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URBACT's Mireia Sanabria on social innovation in health and social care

Author: SIE
Published Date: 16 February 2016

Mireia Sanabria holds a degree in International Politics from the Universitat Autònoma de Barcelona (UAB). She is an independent consultant on integrated urban policies with participatory approaches. From 2012 to 2015, she was Lead Expert of the URBACT II 4D Cities project on Health innovation with an economic growth. Previous to that, Ms. Sanabria spent four years as International Cooperation Programme Manager in the Badalona City Council (Barcelona, Spain) where she conducted exchange projects on urban development with other European, Mediterranean and Latin American cities (i.e URB-AL II EU Program on urban public space and social cohesion). She had previously spent 3 years developing research activities at the Development Programme of CIDOB, Barcelona Centre for International Affairs. At present, Ms. Sanabria is Lead Expert of the URBACT III RetaiLink project. Publications related to Health Innovation can be found in the 4D Cities site, namely the collection of four project interim output reports and the final report titled 'Patient-Centred Health Innovation with and Economic Growth'.

Social Innovation Europe interviewed Mireia on her insights around innovation within health and social care, building on our recently published paper “Social Innovation in Health and Social Care”.

What for you are the most important health and social care innovations that are taking place in Europe?

The starting point is focusing on empowering the patient. The important innovations then I would say is those taking care of patient capacity building and informing and changing the view of health as a given service. The risk with fostering this type of innovation is one (whether it is the government or innovator) can be seen as someone who is transferring the responsibility onto another versus sharing the responsibility. Innovating in health should in the long-term change the way health is managed and the government has to support and be involved in this.

Another innovation is the use of social networks or the supervised use of Internet networks for special social diseases like mental health and alcoholism. When anonymous, peer support is quite spontaneous. When volunteers are engaged in a social innovation health project, it turns to be very useful, but I’m afraid this is more in the culture of some countries but not every country in Europe. One can see that peer support, relying on volunteers may work very well in the UK, Sweden or the Netherlands but not as much in Spain, or other eastern countries, I would say. So for me, social Internet networks with a professional supervision play an important role in bringing together anonymous patients and ‘expert patients’ with same concerns, then support comes more naturally.

The report also talks about integration which to me, needs to be done along with rethinking and redistributing of professional profiles and tasks. From my experience in the 4D Cities project, health service and care delivery changes from one country to another. For example in Spain, nurses and social assistants are two roles that very much touch each other. In some other countries these are completely separate professions. More and more health and social care needs demand services from lower level of health professionals. This translates in social caregivers and nurses feeling the strain of a heavier workload. When this happens this must lead to either higher pay or better support - we need to rethink it differently.

What do you find interesting about the approach taken by the Young Foundation paper?

The paper is a comprehensive mapping of different practice fields that can be transferred to many European national and local contexts. What I find particularly useful is that it identifies key difficulties or resistant points where decision makers may find serious doubts when undertaking such innovative practices. For example, if you express social innovation in health services as something that becomes the responsibility of the patient and the community, it might look as transferring the duties to someone else while cutting health budgets. Or, if health innovation practices means an increase of investment with uncertain results, it demands a higher effort to evidence positive impact and benefits. All this has to be very carefully considered and probably tackled from a broad education and dissemination approach. The paper helps to identify where the difficulties are and how to approach them.

What can cities regions and national authorities do to promote more rapid diffusion of these types of innovations?

I think with enabling piloting projects at the community level and make good disseminating of results among professionals and patients, and the broader public in the end. It shoul avoid the image of a politically driven project and go for genuine co-created practices in line with the local culture. For example in Romania, in the city of Baia Sprie, we saw the case of people engaging and participating in a local project on re-opining a local hospital. Funding came from everyone’s pockets because there was no public budget for it. The success of the initiative had to do with multiple supports and the local religious culture - so something that is community rooted can be really successful.


Read the paper: Social Innovation in Health and Social Care 

Read the interview with 4D Health Centre's Enric Macarulla Sanz