Norfolk Initiative for Coastal and Rural Health Equalities (NICHE)

Norfolk Initiative for Coastal and Rural Health Equalities (NICHE) is an ‘Anchor Institute’, at the University of East Anglia, which aims to co-create a healthy place to live and work, underpinned by collaborative and innovative approach to research, education, and evaluation, maximising sustainable initiatives for Integrated Care System (ICS) workforce and system level transformation. National strategic direction for health and social care aims to develop an integrated whole systems approach to position people and communities and what matters to them at the heart of care providing services that are person and people centred, compassionate, safe, and effective using targeted resources (including the workforce) effectively across place-based systems (NHS 2016,2019a/b, 2020). There is an urgent need to draw on the strengths of the whole workforce and the full potential of our communities to contribute to people working together effectively to achieve a common purpose, as well as focussing on what matters to people and communities and how it is evaluated through co-production and leadership (Best et al; 2012; Stromgren et al; 2017). NICHE works across a geography of coastal, rural and isolated communities, seeking to engage and co-create embedded activity for those who live and work across our locality, coproducing outcomes relevant to local, national and international communities. Central to our shared governance approach is effectively engaging with patients, people and partners across health and social care. NICHE is a co-ordinated approach to embedded programmes of activity working in collaboration with system partners across the Norfolk and Waveney ICS aimed at delivering maximum, sustainable impact for workforce and system transformation focused around four core work streams of activity. Evaluation is integral to all our work, capturing what works, for whom and how through mixed and creative methodologies. NICHE draws upon key principles of Collaboration, Inclusion and Participation. Through working alongside and with communities, government, and industry partners, our programmes and funded research and evaluation activity offers improvements to the economic, health and social sustainability agendas, all of which form part of our Anchor Institute status. Our programmes are in their early phases of development, the following aspects are emerging: a)Caring for the workforce, through addressing their wellbeing is a central aspect of health and social care workforce sustainability b)Health and care system requires new and flexible roles, and the importance of 'live' effective supervision plays a significant role in retaining staff across the ICS. c)Creative arts engagement, heritage sites and inclusion of historical aspects of the locality context are important and often overlooked assets when working in rural, coastal and isolated communities. d)Coproduced, embedded packages as bespoke programmes of work, facilitated effectively to enhance and release talent and promote local expertise are highly effective strategies for cultural transformation across coastal and rural communities. e)Cultural transformation cannot be rushed as new language, partnerships and interactions are formed. When working with coastal, rural and isolated communities it is imperative to engage local partners, to ascertain cultural contextual wisdom to initiate and sustain change for good.