Health > Wellogram

A health care system based around professionals and hospitals designed to respond to emergencies and infectious disease is less effective with dealing with one of the big challenges of our time; lifestyle related chronic diseases. They cannot be cured but instead need to be managed in daily life beyond the GP or hospital appointment. Over half of the population over 65 years are currently living with one or more long-term health conditions. As we continue to live longer, these conditions put a strain on resources with the cost of diabetes alone amounting to 10% of the NHS annual budget.

We wanted to explore a new narrative around health, one that looks beyond illness to wellness and develops a broader story about a capability and relationship based response.

We asked: What does living well mean to you and your family?

We used our transformation design process to drive our Wellogram work. Activities included asking people to share with us how they lived their lives; what they ate, who they spent time with, what they did. We looked at the physical, the social and the emotional. Key insights include:

A focus on wellness, not illness
Asking people about their wellness started a new and different conversation, one focused on life generally, peoples’ relationships, work and environment not just their physical health. People immediately thought about new things they could do.

A common approach 
We met people who were living with more than one health condition, each dealt with in isolation. We saw an opportunity to support people to build habits that led to better lives across conditions.

Building habits
People told us they knew what they needed to do but actually doing it and sticking to it was the challenge. We saw we needed to move beyond education and support people to take action and keep it up.

Seeing someone through a symptom 
We told the stories of the people we met to a group of GP’s, they told us that they are unable to see their patients in this holistic way when treating people symptom at a time. They told us that it was ‘like looking through a letter box’ at their patient.

Feeling part of something bigger 
People told us that our prototypes, focused on helping people to build habits with the support of the people around them, gave them the permission to act in new ways. It was powerful to make people’s relationships and their impact visible and to think about the role that they played. This is why we called our health work, Social Health.

Wellogram, the result of our innovation work, was delivered across three GP practices with over 450 people. The focus of Wellogram was the Wellogram Guide- someone who takes time to really understand the person’s motivation for change and facilitates and supports them to take meaningful actions that are important to them – building in the support of their network.
In this work we have been testing the ‘Relational Worker’ role, working one to one with patients in the heart of GP practices. It is both the relationship with the guide and their way of working which starts with the patient’s goals that drives the continuous process of action and reflection that supports people to make changes and develop their capabilities and ultimately take ownership for their own health and wellbeing.

Building on our body of work, including our youth work, we developed a Capability Measurement Tool so members’ could plot changes in the areas of Relationships, Health, Work & Learning and Communities. We have seen how growth in these areas has directly supported people’s wellness and their continued motivation.

We have co-designed and delivered a prototype service which:

  • Explored a new way of looking at health – from one that focuses on wellness as opposed to illness and supports action over education.
  • Focused on bringing the concept of capabilities explicitly into our conversations with people, shared our tools and supported and encouraged them to consider all when thinking about their health.
  • Developed a new way of working, an approach that places relationships at its heart – we call this a relational welfare approach. 

Wellogram has made a significant impact on the lives of those worked with. Participants improved their health status as shown by standardised measures such as weight loss, which 75% of members experienced. Seventy seven percent of members had healthy blood pressure levels, and 22 percent of members were able to bring their blood pressure down from risky levels. Of those members who smoked, 75% quit successfully. 

Capability measures also improved, for example by 72% for health & vitality and 76% for work & learning. This was a finding of interest to colleagues working on our employability project, Backr.

Wellogram was presented at the ‘Transforming Primary Care for London’ event in 2014, as an exemplar of what “Great Primary Care could look like in the future”.

Wellogram is a powerful exemplar of how everyday relationships can sit at the heart of a 21st century relational welfare state.