence that, in practice, collaborative community-based approaches do help to promote community wellbeing outcomes? Question 5. Is evidence is there of an emerging consensus, evident from changes in professional practice, about the process needed to deliver wellbeing outcomes? Question 6. Do you think new professional knowledge and skills are needed for delivering placemaking for wellbeing, using collaborative community-based approaches? Planners often pointed to the need to develop their own professional skills, for instance for delivering changes in wellbeing through charrettes. Conversely, academics, for example, pointed instead to improving local people’s own skills for engaging in community-based processes. And health care professionals focused on the evidence available about the impact of community collaboration on health. While, in aggregate, the participants suggested that there is evidence that collaborative communitybased approaches do help promote community wellbeing outcomes, few of them provided concrete examples of where this had been or is being achieved. Instead their responses tended to be aspirational, pointing to a long list of Scottish policy initiatives but without signposting what evidence there was about what these were actually delivering in practice. Charrettes were suggested by some participants as a main source of evidence that local people are being collaboratively engaged in the planning of health and wellbeing. But others were more sceptical suggesting that there is, for instance, little evidence of the delivery of long-lasting wellbeing or pointing to obstacles to mainstreaming such collaborative community approaches. Just as improving skills was a recurrent theme so too, if to a lesser degree, were the notions that there has to be a) more ‘sharing’ between professionals and between them and the community members they need to work with and b) more (critical) attention to analysis, measurement and improved evaluation of wellbeing outcomes.

APPENDIX 1: COLLATED RESPONSES FROM THE GROUP DISCUSSIONS GROUP 1 What is happening now? 1. Gathering data about community needs/aspiration is happening 2. Delivering necessary services/signposting to relevant information 3. Policy is there but implementation difficult: fragmented approach and economic growth takes precedent What needs improving? 1. Addressing inequalities – income, access, opportunities, social justice 2. Engaging with those most in need 3. Commit political will and resources to implement design guidance What do we want to happen next? 1. Land management changes to capture value 2. Qualitative approaches to measure the quality of places – what matters to people? 3. Consultation not an outcome – falling off a cliff at the end – but a continuous process.

GROUP 2 Top three points 1. Focus on mobility – joined up decision-making about urban spatial planning and lifestyles 2. Improving delivery: reaching out to different groups in their own language and media for better (inclusive) solutions 3. Translating policies into measurable actions – improved well-being by private and public actors at local level What is happening now? What needs improving? • Young people are integral to the discussion for broader thinking and longer term solutions • Greater clarity of what and how to deliver and for whom • Reaching out to different groups (communities of time and age, etc) on their own terms, media and language • Better access to and application of health data for all disciplines • Following through on place-making actions and consensus What do we want to happen next? • More accountability for achieving delivery • Better policies, better implementation – must be implemented or dropped • Translating policies into measurable actions (private, public local) – improved well-being GROUP 3 Top three points 1. Lack of coherence and understand across different sectors (structural deficiencies) along with lack of exemplary projects on the ground 2.

Need for a common understanding of well-being, identifying the real problems in the community through longitudinal analysis

Dedicated resources in place (non-elected place-making champion) to ensure an emphasis on people living and working in same place: collective well-being arising from shared vested interest

What is happening now? 1. Not very much is specifically being delivered about placemaking: lack of good examples, especially cost-effective ones 2. Lack of coherence and understanding among different sectors and groups, even those who are trying to address well-being 3. Skills, professional and structural deficiencies – planning and community planning operate independently • • • • • • • •

We may not know what well-being is but we know when it is missing Can you deliver an individual’s emotional and subjective experience? Well-being is relative People need to leave their baggage at the door when they come together to consider wellbeing Some delivery still by tick box Small scale groups – local initiatives Charrettes – top down, not meaningful on the ground Well-being co-ordinators in Primary Care but no direct link to place making, i.e. what people think or feel

What needs improving?

GROUP 4 Top three points 1. Preventative and proactive work by NHS and others 2.

