The Bromley by Bow Centre
As we searched for environments and ecologies that bring the idea of Ecology of Health to life, we stumbled across the Bromley by Bow Centre, a community oasis tucked within the busy streets of East London.
About Bromley by Bow
The Bromley by Bow Centre has become an internationally acclaimed organisation that has developed a distinctive response to the complex issues facing a community with very high levels of health inequality and deprivation. Over the past 30 years it has transformed the lives of people who come from some of the most deprived estates in the UK. It has achieved this by providing a distinctive, holistic and easily accessible range of integrated services in one place. Since 1997 it has worked collaboratively with the Bromley by Bow Health Partnership to create the first Healthy Living Centre in the UK with a pioneering model that integrates primary health care with an exceptionally comprehensive range of services that engages the community and by focusing on improving the wider social determinants of health, alongside high quality clinical services.
The services available stretch from healthcare for local residents to opportunities to set up your own business; from support with tackling credit card debts to becoming a stained glass artist; from learning to read and write to getting a job for the first time or a helping hand up the career ladder.
The charity is focused on transforming the lives of local residents and the community as a whole. It’s based in Tower Hamlets, but operates across East London and delivers services in areas of very high deprivation. Whilst providing universal services, the Centre focuses on those with greatest needs and vulnerabilities, often the people considered the hardest to reach and engage.
The Centre is accessed by thousands of people each month who use its facilities and services and contribute to their development and running. The buildings and flowing courtyards are designed around a three-acre community park and have been created to promote access, interaction and empowerment.
We couldn’t think of a better place to represent the idea and reality of what Ecology of Health can mean.
We met with Dan Hopewell, Director of Knowledge & Innovation. Our meeting started in a church, the starting point for the Centre, which began with £400 in the bank and a congregation of around 15 elderly people. It is now a hub of multiple social enterprises. To give an idea of scale, its annual turnover is approximately £4.5 million. A second hub is a GP practice. It also has a popular and bustling café, provides employability training, even teaches people in the community how to fix mobile phones to earn income.
The first thing Dan talked about was the history of Bow, placing the centre into context, but also underlining a sociological interest. The values of the organisation and its place in the community were openly discussed: not in the sense of the contrived lists espoused by most organisations, but as a sense of real meaning.
The Centre is a charity, owned by the community. The GP practice operates as a discreet organisational entity, though the governance between the two entities is deliberately intertwined. The GPs were interviewed by the community for their positions. Which as a mechanism seems a beautifully simple alternative to the complicated way in which the neoliberal system has attempted to apply market based principles in healthcare. As an example of this top down approach, Choose and Book, has been spectacularly costly and ineffective.
At Bromley by Bow, patients pick which GP they would like to see. Those who choose not to pick are allocated. So a GP list is heterogeneous, contrasting the model of GPs with specialist interests. From the perspective of caring for the whole person, the BBBC model opens possibilities in not stigmatising conditions and enabling connections with wider context (i.e. a return to the model where a family can conceivably have a family doctor). From the evidence that social dislocation is a major cause of addiction in its varied forms, this could be a considerable advantage.
The architecture of the centre is very important – from in the way Dan describes it, and in the feeling of interacting with it. Dan described how consciously the place had been designed for experience. The whole place felt welcoming and inclusive. Dan likened it to the feeling of being at home. This applies even to the GP centre, in stark contrast to the clinical picture of traditional Health Service estates.
A tell tale sign of the level of humanity you experience at Bromley by Bow is given away by Dan’s level of enthusiasm for connecting our project with the best that the Centre can offer. At one level we’re talking about the conceptual origins and possibilities of the project with an influential director of an internationally famed community organisation. At another, we’re talking about the ideas that would really help bring our day to life. And Dan is also painstakingly focused on the detail of the arrangements that will create the best experience for our participants. That’s the kind of place the Bromley by Bow Centre is.
Find out more about the Bromley by Bow Centre