Service Reconfiguration

21.10.16

Unlock your role in the local health economy

Michael WoodMichael Wood, NHS local growth advisor at the NHS Confederation, explains why now is the time to be looking outside the health sector to build some of the relationships to make final sustainability and transformation plans (STPs) a reality.

A better understanding of how the NHS relates to the local economy can help our local NHS leaders to finance, staff and improve service delivery. With ongoing guidance from the NHS Confederation, it is hoped that a range of new relationships will be growing all over the country – whether in England’s diverse cities or the more rural economies.

The new prism through which the health service is viewing everything is that of STPs. While the draft plans will have been submitted to a 21 October 2016 deadline, now is the time to begin looking outside the sector for some of the relationships that can make final plans a reality.

At the heart of STPs is partnership-working, and not just within health and social care. Understanding all the drivers of population health and wellbeing will only become apparent by coalescing with those responsible for realising a community’s full potential. The STPs present the ideal framework for this.

Take for example the 39 local enterprise partnerships (LEPs) in England that have been tasked since 2010 with driving local prosperity. One of the LEPs’ key tasks is to develop a Strategic Economic Plan for their respective region, using data and evidence to understand the strengths of that particular economy and thus the chosen priorities for large-scale investment. They can’t do this job themselves. While they work closely with local, and increasingly combined, authorities and a range of other partners it’s often the NHS that is not at the table.

NHS leaders are in a strong position to influence those LEPs on a range of matters, given the powerful positive role of the NHS in bringing prosperity to local communities. The trick is knowing our value to that economy and not being shy about talking about it! Without going into detail, do we know how much of our expenditure stays local? How many people do we employ collectively in an area? What about our estates, our university links or our work to tackle social exclusion?

Where you should focus will differ according to local circumstance. In terms of kicking off relationships, there is no golden rule or one ideal method. You need a blank sheet of paper and an open mind – only through discussions will the areas of mutual interest appear.

Don’t forget about your elected leaders too. Devolution in particular is political, economic and social – to influence plans we need to remember all three and the new metro mayors that will be elected next year will all have their own views on what is the priority for the local health system.

One area where we do need to improve if we are to align STPs with other local plans is in understanding non-clinical outcomes that relate to the local community. Several CCGs recently told me that local transformation was pushing them to better understand how their work brought increased prosperity to their communities – with knock-on effects such as higher tax receipts and increased productivity a success story everyone can share in. A mixture of leadership, data and partnerships is the way forward, with everyone participating in the process.

Finally, there is the inevitable push-pull between local control and central control. If your focus is firmly on the place, then the demands of the centre may well become secondary – responsibility for decisions will naturally be shared with a range of local stakeholders. It is more power to your elbow.

The NHS Confederation will continue to support NHS organisations in this important local engagement. For too many decades the NHS has had an overburdened, centralised dynamic. Now it’s time to play our full part in realising our place’s potential.

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