Examples & Case-studies » Health & Wellbeing
» Ketso in Health & Wellbeing

Overview

Ketso has been used in a range of health and wellbeing contexts, from engaging directly with patients to developing new approaches to amongst health and social care professionals and people working in related fields.

This section includes:

NEW! Health and wellbeing -learning from each other in a time of change

The Research Institute for Health and Social Change at Manchester Metropolitan University hosted two interactive dialogues run by the Ketso team on Feb. 10th, 2012. Seventy-four practitioners and researchers in health and social care from across the North of England came together in these two half-day workshops to discuss what is working well, to develop ideas about new ways forward and to explore key challenges and ways to overcome them.

Feedback from the event included:

  • Warm, friendly, structured conversation
  • New ideas for facilitating discussions
  • Good facilitation, techniques rock!
  • Liked low tech approach. Will think how to try out
  • Mind map style - organic growth of ideas
  • Will carry on the process of working through model. Sharing it
  • Good contacts made – to support forward working
  • There are people out there who share the same views/inspirations – change can happen
  • This exercise is a further validation of my work - I am going to carry on!
  • Renewed enthusiasm for my work, therefore work harder

Over 1400 ideas, including 386 creative 'future possibilities', were generated around the following themes:

  • Access & equality - who is this for?
  • Prevention & cure - what are we trying to achieve?
  • Joined-up working - how can we work smarter to achieve it?
  • Community engagement – how to involve people?
  • Resource & cost effectiveness - how can we pay for it?
  • Sustaining action – how do we keep things going and maintain momentum?
  • The bigger picture - what are the broad contextual challenges and opportunities we should consider?

You can download the full set of results (excel spreadsheet) here.

The next steps (along with what attracted people to the event) can be found in this spreadsheet.

There was a lively discussion around re-defining health and wellbeing and the future of the health service. Some ideas that were highlighted include:

What works

  • Demand side thinking and action
  • Collaborative approaches
  • Validating people
  • Being part of a team - not necessarily the whole of the team

Future possibilities

  • Potential to change
  • Manage to give more direction
  • Community engagement to be bottom-up not top-down
  • Identifying needs of individuals; not one size fits all
  • Ensure basic needs are met – housing, finance etc.
  • Greater integration of alcohol and drug services
  • Deal with mental health problems rather than prescribing medication

Challenges

  • Fragmented services and support - who's doing what?
  • Establishing dialogue with closed communities
  • Local Authority cutbacks threat to the organisation
  • Lack of risk taking - always retreat to behaviour change rather than social solution

Next steps

At the end of both workshops, participants were asked to note their 'next steps'. 131 ideas were generated in this exercise. Examples include:

  • To consider of all these factors when developing a new service - to ensure as many are met as possible
  • Recognise the inter-relatedness of everything
  • Stay positive!
  • Be a positive influence at work
  • Take and use this knowledge
  • Try and retain the fertile ideas
  • Try to do more joined-up work
  • Talk more to different people
  • Reach out to many more partners
  • Consider people here as potential stakeholders and partners
  • Go out and listen to local community
  • Engage better/more with hard to reach groups
  • Remember every contact counts!
  • Learn from new opportunities and pass this knowledge on
  • Be more creative

Some next steps were quite specific, for example:

  • Consider the ideas in the development of our H&WB Board Engagement Strategy
  • Promote wellbeing in the staff team where I work
  • Think about healthy options for my students
  • Apply to be on Wigan Local Involvement Network
  • Explore a community arts project with the Metro regarding lift shafts

Next steps involving Ketso included:

  • Share concept with colleagues. Ketso - how we can use in all programmes and offerings?
  • Look to promote the resource and methodology with Healthy Cities
  • Look at incorporating methods to wider applications
  • Use ideas in some consultation that is planned
  • Plan how I can use Ketso in my work - to help disabled people find solutions
  • Look at using the Ketso method in grief counselling

You can find useful resources from the event here, including a ‘Brief Guide to some Terms and Upcoming Structures in Health Care’. A summary report will follow shortly.

LINk: Black and Minority Ethnic (BME) Workshop for Women

Claire Stevens, Link Manager at Brighton & Hove Local Involvement Network

Brighton and Hove LINk (BH LINk) is the independent health and adult social care watchdog for the city. We are a member of the BME Health Forum which facilitates the involvement of BME community groups and individuals in the planning, design, delivery and monitoring of health services and the wider health policy agenda.

The Forum is a collection of diverse individuals, groups and organisations from the community and voluntary sector and statutory sector, who have a shared interest in the health care needs and provision of services to BME communities.

Claire Stevens, the manager of BH LINk, agreed to facilitate a workshop using Ketso at a BME Health Forum event with the assistance of Nora Mzaoui a Development Worker Health and Support with People Can (formerly Novas Scarman). About twenty women from BME communities attended the workshop on women’s health. The team used an interpreter for one group of women from the Chinese community.

A comment from an anonymous evaluation form was:"method of capturing people’s view very good. Should be used for future workshops".

You can download the report from the event here.

Ketso in work with patients and in grief counselling

A psychiatrist in Merseyside is using Ketso with patients to explore risks and their responses to them. Other members of her team are working directly with recovering drug users to help them in their recovery process. One of the aspects that they find particularly useful with Ketso is the fact that patients can work at their own pace, adding ideas to the Ketso as and when they feel able to.

In Scotland, Ketso has been used in alcohol reduction programmes with a cross-section of community members, gathering ideas and developing connections between them for action. Feedback from these workshops has been positive.

Anne, the founder of Jigsaw4U, bought a Ketso 24 and uses it for grief counselling with children and families. Both children and parents participate in this workshop. The felt workspaces are used as ‘Worry Trees’  with Ketso centerpiece used to represent the child/family’s life.  Branches are used to explore what has changed in life since the source of their grief occurred.  What are the concerns? Fears? Losses? What are the hopes? Possibilities? Positive things?

The benefit of using Ketso in this exercise is being able to move the leaves around, e.g. to transfer a loss to a hope. 
Using Ketso in this way is seen as non-threatening and gentle, allowing children to feel safe while they are exploring their feelings.

The felts are used one to one or in family work or in groups of families.  It works equally well in all of these settings.

The simplicity of Ketso makes in a valuable concept and tool for Anne and Jigsaw4U.  Anne says using it opens doors, and helps to get beyond language, culture and gender barriers.  Some children have expressed themselves through pictures on the leaves.  The use of Ketso in this way has encouraged discussion and sharing between children and parents.

Health and Wellbeing - Open Space

Katie Stevens, Health and Well Being Project Manager at Groundwork South West

Groundwork South West (GWSW) have employed a Research Associate to undertake a research activity in partnership with University of the West of England, Bristol to develop an evaluation toolkit to assess the health benefit of community-based programmes delivered by GWSW. GWSW have used the Ketso kit as part of consultation work in a programme funded by Marks and Spencer (M&S). The activity involved community members discussing what the programme will involve and ideas for improving an open space. M&S employees then assessed these ideas against each of the health and well being outcomes of the programme proposal.

The Ketso Kit was a relevant tool for this activity as the group could logically work through the ideas and assess them against the programmes outcomes, and staff could contribute their ideas on the Ketso Kit without being influenced by each other. The Ketso Kit kept the group engaged and focused throughout the discussion workshop, as each person was involved in contributing their ideas.

GWSW now plan to use the Ketso Kit with staff at GWSW as part of the research project we are undertaking. We will use the Ketso Kit to answer the following questions:

  1. What community-based programmes being delivered by GWSW promote health or have a health aspect?
  2. What aspect of health can be evaluated in these community-based programmes?
  3. How can these health aspects be measured?

This activity will get staff in GWSW to begin thinking about how their programmes are incorporating health and to begin thinking of ideas of evaluation. The Ketso Kit allows the Research Associate to demonstrate to staff practically how the Ketso Kit works, it also allows for all staff to input their ideas into the research project. These findings will lead on to developing a database based on the information given by staff. GWSW have two Ketso Kits so are able to use each of the workspace felts with 8-10 people on each one, so the whole organisation are able to participate.

A participant from from M&S, who was at the consultation workshop with community members commented: "It was an interactive and colourful way to get the opinions of myself and local residents."

Health and Wellbeing Boards - an Ageing Dimension

Fifteen participants from local authorities, health agencies and consultants working in health and wellbeing from across England attended a workshop on the 26th September 2011, which launched the Ageing Well – health and wellbeing programme (part of the Ageing Well Programme, of the Local Government Group). Participants worked in teams to discuss ways to include an ageing dimension in the shadow Health and Wellbeing Boards that are in the early stages of development across the country.

In the workshop, branches were used to provide themes for organising the ideas. The starting point for these themes was the New Economic Foundation’s (nef) Five Ways to Wellbeing:

  • Connect
  • Be Active
  • Take Notice
  • Keep Learning
  • Give

The discussion throughout the day was lively and involved some searching debate about the role of local authorities and the various bodies involved in health and wellbeing. There were some serious questions asked about changing cultures and practices. Whilst there was recognition that these were difficult times, there was also a sense of hope that opportunities to share ideas such as this workshop offer an opportunity to question assumptions and could lead to new ways of working.

The workshop lasted for two hours, and a total of 215 ideas were developed and discussed. You can download the results here:

The interactive nature of the workshop was seen to support such dialogue and debate, as one participant commented: “Ketso offers a simple way to get everyone talking, with a bit of structure and a way to make connections between ideas.”  Steve Pitt, Consultant on the Health and Wellbeing - an Ageing Dimension Project.

Merseyside's Decade of Health and Wellbeing

In Jan. 2011, eighteen members of the Creative Leadership Forum of the Merseyside NHS Trust  have used Ketso to explore ways to increase wellbeing, as part of their launch of the Decade of Health and Wellbeing.

The Five Ways to Wellbeing developed by the New Economics Foundation were used as the basis for the discussion.  The half hour discussion allowed some interesting connection to be made, such as the need to lobby for cultural partners during this time of budget cuts, due to their important role in enchaining wellbeing, and the need to create new partnerships . Nature and the value of time in open space was a common theme. there was a lot of discussion around exercise and the need to walk and move around more, as well as the need for healthy nutritious food. Giving in creative ways and volunteering was discussed, as was the value of developing coaching skills and more mentoring opportunities to increase connections between people. The idea of abolishing boring meetings was also brought up.

