Archives

Making change happen in primary care: the story of IRIS

VISION Director and Professor of Primary Care at the University of Bristol Medical School, Gene Feder, was a keynote speaker at the webinar: Making change happen in primary care – The IRIS story, on 28 November 2023.

With his co-presenter, Medina Johnson, CEO of IRIS, they shared the story of the concept and ambition that led to the beginning of the social enterprise established in 2017 to promote and improve the healthcare response to domestic violence and abuse (DVA).

DVA is a violation of human rights that damages the health of women and families. The health care sector, including primary care, has been slow to respond to the needs of patients affected by DVA, not least because of uncertainty about the effectiveness of training clinicians in identification and engagement with survivors of abuse.

To address that uncertainty, Gene and Medina conducted a cluster-randomised trial in Hackney and Bristol, finding that both identification and referral to specialist DVA services substantially increased in the intervention practices.

In the webinar they mapped the (not always smooth) trajectory from trial results to a nationally available programme commissioned by Integrated Care Boards (ICBs) and local authorities in over 50 areas to date, including getting into guidelines/policy, further implementation research, negotiating with commissioners, and setting up a social enterprise (IRISi) to drive the scaling up of the intervention.

For further information please watch the webinar video below.

For any questions or comments, please contact IRISi at info@irisi.org

Community mental health through a complex systems lens

Researchers tend to evaluate the mental health effects of national trends and policies or of individual-level treatments and interventions. In The Lancet Public Health, VISION members Dr Olumide Adisa and Sally McManus argue that researchers also need to take account of what is happening at the local level.

Complex systems can be challenging both to action and evaluation. But it also offers a new way of thinking about real-life problems as experienced by diverse populations within local ecosystems. Olumide and Sally comment on a study by Tanith Rose and colleagues which shows that local economic and procurement strategies are a part of this complex system with implications for community health. Rose and colleagues show how local systems that are people-centred, redirect wealth back into the local economy, and give control and benefits to local people and institutions have the potential to improve health and reducing inequalities in a relatively short time.

A decade ago, statutory duties for public health moved from the National Health Service to local authorities, local authorities subsequently saw their budgets reduced. Finding ways to transition to a wellbeing economy through transforming local systems therefore needs multiple local partners, including employers, health and care institutions, specialist and police services, and public and not-for-profit organisations.  

The VISION consortium is developing ways to apply complex systems thinking to reducing violence and health inequalities, taking an intersectional and intersectoral approach that includes activities at the local level.

For further information please see: Community mental health through a complex systems lens – The Lancet Public Health

For more information, contact VISION lead on complex systems approach, Dr Olumide Adisa, o.adisa@uos.ac.uk

Photo by Chang Duong on Unsplash