Longer term, collaborative approaches (linked to secure funding) to make community involvement and well-being promotion part everyone’s business

Knowledge into Action – developing and sharing evidence base across the wider system

What is happening now? 1. Work of NGOs and Third Sector and social prescribing activity 2. Preventative and proactive work by NHS and others 3. Targeted activity for those people experiencing inequalities with focus on determinants • • • • • • • • • •

Adopting participatory processes as a way of engaging with communities Health and social care integration Equally well in Dundee working alongside a wide range of organisations to engage residents of deprived areas re: what matters for community well-being To develop local responses including community assets Scottish Government supporting different sectors to become involved in design Work of NGOs and Third Sector, e.g. Paths for All, Living Streets, as well as local projects NHS becoming more proactive in terms of well-being, e.g. placement and design of health centres Work of CCPs and Local Community Planning Partnerships Work around active travel involving participatory methods Lots of locally based initiatives with an increased focus on and recognition of well-being

• • • •

Cultural arts work linking to health and well-being agenda SAGE (Saving and Growing Your Own) growing and gardening projects with a range of health and environmental benefits Work linked to mitigating the effects of Welfare Reform Social prescribing/link worker approach in primary care and offer setting (Deep End Practices)

What needs improving? 1. Longer term funding/approaches to make community engagement and involvement part of daily business 2. Better collaboration across all sectors at all levels 3. Accountability to put ideas into action • • • • • • • • • • • • • •

Better co-ordination and collaboration in linking wide range of activities at all levels Balance between making small steps and big changes needed to tackle well-being inequalities Longer term approach linked to funding Is well-being delivered or generated Need maintenance as well as improvement Connections between spatial planning and social and mental outcomes and impacts: think about this during the planning process The needs of space for children and young people – the positives would continue throughout lifespan: physical improvements in deprived places Make active travel the norm in all areas Up-skilling of professionals to deliver on this agenda and communicate well with local people Up-skilling to include tackling the attitudes and pre-conceived ideas of professionals Important to build a positive relationship with people and communities to support them to engage Not just about engaging and asking questions: also about action and working alongside local people to deliver solutions Real effort required to reach most marginalised members of the community Range of methods required to engage effectively – not just one-offs but the way we do things

What do we want to happen next? 1. System wide systematic approach to improving well-being and tackling determinants 2. Knowledge exchange and education at all levels re: evidence base for well-being, including opportunities for professional development and CPD 3. Increase evidence base to be sure of what works to improve well-being but also to tackle wellbeing inequalities • • • • • • •

Some services need to be more involved in community action on well-being: e.g. NHS – social prescribing is a good example of non-clinical staff working within an NHS setting More systematic approach: too many fragmented interventions Raise awareness of evidence base for well-being activity Maybe can’t measure everything but doesn’t mean it isn’t important. Do we need more robust measures – link to national health improvement outcomes framework Positive action on making well-being everyone’s business (promote evidence and good practice but also embrace innovation) Recognise actual and perceived barriers to well-being and address these (individually and societally) Identification of what matters most, e.g. does welfare reform trump everything else – but do the best with what you have

GROUP 5 Top three points 1. GIRFEC – common understanding and priorities 2.

Integrated approach – organisation, programme and information

Local investment – community capacity building, social enterprise and breaking down barriers

What is happening now? • CCP not working well together • Community Empowerment Bill may not have much impact on all communities – do they have the capacity • Community-led projects, social enterprise, CCP • Well-being moving up the agenda, therefore we are more mindful in delivering better places and preventing bad decisions • Regeneration (town centres) • GIRFEC What needs improving? • Join up the dots at all levels – information sharing • GIRFEC applied across the board • Value, respect and ownership of public services: more integrated consultation, education • More community enterprise – social benefit and profit What do we want to happen next? • Exposure to community enterprise and social capital • Local long term pension investment • Investment in community capacity building – link with Community Empowerment Bill • Breakdown policy and legal barriers Group 6 What is happening now? • LOTS! Framework, policy, strategy, delivery but practice = short term, limited interventions • CHALLENGE – can you deliver well-being? • There is stuff happening. It’s good but what does it look like when take the blinkers off? • Cross professional learning – don’t re-invent the wheel • Maintain long term consistent funding (flexible around outcomes) • To target well-being you have to tackle INEQUALITY What needs improving? • Forget about the answers, focus on the questions – orchestrated outcomes, preconceived ideas! • Reconceptualise the process – longer term instead of short term (sticking plaster) • Short term shuffles community into a process • Long term – continuous, educating process, dialogue – as new norm • Empower communities – they design, deliver, operate processes for themselves • Discussion needs to happen – how is well-being achieved • Bring together disparate and unconnected

What do we want to happen next? • Genuine on-going dialogue • Place approach is good but make it meaningful • Re-envisage relationships between planning, community engagement, community education, community workers (better use of skill sets) • “So what are you doing about it?” – which is why need on-going trust • Target timing and resources to the right places GROUP 7 Key points 1. Alignment of policy in Scotland - informed by good principles, moving in the same direction but often not integrated 2.

