Health Service Focus

09.02.18

Health creation is here to stay

Source: NHE Jan/Feb 18

NHE’s Sacha Rowlands speaks to Michael Macdonnell, NHS England’s national director for transforming health systems, about the value of health creation when designing strong sustainability and transformation parnerships (STPs).

Meeting NHS England’s Michael Macdonnell at New NHS Alliance’s bustling summit on 6 December, he is keen to tell me why he believes that STPs, accountable care systems and health creation are so important when addressing health inequalities.

“The whole point behind these is to build vehicles of collaboration for the NHS, for local government, for local groups, and for the third sector in order to try to get the best health for people in their patch,” he explained. The ultimate goal is partnership working and establishing how to get the best return on public pounds.

“Additionally, we’re trying to ask them to focus on population health, not just healthcare, which means really trying to understand the needs of the population – not just focusing on hospitals, but trying to redesign care in a way that prevents illness or prevents people from becoming acutely ill. That means drawing on the skills of some of these wider groups, but also getting upstream and getting to a more proactive way of doing healthcare.”

There are also technical fixes to be implemented, such as moving away from a hospital-based finance system that rewards activity and working towards a budget approach to try to get the best return on resources.

Health creation is an important part of STPs, but not the only part, Macdonnell told me: “We also need to improve healthcare services; we also have to deliver within the budget that we have. But as we ask people to collaborate and to think over the longer term, which is what these vehicles are about, we have to be asking: how can we reallocate some of our investment and some of our activity to try to prevent illness, not just deal with it when it comes?”

Council leadership in the DNA

That’s central for the mission. When STPs were first described in the Five Year Forward View, they were intended to deliver on three ‘gaps’: health and wellbeing, care and quality, and the funding and efficiency gap. The first is all about health inequalities and how to make an upgrade in prevention.

“Unfortunately we’ve had our preventative services cut in part, but we still have to get upstream and ask,” explained the national director.

“The best STPs are clearly ones that have local government at their heart – places like Milton Keynes, Bedford and Luton, Nottinghamshire, and Greater Manchester, which all have local government leadership baked right into their DNA. They’re making some of the strongest progress because they’re asking, ‘how can we bring housing, policing and fire services to the table in a way that solves health problems as well?’”

But the NHS England director claimed that is not being done well everywhere, with some areas finding it almost impossible to get local government and NHS organisations in the same room. “That’s the sort of thing we have to fix,” he argued.

Beyond ticking boxes

In too many parts of the NHS, health creation also is seen as a “tick box exercise,” and Macdonnell said that this is something they need to get much more forceful on. “It is about changing some of the incentives as well. If people want to do the right thing, we want to try and make it easy for them to do the right thing. And that means, for instance, changing how money flows; it means recognising some of those contributions as much as we do for A&E.”

But can NHS bodies really focus on health creation when they’re so intent on bringing down the deficit? “It’s easy to paint us into a corner where all we do is worry about money. We’d be in the wrong jobs if that was what we worried about all the time. We worry about trying to do the right thing,” he explained. “We don’t get to set the budget; it would be great if we could, but we don’t.”

When asked whether he thinks STPs will help facilitate long-term planning, the director argued that is “exactly what they’re for,” adding: “What we’re trying to do is create conditions in which local leaders ask serious questions about how they’re going to change things over a five-year period, for instance.”

If Macdonnell has one key message to give, it’s that every heath and care system across the country needs to engage with people to help prevent illness and put them in control of their own health – “not only because it’s the right thing to do, but because it will help them with their other jobs too.”

 

TELL US WHAT YOU THINK
opinion@nationalhealthexecutive.com

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Infant death sparks national investigation from Healthcare Safety Investigation Branch

21/03/2019Infant death sparks national investigation from Healthcare Safety Investigation Branch

A national investigation into NHS staff’s ability to recognise seriously ill and deteriorating infants has been launched following the deat... more >
NHSE to strip Capita of ‘shambolic’ cervical screening contract and bring it in-house

21/03/2019NHSE to strip Capita of ‘shambolic’ cervical screening contract and bring it in-house

NHS England (NHSE) has stripped Capita of its cervical screening administration services following “shambolic” errors made in failing... more >
NHS staffing crisis to double without radical change in ‘vicious cycle of growing shortages and declining quality’

21/03/2019NHS staffing crisis to double without radical change in ‘vicious cycle of growing shortages and declining quality’

The NHS could have a shortfall of 70,000 nurses and 7,000 GPs within the next five years and the crisis is so now so severe it “cannot be f... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Personal Health Budgets: empowering individuals

20/03/2019Personal Health Budgets: empowering individuals

Jon Baker, PHBChoices director at NHS Shared Business Services (NHS SBS) believes that the extension of Personal Health Budgets (PHBs) is a great opportunity for clinical commissioning groups (CCG) to expand and improve care provision – provided that the right infrastructure is in place. The personalisation agenda is transforming our NHS as we continue to migrate from a one-size-fits-all model of care towards care provision that i... more >
read more blog posts from 'the scalpel' >

comment

Staying curious with the Shadow Board Programme

20/03/2019Staying curious with the Shadow Board Programme

Kirstie Stott, director of The Inspiring Leaders Network, discusses organisational and system curiosity alongside the work of the Shadow Board Pr... more >
Fiction as Therapy

20/03/2019Fiction as Therapy

Elaine Bousfield of ZunTold Publishing – a press specialising in fiction for children and young people – discusses ‘Fiction as ... more >
Capturing funds for the NHS estate

20/03/2019Capturing funds for the NHS estate

Aahsan Rahman, department head of town planning at NHS Property Services (NHSPS), looks at an alternative and perhaps underutilised funding sourc... more >
The digital revolution for healthcare is now!

20/03/2019The digital revolution for healthcare is now!

Richard Corbridge, chief digital & information officer at Leeds Teaching Hospitals NHS Trust, focuses on the practices his trust has put in p... more >
A Critical Moment for the NHS

07/03/2019A Critical Moment for the NHS

As part of our guest blog series, chief executive of NHS Employers, Danny Mortimer, reflects on a recently published Health Foundation ... more >

interviews

How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >
Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >