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22.02.18

Existing schemes prove strong ties between NHS and councils ‘would change everything’

The chance to build a strong partnership between the NHS and local government to the benefit of communities is “the greatest opportunity in 70 years” and would “change everything,” top NHS England leaders have claimed.

Professor Keith Willett, the director for acute care at NHS England and the country’s top urgent care doctor, argued the two sectors had historically struggled to work together due to their financial, cultural and operational differences, but acknowledged that their goals are increasingly overlapping as systems integrate.

“Many in the NHS and social care have no idea of the complexity of the other care system yet we are interfacing with them all of the time,” he continued. “You can’t understand the complex needs of people until you’ve listened to a patient or carer talking to their GP or ringing 111 or 999 for a local mental health response or to sort out a care issue for an elderly person who then ends up going into hospital.

“The NHS traditionally presents change from an evidenced-based and population-benefit perspective, and local government often sees such change from the individual constituents’ day-to-day life circumstances and their holistic social need.”

And in a short film made to promote a joint health coaching scheme being adopted in in East Sussex, Dr Nick Harding, NHS England’s senior medical advisor, says: “Wouldn’t it be amazing to see health and care without boundaries, the NHS working with local authorities for the benefit of the local population – now that would change everything.”

Both Willett and Harding have highlighted the work taking place in Sussex as a “doable” example of joint working between both sectors. Willett even went as far as predicting that if NHS and local councils fail to establish these partnerships, they will face “increasingly hard questions from the public” because the status quo is “looking less and less attractive” – although analysis has showed that current plans for care integration, such as accountable care organisations, have not gone done well with most people.

In partnership with the District Councils Network, NHS England has also highlighted five schemes where local authorities and the health sector had formed ties that were already improving services.

This is the result of interviews with more than 50 council CEOs, directors of social care, public health, children’s services, mayors, local councillors and officers, all of whom stressed the importance of place-based working, co-production, early engagement and sharing expertise.

The schemes – which include initiatives in East Sussex, South Norfolk, Leicestershire, Buckinghamshire and Suffolk – also showed that clarity over the direction of sustainability and transformation partnerships (STPs) is crucial, as is building mutual trust and building “understanding of structures and constraints.”

(Top image c. Radachynskyi)

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