Innovation and piloting needs support - pilots need mainstreaming, lesson learned and integration

Integration of approach at lower levels – consistency, resources, leadership

What is happening now? • Creating physical and social conditions for well-being • Defining well-being for individuals and communities - scales of well-being, time and dynamics, feelings and emotions – with place as the focus • Delivery mechanics – planning, all departments, communities (but representation and lobbying?) • Lots of work in the Scottish context –land reform, community empowerment, poverty alleviation, health and social care, self-directed support, early years • Alignment of policy in Scotland – different aspects of well-being • Cross-sector and different scales of delivery • Lots of pilots and experimentation (agreement on vision) – dynamic process What needs improving? • Integration at lower levels - public, private, and third sector, e.g. health and social care. • Need leadership, capacity: key people to make this happen and translate for different audiences • Development of workforce – interdisciplinary, real world, engagement and participation – training and practice • Constant focus on innovation and improvement, being honest about mistakes: choose right places What do we want to happen next? • Timescales? Change takes time • Resources, doing things differently (or more with less) • Spreading good ideas – not straightforward • Learning from mistakes – identifying key elements Group 8 What is happening now? • Planning and design processes – well-being from outputs? Lived experience, delivery? • Well-being from co-delivery. Scottish Government desire to do more: co-commission, coproduction, co-assess = co-delivery • A lot happening but not connected, lost as trickle down “contrary to what it is professing” • Charrettes but need for more resources • Bits and Bobs: little evidence to show delivery of long lasting well-being

What needs improving? • Redistribution of access to resources and organisation of democracy: smaller communities and democratic organisation sizes • Freedom to express aspirational ideas and thinking (drives out dialogue if can’t) • Recognition of professional expertise and community expertise: need both • Issue of who owns the process, e.g. client paying for engagement, or who has the power • Cultural change: “Just say yes”, practical ways to get around the system, bureaucracy What do we want to happen next? • Encourage dialogue, facilitate change – need a systems approach or start with individual? • Capacity and capability and change from within – dialogue is not a risk, allowed things to get worse, work out a solution together • Need a longer term view, too many planning iterations • Learn to have dialogue from an early age (schools) • Things are too outcomes driven at present – need to be driven to achieve outcome • Community knowledge – expert knowledge

APPENDIX 2: COLLATED INFORMATION FROM INDIVIDUAL PARTICIPANTS’ Q1. Is there evidence that, in practice, collaborative community-based approaches do help promote community well-being outcomes? Yes

Yes and No

Don’t know

Yes but

No response

Yes There is evidence but don’t know how much this came out during the presentations. There is evidence in the field of CLD and also in the literature for mental health improvement/tackling health inequalities: the work of Gerry McArtney, Sally McIntyre, Lynn Friedl: what was presented today needs to look more into what is going on elsewhere in the field. Yes, such as those done in many places like India, NY, Scotland, Copenhagen, Stockholm. Collaborative approaches always seek to know what people know and want. So the outcomes of process based on these approaches ‘should’ meet the inspirations of people, in spatial planning, planning and designing places. After asking and reviewing what people thought will ‘theoretically’ end up with a design that people will feel happy to in and that will enhance their well-being. Little evidence of delivery of long lasting well-being – bits and bobs going on. Charrettes. Yes.

Occupation Undisclosed.

