Nuka system of care was developed by the Southcentral Foundation in Anchorage, Alaska to support the native community. It is essentially a way of thinking. Focus on wellness not a specific problem. Build meaningful relationships between people who can help and people who need help. Use the trust from that relationship to help citizens take responsibility for their own wellness.

There are also integrated teams bringing together many practitioners into hubs. The workers are trained to value the story of those they support, and so build the relationship and trust that is core to the Nuka model.

When health worker Karen Barnett considered the relevance of Nuka for the U.K she came to the following conclusion:

  • Build relationships with communities and work with them to design and deliver new models – real engagement and commitment to listen and create the delivery focused on the needs of the customer, not on the needs of individual professions or organisations.
  • Build relationships in teams and with individuals across the system that creates trust and commitment where staff feel that delivering at the top of their game is the norm and that they can’t let their team or their customers down.
  • Commit to a long term mission, vision and strategic goals where everyone understands how they can contribute and feel a connection to the achievement of the goals.
  • Delegate to grow – trust people to do a good job, provide them with the training to deliver, and provide clear expectations and measures so that they can see the impact that they are having.

You can read more about Nuka at: more about Karen Barnett’s reflections at:

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