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In the early 1990s the Newcastle and North Tyneside Health Authority’s strategic objective was to ‘rationalise’ the hospital service in Newcastle by strengthening community-based services at the same time as closing hospital beds. They realised that they had to build closer relationships with the City Council, the universities and the many active voluntary agencies in the city. This led to the formation of the Newcastle Health Partnership that brought together the major stakeholders with an interest in improving the health of the city. One senior official said:

"When I heard about the whole system idea I thought ‘Yes!’ It seems
obvious to me that the whole should function as greater than the sumof its parts. The very democratic approach of whole system working is something that promotes the wide involvement needed to ensure that this happens."

A group of people came together in early 1995 to explore the ideas and how they might be used to improve the well-being of older people in the city. They knew that this would depend on a lot of different organisations and on older people themselves, and could imagine that bringing them all together might be productive. So they went to the newly formed Newcastle Health Partnership with a proposal to hold a Whole System Event. By the final planning meeting in September 1995 more than 35 people and organisations were already involved and on the big day something like 200 people gathered at the Eldon Leisure Centre.

I remember going down the long corridors with a real sense of expectation but also nervousness. There was a tremendous buzz. In the main hall lots of round tables were set up and all sorts of people were milling around wondering what was going to happen.

Participants had all sorts of concerns - would this just be a talking shop, was it worth three days of their time, would their concerns get to the top of the agenda, would the results be anything other than an unrealistic wish list?

To me the essential thing was to suspend disbelief and give the event a chance. I’m glad to say that most people did the same and it began to gather real momentum.

A whole system event is not at all like a normal conference or public consultation. There is no platform, no presentation and no outside experts. Almost a quarter of the participants were older people. They were some of the most enthusiastic, not least because they found themselves sitting around the same tables as senior managers discussing issues that really mattered to them.

Getting chief officers on board is really important. We worked hard at that. The most important thing is that top people are supportive, even if they’re not all present

Local people formed 15 small groups after the event to work on issues they felt strongly about. Some got on quickly with specific work, such as publishing a directory of housing suitable for older people. Some grew in unexpected ways, others floundered. One group began with a concern about culturally appropriate services and developed a programme of work to improve hospital discharge.

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