The difference lies between professions. There is a need to share both the understanding and the skills as no one individual or profession can do it all. NHS preventative health care initiatives. Attendance, participation and interest in becoming part of a community voice to help assist in the transformation of their spaces towards place. In other words, further improved programmes which are being developed in response to prevailing unaddressed issues. Charrettes, charter events, symposiums, even customer service enquiries at Departmental level (Council). Yes

Planner

There are examples from practice and research in health and in planning that well-being can be improved if people affected are involved with the solutions. This can be in individual projects but also in wider policy terms. I have worked on a … (indecipherable) re-development project where this was evident and examined an MSc study of a Welsh policy that led to well-being outcomes for children. Usually by big data sets initially. Would be good to see a set of case studies that evidence success. It’s a kind of collaborative work and exchange between both NGOs and local community to put the agreed plan into action and implementing project on a short and long term in Scotland. Because it helps fight against exclusion and hear everyone’s voice. It also helps empower the communities.

Academic

Case by case evidence that the charrette approach engages people in local communities and – if extended into long term interplay between community groups and planning/designing/management bodies – has the potential to maintain good community health at macro and individual levels Benefits of collaboration/participation generated by charrettes

Health-related

Undisclosed. Undisclosed.

Undisclosed. Undisclosed. Undisclosed.

Planner Planner

Planner

Academic Academic Academic

Health-related

Lots of diverse case studies, primarily – the remaining challenge is to make successful application of such approaches “the norm”.

Health-related

Resident surveys after projects engaging communities, asking questions about well-being. There is a variety of work – collaborative that aims to promote and addresses well-being outcomes. An example of this is highlighted in local community plans under the well-being section and are addressed at Health and Well-being networks across Dundee.

Third sector Third sector

Lots of good examples – charrettes plus etc. Impossible units of power – no … (indecipherable) local democracy. As illustrated by the presentations. But who defines community? Administration boundaries don’t necessarily reflect the way that communities see themselves. Is the process just about the issues of distribution, production, justice and recognition? Links to active participation in democracy – must be ongoing. Places are part of the public domain and so must be actively and continuously negotiated (and renegotiated)

Heritagerelated Heritagerelated

Solomon Islands project and green revolution in India. Need to engage with seldom heard groups. Increased awareness from planners in creating places to live and thrive rather than design of places merely to survive. More collaborative discussion and co-operation between architects, surveyors, etc and Government to meet Government targets. Need to develop new ways to ensure community inclusion. (Informal gatherings, need to informalise process to break down barriers.)

Surveyor Surveyor

Charrette reports are leading to community planning [which] is becoming real statutory planning. Heilston Charter followed be charrette is now SPG in Local Plan.

Consultant (landscape)

Yes but Practical examples deliver results, positive outcomes for communities break down silos and encourages co-production – but resource intensive nature limits delivery, People are being engaged with more often using creative/innovative ways/approaches. Having input in olanning/decision-making allows people to have an element of control over things that affect their well-being. However, we need to ensure that ‘hard to reach’ local people – those with the poorest well-being – are also included in engagement and this can be difficult. Only with right framework, feedback loops, measured aspirations, holistic approach. Conversion of currency to well being and happiness Yes but few and far between. Yes but lack of longitudinal study and delivery to learning, capacity and empowerment – still the weak link in terms of sustainability. [Need for] more participation, learning. Some limited beginning of charrettes in local authorities but lack of cohesion. Proposed place standard to (indecipherable) discussion. Delivery and ongoing engagement is key but very resource heavy. We need to understand better the healthcare data and interpret this into clear, deliverable, measurable and achievable policies and actions. Planners are good at bringing things/people together – cross-cutting but there is a skills gap. Physical changes vs. the less tangible more ‘social’ changes. Evidence from case studies, e.g. charrettes. But this evidence seems fairly limited, e.g. no long term studies to demonstrate continued success, i.e. are places which have the subject of charrettes popular, healthy, etc? And do the local communities remain engaged in the process of change? Community-based organisations led and … (indecipherable) local volunteers are often effective in community well-being. But top down collaboration is very limited and … (indecipherable) bureaucratic mindsets a major constraint.

Undisclosed. Undisclosed.

Undisclosed Undisclosed

Planner Planner Planner

Planner

Collecting evidence is problematic – different stakeholders value and give credence to different Health-related kinds of evidence – whose voices are heard? Good examples locally in Health – Equally Well in Dundee, Healthy Community Collaborators in Perth and Kinross. More about how people live in

their place than about place-making. Exemplar local initiatives demonstrating what can work well, how and why but don’t get mainstreamed very well for a variety of reasons.

