Dear Secretary of State for Health and Social Care
blog | Words Matthew Horne | 08 Jul 2024
Congratulations on winning the General Election, and being appointed to the Cabinet. The next five years will undoubtedly be very challenging for our health and social care system: the workforce is stretched, demand for care is high and rising, and the poor state of the public finances means there is very little new money.
Innovation Unit has spent the last 15 years supporting innovation that addresses health and care inequalities, reduces demand for acute care, and repurposes the resources that are already in the system.
Below we have picked out five commitments from your manifesto, where we can share lessons of how to deliver these promises, as well as evidence of what does and doesn’t work.
1
Tackle the social determinants of health, halving the gap in healthy life expectancy between the richest and poorest regions in England.
For almost four years we’ve been running the Health Anchors Learning Network, which has 1700+ members across the UK who are all committed to reducing the gap in healthy life expectancy by addressing the social determinants of health. Members include NHS employers, local authorities, charities, and business. Collectively these anchor organisations, spend hundreds of billions each year in our economy with the power to change lives. We run this network to spread good practice about how organisations can creatively use their power as employers; as owners of buildings and land; and the power of procurement, local advocacy, and community engagement to improve the health of local populations. We argue for much stronger accountability in the NHS and local government for how they support broader social and economic development.
2
Move the NHS to a Neighbourhood Health Service, with more care delivered in local communities
My Care My Way is an innovative integrated model of care for older people in West London CCG. The service started initially with two new patient-facing roles based in GP practices: case managers and health & social care assistants – who provide all people over the age of 65 with a single point of contact into the system. The wider neighbourhood team can provide multidisciplinary assessments and extended appointments bringing together GPs, social workers, geriatricians and Pharmacists. The model has a strong whole system focus on self care, social prescribing and prevention. Our team worked closely with the frontline practitioners from primary care, social care, acute care, and local voluntary organisations to rapidly develop, refine and improve the model and practice. We argue for a plan to spread and scale similarly successful examples of a neighbourhood health service that are coproduced with local communities to meet their needs – rather than a one size fits all straight jacket.
3
Establish a network of ‘Young Futures Hubs’ to provide open access mental health services for children and young people in every community.
We have spent the last five years designing and setting up open access mental health hubs for working-age adults through Living Well systems. Our experience shows that providing flexible, easily accessible, community-based mental health services significantly improves outcomes that matter most to people. Our work in Edinburgh, Greater Manchester, York, and Derbyshire has led to new local multidisciplinary hub teams delivering recovery focussed and preventative support to thousands of people. We have learnt a huge amount about transforming our mental health system for the better, and how to design and open Mental Health Hubs that work for local communities. We argue for greater integration between adult and adolescent mental health services, and for the design of Hubs for young people to be done in partnership with young people and their families in local places so they better meet the needs of children, adolescents and young adults as they change through their lifecourse.
4
Develop an NHS innovation and adoption strategy and streamline processes for clinical trials
Creating an efficient and effective innovation and adoption strategy is essential for the NHS. Our report, Against the Odds: Successfully Scaling Innovation Across the NHS, analyses the challenges in the NHS and identifies specific opportunities for clinical trials and the need for a supportive infrastructure to foster continuous innovation. We have put this learning into practice through the Adopting Innovation programme funded by the Health Foundation. We have helped to set up Health and Care Innovation Hubs across the UK, and developed an Adopting Innovation Framework to help NHS staff make sense of the complex, ambitious task of adopting innovations in the NHS. We argue that the innovation ecosystem in health and care should be more open and collaborative, growing and evidencing impact through innovative partnerships with voluntary and community groups and the populations they serve.
5
Transform the NHS to put patients in control of their health.
We support the values and ambition behind this commitment. Our programme, People Powered Health, funded by Nesta exemplifies what this can mean in practice. Our NHS can give people much more control over their health, support healthy behaviours, and help to shape the services on offer locally. But only by changing the way it works at a Place level by
- involving patients more directly in their care decisions through care planning conversations;
- providing ‘more than medicine’ support that meets people health and social needs;
- investing in peer support and social prescribing;
- and by taking a collaborative approach to commissioning and delivery, which embeds co-production with patients and citizens as well as partners across health, social care and the voluntary sector.
We argue for stronger incentives in the system for coproduction in health and social care, with greater accountability to communities and a stronger voice for patients in how decisions are made and how quality is measured.
We are keen to help shape a future where care is more equitable, more person-centred and more empowering. We look forward to helping make these goals a reality – sharing our insights, our evidence, and our approach to system change locally and nationally. Please do get in touch, if you want to learn more. Meanwhile we will be getting on with it.
Warmest Wishes
Chief Executive