The NHS contributes to the health and wellbeing of the population over and above providing access to healthcare
The NHS is famously the fifth biggest employer globally, spends nearly £30 billion each year on goods and services, and is one of the largest land and property owners in the UK. But the economic and social impact that NHS organisations bring to the towns and cities they serve has been underappreciated, not least by the NHS itself. Awareness of how the NHS acts as an “anchor institution” and contributes to the health and wellbeing of the population over and above providing access to healthcare is gaining momentum within the health and care sector. In Leeds, working with our health and civic partners has accelerated this effect.
We know that health has a social gradient, and those who live in deprived neighbourhoods are more likely to suffer ill health and have lower life expectancy, resulting in higher healthcare costs. If the NHS is going to make the biggest difference to population health outcomes, we need to consider how we can positively influence the wider social determinants of health—for example access to good quality education, employment and housing—alongside action on prevention and healthier lifestyles. These complex issues require action across organisations, working in partnership with a clear place-based strategy, aligning discrete interventions so that we are greater than the sum of our parts.
In Leeds our ambition is to be the best city for health and wellbeing and to improve the health of the poorest the fastest; over 170,000 people live in areas ranked amongst the most deprived 10 per cent nationally. To meet these aims, anchor institutions across Leeds have come together to form a network: the city council together with NHS trusts, universities and Further Education colleges. We are collectively using our assets and influence as large employers, spenders, land owners and providers to develop a common strategy to improve outcomes for people, address organisational needs, and realise civic opportunity. With help from the city council and third sector partners, we are developing a deeper understanding of ‘priority neighbourhoods’ to provide targeted support based on the needs, assets and aspirations of local people.
Leeds has a younger population than other comparable cities, with the largest proportion of young people living in poorer areas. If we can maximise the potential of these young people through access to good quality employment, we can improve their health over a lifetime. The Leeds Health and Care Academy brings together healthcare and education anchor institutions to provide opportunities for skill development, job and wealth creation, with a focus on engaging and recruiting those in our most disadvantaged communities. This not only supports local prosperity, but importantly, is a proactive response to the workforce pressures in the health and care system. The NHS struggles to attract and train enough staff to meet demand, so engaging and supporting more local recruitment is key part of inspiring the next generation of the health and care workforce.
Within Leeds Teaching Hospitals our apprenticeship programmes widen access into employment, including into professional roles such as nursing. We have a comprehensive development offer and have worked hard to increase the proportion of our lower paid staff who are promoted, improving retention and investing in people’s future.
One of our sites St James’s University Hospital is situated within Lincoln Green, the third most deprived area in the city, and among the 1% most deprived nationally. Working with the city council we have run bespoke outreach events promoting health and care careers to the local population. Over 130 people attended the first such event earlier this month and every person left with either a place on an employability skills training course with a guaranteed interview for a job on completion, a place on an English as a second language course, or an invite to apply directly for a currently advertised role.
With the publication of the NHS Long Term Plan, NHS organisations across the country will be thinking about how they can address health inequalities. To maximise the opportunity, they should consider their role as an ‘anchor’ within the local economy and seek to work with partners to best address some of the social determinants of health.
Competing interests: none declared
James will be presenting a session, ‘Anchored in the community – how the NHS can influence population health’ at the Health Foundation annual event 2019 on Thursday 23rd of May, with Dr Tammy Boyce from the WHO Regional Office for Europe, John Craig from Care City and Sarah Reed from the Health Foundation.
Keynote sessions from the event will be livestreamed and you can register now to watch them here.