Consultant (sustainability)

Yes and No At very close to ground level, yes, simple interventions like wild flower gardens, seats, playgrounds. At design and masterplanning definitely not. Manipulation, power and money, capacity, unrealised expectations, poor political conditions, lack of shared experience

Undisclosed

Evidence that participation in activities and having your voice heard contributes to positive Academic health outcomes. However, at the same time, they can further entrench the status quo as often it is those with … (indecipherable) resources who are able to get their voices heard. This can further disempower the disempowered while empowering further the already empowered. Yes, at the local government level but seems to be smaller projects, not fully co-ordinated. No – Third sector need to work more in partnership with those that already have these skills, e.g. CLD workers. No No, working on single service agendas. Undisclosed. Poor links between collaboration on improved well-being. …. [Undiscipherable] Evidence is Undisclosed. patchy – as is effective practice. Very little empirical evaluation or evidence ‘at scale’ exemplified or emphasized this morning. If Undisclosed. empowerment = entitlement, then demand exceeds …, c.f. NHS. Don’t know There remains a silo mentality towards collaboration and a difficulty in articulating real problems and aspirations: discussing the undiscussable.

Undisclosed

No comment.

Academic

Unsure of what evidence and bench marking and measuring has been carried out to demonstrate success.

Surveyor

Q2. Is evidence is there of an emerging consensus, evident from changes in professional practice, about the process needed to deliver well-being outcomes? Yes

Don’t know

Yes but

No response

Yes Place Standard. Collaborative processes, community empowerment and long-term objectives are key. Need feedback loops, evolution of processes and consideration of on-going management. If we took a look at planning regulations and policies from early time of the 20th century, the planning regulations came to deal with the problem caused by the industrial city and work to enhance the sanitation and health issues of the city. And the process still moving on. Needs to be joined up policy making and policy implementation. Also needs to be more balanced bottom up approach. Yes, a wide range of approaches required.

Occupation Undisclosed Undisclosed

Partnership working/a range of different bodies working together. Greater link between geography and town planning courses at university – holistic range of subjects covered in geography course are helpful in terms of well-being in planning. We have effective processes. Key point is not be too wedded to them and ensure we remain flexible. Good Places, Better Health, Place Standard and Creating Places. Recognition between the various disciplines [of the] importance of collaborative way to understand impact of physical environment on health and well-being. That everyone needs a clearer understanding of outcomes and outputs. Acknowledgement that this is not an easy one size fits all process. Healthy Sustainable Neighbourhood Model – now embedded in Glasgow Development Plan.

Planner

I think there is consensus that participation is important in process and also in the longterm nature of successful projects. I think practitioners are also striving to be more inclusive, though they often struggle with this. More recognition than in the past and the need for more grass roots design and input into the process. More emphasis on consensus at a local level rather than at large scale now. Getting people involved in the design process of shaping their places from scratch to completion and professional role is to facilitate such work – US, NY.

Academic

On the evidence presented today, there is a growing consensus that a collaborative approach to planning can contribute to well-being. Increasing involvement of Community Learning in Health and Social Care developments, e.g. Well Connected Perth and Kinross. Consensus is mostly rhetoric but it is becoming embedded. Alignment of policy around common vision for Scotland. Increasingly common language – co-production, assets, community engagement.

Health-related

Getting it Right for Every Child being embedded in Scottish Government and local authorities.

Third sector

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Academic Academic

Health-related Health-related Health-related

Current reforms – Health and Social Care Partnerships

Third sector

Need a collaborative, holistic approach delivered at community level. The end goal should be part of the process. Recognise the knowledge of local people in community and how this knowledge can be used in the process. Open decision making process.

Surveyor Surveyor

Best results come from multi-disciplinary measures with both a strategic and in-depth focus Consultant where specialists work with community in partnership (sustainability) Yes but Enlightened stakeholders get it, politicians who have experienced the technique see the benefits but resources for expansion are not following the good experience. Yes. Collaboration across professions and departments is becoming more normal, but there is a lack of uniformity in the leadership. This might not matter though. Approaches such as co-production community development, asset-based working is building up a research base but more needs to be done on this. Distilling the evidence would be a good start if this hasn’t happened already – and sharing in all fields, at all levels, so we aren’t re-inventing the wheel. Yes but to an extent. More people are seeing well-being as important to their role/results and these people are changing ways of working based on this awareness. There are still others, in my experience, who don’t see it as their responsibility and resist changes to ways of working. Yes, UK, US. Recognition but no practice response, i.e. I know what is needed but not changed the way I work.