A 'next step' that was placed next to the future possibility 'Treasure your wellbeing project' was  'Reflect on use of Ketso in my role'. 

You can download the full set of results here.

Creativity in Mental Health Care

Ketso was used in a Mersey Care Conference, focused on Contemporary Mental Health Care in May 2011. Ketso was used to gather inputs from 150 participants in 'Cafe Conversations', with the aims of generating conversations, encouraging creative thinking and making connections. The following is a quote from the researcher who helped plan the event and who analysed the results.

“The challenge we faced was how to generate a collective view across approximately 150 people, whilst still ensuring that the individual voice was heard from all participants. Moreover, the event included people from a range of sectors with different cultural norms and ways of working. The advantage of Ketso was to give each participant the opportunity to record their own thoughts and ideas and also to hear and discuss other views in an approach that was easily accessible for all, regardless of sectoral differences.

The inquiry that we followed concerned creativity in healthcare, and Ketso enabled us to approach this in a way that was in itself creative and consequently allowed innovative and free thinking ideas to emerge. Attendees particularly enjoyed the opportunity to view and reflect on other groups' views and the beauty of Ketso is that there is no 'right or wrong' answer or way of responding, which seemed to generate a supportive and positive environment. Moreover, when it came to the generation of themes from the responses, the practical nature of the materials meant that responses across groups could be easily grouped. The only challenge at the end of the event was that although the hundreds of responses generated demonstrated the success of the method, cleaning the hundreds of 'leaves' created was a task in itself!” 

Justine Karpusheff of Baseline Research

Note - please see our video on cleaning the kit for tips on making the cleaning easier!

Alcohol reduction in the community

In early 2011, Paisley West and Central Community Council asked various departments of Renfrewshire Council, the Community Health Partnership, Renfrewshire Community Health Initiative (RCHI), the Police, local schools, Strathclyde Fire and Rescue and local elected members to support them in trying to change the way that alcohol affects lives in the West-end of Paisley.

Together, they agreed to seek the views and opinions of local residents about how drinking alcohol could be made more positive and less harmful, and to get them involved in the process.

As a result, a small community-led working group organised an event which used Ketso to gather input from participants into this issue. A representative cross-section of more than forty residents participated and a Member of Scottish Parliament and local councillors were also in attendance.

Extracted from report by John Wilby, Chair at Paisley West & Central Community Council.

To download report, click here.

Dialogue and communication amongst professionals in healthcare

There are many examples of Ketso promoting more effective dialogue amongst diverse groups of professionals and stakeholders in health care.

Stakeholders from disabled people, to refugees, to the National Trust and nursing students have used Ketso in discussing how to help disabled and disadvantaged people to access heritage sites (a Somalian refugee is shown adding her ideas to the Ketso here).

The Faculty Training Manager in Medical and Human Sciences at the University of Manchester has used Ketso kits with clinicians and researchers to map out how they are going to effectively communicate their research findings to multiple different audiences (patients, patient groups, researchers, family, support groups etc).

The MerseyCare team is also using Ketso in team meetings and planning events. The following quote is a reflection from Berenice Gibson (Programme Support Manager, Creativity & Wellbeing/ Arts Co-ordinator, TIME Project, Mersey Care NHS Trust) about using Ketso in such planning:

"For me as the organiser it has been great being able to have such a visual record of each meeting, we’ve take photos of the sheets after each meeting and then circulated them as you would minutes. In addition at each meeting the photos of the previous meetings are up on the walls giving people an instant recap of the meeting before we move forward. We used the action planning felts yesterday to plan the day and the sessions, and again that worked very well."

A Healthy London - a dialogue

Twenty-three professionals involved in health and social care met on March 16, 2011 to explore how Ketso could be used in promoting health and well-being and engaging with the diverse stakeholders who are involved in the health arena.  As well as learning new tools for creative involvement of stakeholders in working out ways to improve health, participants learned a different way turn ideas to action and create an action plan on a collaborative Ketso.Healthy_London

Outcomes

The workshops yielded 430 ideas in under three hours. Assets which could help London to be healthier that were highlighted as significant were: ‘polyclinics’, ‘patient support groups’, ‘banning chicken shops within 400m of schools’, ‘smoking ban and help to stop smoking’ and ‘walking routes’. 

A problem that was highlighted as significant was: ‘NHS taken for granted’. Ideas that were clustered around this issue were: ‘ignorance about entitlement’ and ideas to improve this problem were: ‘get rid of Quangos and train media staff better’ and ‘stop whingeing culture’. An overarching goal to emerge from this discussion was ‘NHS awareness’.

There was a general sense of the need to involve the community more in health planning, and to develop more locally based projects with the aim of improving health. There was recognition though, that there was a lot of good work already going on in this area, and that there had been an ‘increase in public consultation’.

Please download the full report (pdf) of this workshop. An exel spreadsheet containing all the results from the workshop is available to download here (xls).