Charity highlights ‘moral case’ for widening remit of NHS

14 Aug 19

By going beyond clinical care the health service can improve the socio-economic conditions of people in local communities, a charity has stressed. 

The Health Foundation said the NHS is “uniquely positioned” to improve the socio-economic wellbeing of local areas given the scale of commissioning and assets in the health sector.

“There is now a ‘moral case’ for maximising the role of the NHS in improving peoples’ health and wellbeing, beyond just providing clinical care,” the foundation said in a report out today.

By helping to reduce widening economic and health inequalities this will in turn reduce the growing pressure on health services, the charity added.

The report, produced by the foundation and drawing on work commissioned from the Centre for Local Economic Strategies, said the NHS can serve as an ‘anchor institution’ – a large, public sector organisation with sizeable assets that could be used to support community wealth building and development.

It suggested five ways the NHS can use its role as an ‘anchor institution’ to help local communities:

  1. As the UK’s largest employer – employing more than 1.6 million people – it could widen access to quality employment
  1. Commissioning with a focus on ‘social value’ it can improve the circumstances of local areas, as it is a £27bn industry in England alone.  An example of social value is when purchasing goods and services from more small and medium-sized enterprises, which means more money is reinvested into the local community
  1. NHS land and assets could be used for the benefit of communities. In England the NHS estate includes 8,523 trust and primary care sites across 6,500 hectares of land. Where land is not used for clinical purposes it could be used as space for more affordable housing – an important driver of physical and mental health.  
  1. The NHS could “use its voice to push for broader developments that support the environmental health of local communities,” given its influence over local supply chains. It could also make the NHS more environmentally sustainable, with the heath service currently responsible for 40% of public sector emissions in England.
  1. Use its influence and work collaboratively with local organisations.

Dominique Allwood, assistant director of improvement at the Health Foundation, said: “Access to good medical care is also crucial but it ultimately plays a lesser role in our overall health than these wider societal factors.

“There is therefore a clear need for the NHS to make a broader contribution to people’s lives, leveraging its considerable resources to improve the economic and social conditions that impact so fundamentally on our health.”

Neil McInroy, chief executive of CLES, said: “As part of a community wealth building approach, health institutions as anchors can help to repurpose our public services and generate significant social value.

“We urge the NHS to move forward in recognising any systematic changes that need to happen for it to maximise its potential as a significant anchor.”

Michael Wood, head of health economic partnerships at the membership-body NHS Confederation, said: “The NHS is the largest employer in this country and this report taps the growing enthusiasm to maximise its importance in local communities and economies as a force for positive change on issues including workforce, affordable housing and reducing environmental impact.”

The Department of Health and Social Care has been contacted for comment.

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