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Need for processes that engage the community is recognised but limited resourcing for making things happen on the ground. Are there real changes in professional practice? There are some good examples but there is no consistency across Scotland (whilst understanding that it is not a one-size-fits-all approach). Leadership is key to push well-being up corporate agenda (local authority) and political agenda. Chief Execs/Heads of Planning/politicians need to understand the links between the built environment and well-being. Some evidence, e.g. general buy in of charrette process and acceptance of statutory community consultation. But (in my opinion) continued question around who participates and how representative they are? In my experience, the usual suspects are while, male, retired professionals. Changes in professional practice. Further emphasis and specialised documentation (Designing Streets, Places, Engagement, etc) from state level which facilitate participation and, perhaps, not person-centred decision-making at the local planning authority level as we work for the client. Improved LPA effective customer service delivery. However … do we deliver micro-based well-being outcomes – that is what I am unsure of as part of Development Management. Perhaps opportunity here for Development Planning to collaborate with Development Management better to deliver person or area-centred wellbeing improvement. Qualified. Structures continue to impede horizontal co-operation, albeit that often professionals have open attitude if limited grasp of the expertise held by those in parallel organisations.

Planner

Emerging policies/practice, e.g. Place Standards, charrettes. Still concerns around the opportunities for marginalised groups to shape developments. Images used in presentations vis a vis inclucion/participation demonstrate (to me) that groups such as gypsy/travellers are not on the decision-makers’ radar (with the exception of Pas).

Academic

Yes but need to integrate proactively across services to actually deliver.

Third sector

Planning

Planner

Yes – deliberative and ‘just’ (distribution, procedural, recognition). Not all well-being can be Heritage-related measured! Values, beliefs, narratives and strategies are all important. Narratives and strategies = framings (which influence ‘evidence’ and how it is shaped and used. Not everything that can be measured matters; not everything that can be measured should be managed. All Council SOA have it centrally. Not sure they know how to deliver the necessary elements Consultant though. (Landscape) No Quite the opposite. An industry in itself. Self-serving. Silo mentality.

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Different people/organisations with different viewpoints. No systematic approach. More research is needed. The priorities of every sector are different, sometimes they exclude each other.

Academic Academic

Only that “things should be participatory” – not questioning fundamental structures of power and inequitable distribution of resources which it would be vital to change.

Heritage-related

Don’t know Need consensus in meaning and avoid current dichotomy of health … and … well-being – encourages divergent views and not helpful for asset-based salutogenic thinking. I would value a consensus on any convergences – empirically evidenced and reproducible, rather than well-articulated slogans and assumptions. Mixed. I think there is improved changes in knowledge and practice but probably not consensus.

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Q3. Do you think new professional knowledge and skills are needed for delivering place-making for well-being, using collaborative community-based approaches? Yes

Yes and No

Don’t know

Yes but

No response

Yes Less policy driven and more understanding of the daily lives in challenging circumstances. In a society under austerity with lack of access to basic resources … that’s where we need to aim … and those folk know what they need! Better facilitation, teaching learning skills. Shared learning across professions. Transdisciplinarity to articulate problems and reach new places for collaboration – learningorganisation, You never stop learning. CPD should become more place-making and well-being focused across professional disciplines. Funders also need to tailor their criteria in the same way. Why is this agenda important? What it means to you in your role? (wider determinants) What needs to be done differently? How to do it? Support needs to be given across the system re: above. This may involve changing attitudes, preconceptions, behaviours, etc. Need more multi-agence CPD/PLT etc. Possibly need a shared language so everyone is working towards the same thing/using similar approaches and communities should also know this. Maybe need to build knowledge/skills/confidence with partners who could be involved around coproduction, particularly if they don’t already work this way or see the benefits. It’s not new but not used by everyone either. For sure a shift in thinking and priority is needed. Understanding of shared outcomes, sharing skills, different stakeholders working together, e.g. public health and planning, e.g. health and social care. Engaging local professional groups and the public in process. It is very important to develop and enhance the professional knowledge and skills, as the professionals will take the decisions. Co-production skills. How to engage and have productive conversations. Need to understand health inequalities. Also need to redefine values. Yes. Need all stakeholders working together learning and sharing skills and knowledge to ensure best outcomes. Working with everyone and engaging with all.

Occupation Undisclosed

The difference lies between professions. There is a need to share both understanding and skills as no one individual or profession can do it all. Using charrettes more, taking on the objectives of Creating Places, Better Places, Better Health and how they could be used in practice. Coaching on all levels to allow adult conversations. General ‘listening’ skills. Better understanding of other people’s interests. Better understanding and acceptance of ‘health and well-being’ as goals in themselves (on a par with economic growth, new housing, etc). Work on capacity building for communities and professionals. Understanding of different viewpoints and agendas, negotiation skills, facilitation skills, consensus building. Yes. Ability to common speak, ability to listen and not sell, ability to think creatively, ability to

Planner

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Planner

grasp big picture. More skills in engaging more marginalised communities. Particularly in encouraging facilitators to be more accessible and sensitive rather than attempting to teach communities how to understand and use their technocratic language. Managing expectations is also something that may require more skills. More effective cross-collaboration. The Scottish Government’s focus on charrettes as an effective form of coproduction/participation – need to ensure that this is fully inclusive, e.g. involving gypsy/travellers in the processes. Potential means to address the social capital deficit in the gypsy/traveller community. Although any involvement in charrettes would required to be preceded by opportunties for capacity building (skills and knowledge). Practice and developing skills and experience in working with community groups, especially with groups who are initially very cynical about participating in community-based approaches. Communication skills, believing that community are the expert – making things with people, not for people. More long term evaluation of good practices and processes. Evaluation of processes that have been able to be delivered successfully.

Academic

Consider engaging people in specialist sectors (e.g. health, education, sport) and those who understand human biology and behaviour in dialogue with planners/designers/managers of services in how to maximise chances of achieving greater sense of community and individual well-being. The skills already exist in certain staff groups, e.g. CLD – need to be spread to a much wider range of ‘professionals’. Community members also need support and opportunities to develop skills in participation – learning as they participate. All need greater understanding of mental health and well-being and determinants/protective factors. Skills of collaboration, community engagement, cross-sector working, inter-professional education.

Health-related

Engaging young people, older people, the seldom heard. Communications skills, 3 D modelling CPD training. General awareness raising through a de-jargonised approach.

Third sector

Place-making – well-being and public health are all issues in the public domain – must ensure voices are heard and participate equally. Process must mediate power relations across public, private, and market interests. Everything matters = systemic interventions = work at neighbourhood scale. Action-centred – adaptation – research and practice. Community members need opportunities of training in critical questioning, activism, democracy. Professionals need listening skills, including how better to go to communities and identify vital groups and individuals.

Heritagerelated

Not new knowledge and skills, just make sure the existing ones are transferred.

Surveyors

Academic Academic

Academic

Academic Academic

Health-related

Third sector Third sector

Heritagerelated

Yes but Great increase in skills base but perhaps only 10% of those who could contribute have the Undisclosed necessary training or opportunities to put into practice. Skills gap – knowledge and expertise. Community building, inter-personal skills, time or space Undisclosed to be creative. Not just skills – professions can deliver this. Freedom, time, space. You can have all the knowledge and skills you want but if you don’t have the role freedom to deliver it. How to root these procedures in empirical evaluation at scale to compare models – not to Undisclosed espouse some.

We need to understand better the healthcare data and interpret this into clear, deliverable, measurable and achievable policies and actions. Planners are good at bringing things/people together – cross-cutting but there is a skills a gap. Physical change vs the less tangible more ‘social’ changes. There are a limited number of professionals that a building a skill base but this experience is relatively new/absent and there is need for knowledge and experience sharing.

Planner

To an extent we need new people to become involved and existing practitioners to develop new skills. But a major issue is harnessing skills that we have, across professions and silos.

