NHS is ‘not a great partner’
The biggest barrier to developing a neighbourhood health service in England is not money, estates or data – it’s the NHS.
That’s according to Lord Victor Adebowale CBE, Chair of the NHS Alliance, who told the LGA’s annual conference in Bournemouth that the NHS is “not a great partner”.
“We tend to arrive in communities wanting control, defined boundaries, detailed governance, and we call that leadership. It isn’t,” he said.
“Local government… is better at the things that make neighbourhood health actually work – genuine partnership, being led by the community and being brave enough not to impose one model on very different places, because different communities have different needs, assets and histories.”
He added: “The inverse care law still holds – that those who need care most are least likely to get it. A neighbourhood health service that forgets that isn’t reform; it’s the old system with a new name.”
In the same conference session, Professor Lisa McNally, Director of Public Health at Worcestershire County Council, urged delegates “not to let neighbourhood health become another service transformation of the NHS”.
Eighty per cent of health outcomes are determined by social factors, which are most influenced by local authorities – “things like financial security, housing, education, employment, skills and, importantly, access to a community full of socially supportive connections”, she said.
Prof McNally highlighted how residents of the Westlands estate in Droitwich Spa, given £100,000 to spend on improving local health, had invested in a local wellbeing hub and support for children with special educational needs, plus a nature trail and bike repair shop.
After one year, urgent hospital admissions dropped 7 per cent (up 5 per cent for the rest of Worcestershire) and demand for children’s social care was down 20 per cent.
“That’s what happens when you trust in communities… and make neighbourhood health about neighbourhoods,” she said.
The session also heard from the then Health and Social Care Secretary James Murray MP, who emphasised the importance of having the right structures in place – such as strengthened health and wellbeing boards – to “make sure cooperation happens routinely” between the NHS and local authorities.