Health-related

Yes and No It is more about developing existing skills to take account of the changing environments. The problem with this is that professionals may take on compartmentalised thinking due to their length of tenure in their profession. Universities can assist in opening up ideas to these ‘procedural’ professionals to show these people that there are new ideologies which we need to make happen – and that which cannot be achieved with previous thinking. We need to enable internships, secondment and opportunities for passionate change makers and allow these voices to be heard within their respective organisations. Power and relationship (political). No Not new skills, just education and knowledge transfer.

Planner

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I think the skills and knowledge that we already have are diverse and valuable. I think what is needed is better leadership in how we can use better what we already have and develop better outcomes through this. The Place Standard technique could become a helpful tool but very important to consider the groups that this will be used for and ensure language is appropriate for them.

Planner

Better application, sharing knowledge and experience with much better, commonly used/shared metrics.

Consultant (sustainability)

There are plenty of professional experts and lots of local knowledge. It’s how it all works together that needs improved.

Consultant (landscape)

Don’t know We need to be able to talk and listen. At times professional knowledge and skills can block this – “I have training, I know best!”

Planner

Additional comments Positive Local revenue budget for delivery champions is required to ensure resilience. Particularly enjoyed workshop discussions, although they were a bit rushed. A Briefing Paper on what we mean by well-being/evidence base etc would have been helpful. There was a really mixed knowledge base on this, which was good in many ways as participants learned from one another, but there are also some fundamentals which would have helped to have as a starting point for everyone. Interesting to learn about the different approaches used. Participatory and collective approaches are very important to develop the decision making process and build trust between officials and citizens. Very enjoyable session. Appreciate the opportunity to engage with folk from other organisations/professional backgrounds.

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Fantastic series of presentation and thought-provoking topics. As a practitioner, I aim to engage when and where I can. Consequently, providing quality customer service. What I take from the talks will help me frame ideas to propose for department improvement and personal continued development.

Planner

Great event, looking forward to attending the next one.

Academic

A very interesting symposium, well beyond my usual area of interest, which has demonstrated the value of cross-fertilisation of ideas when organisations/services approach the task of achieving change through a redesign process. Useful models for translation to my own sector – reflecting the benefit of cross-sector collaboration.

Health-related

Great event. Lots of food for thought.

Consultant (sustainability)

Neutral Is there a place for satisficing? If so, where? We all need to learn to listen and to be prepared to step back from our own agendas. Ask more practitioners from local authorities to present their work – lots of good work happening but not being recognised. Places are much more than physical assets. Activities occur in places. Interaction is often purposive not simply casual. Much more attention to economic (broadly defined) transactions and character of place-making required.

Health-related

Undisclosed Planner Planner Planner

Organisations have to be more aware that well-being is everyone’s remit. Collaborations across Third sector local and national sectors have to happen to improve health inequalities and well-being The role of nature at all scales (buildings, gardens, streets, greenspaces and networks), health and well-being. Don’t forget existing places – retrofitting these. Ideas to … (indescripherable) the places that people live and work in now? The quality of places and health consequences can be viewed as emergent features (measures of) the fairness and engagement in political economy. (Well-being is not delivered.) Representatives of lesser-known community groups could contribute vital perspective and are often left out.

Heritage-related

Ensure local communities are fully aware of advantages of development to decrease NIMBYISM. Break down barriers between those in authority and give decision-making back to the community. (Reduce them and us attitude.) Communities need to be at the heart of the project. Is there evidence for decreasing population equating to lack of well-being?

Surveyor

Negative Same old, same old – no new thinking, just polishing the old techniques. Time for a paradigm shift. Non female speakers (5:0). Only in the chair in the morning session. Enthusiasm doesn’t equal expertise.

Heritage-related

Surveyor

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For further details on this report, contact:Dr Husam AlWaer Senior Lecturer in Sustainable Urban Design The University of Dundee School of the Environment Architecture +Planning Matthew Building, 13 Perth Road Dundee DD1 4HT, UK T: +44 (0) 1382348805 E: H.AlWaer@dundee.ac.uk The report of the Symposium is also available on: http://www.dundee.ac.uk/geddesinstitute/events/planandplace/wellbeing/

Centre for Environmental Change and Human Resilience Research Report 2015-1 University of Dundee Dundee DD1 4HN, UK Tel: +44 (0)1382 388692 Email: cechr@dundee.ac.uk Web: http://www.dundee.ac.uk/cechr/