It pays to behave like an investment partner

Wednesday’s spending review will reinforce the importance of local decision-making in England, whether through formal ‘devo deals’ or other such place-based arrangements designed to encourage growth. By cultivating a deeper understanding of how health plays a vital role in the local economy, the NHS can maximise these new opportunities to secure the investment needed to make the Five Year Forward View a reality.

It sounds obvious but, as a starting point, every local health economy is part of a local economy. The decisions we make affect not just the health of our population but also the health of our economy. Likewise, shocks to the local economy (as we have seen recently with the steel industry) will be felt by the local health service. It’s in all our interests to align our respective thoughts and strategies.

Leaders of growth

Every local economy has a Strategic Economic Plan outlining the strengths and weaknesses of that particular economy. Whether these mention the NHS will depend on what the local leaders of growth know about us. These leaders of growth will be your Local Enterprise Partnership (of which there are 39 in England), closely working with local (or combined) authorities. Their regular partners will cover public, private and the third sector and anyone who has a say in driving jobs and growth should be on board, including the NHS. How to advance this conversation, then?

As a starter for five, here are some of my initial thoughts on how we in the NHS might go about affecting local growth strategies:

Competitive advantage: a phrase considered anathema to many NHS colleagues, yet it’s the driving force behind our local partners demanding more powers. Wanting your area to be the best it can possibly be is a natural and important goal and anything the NHS can offer its local business and community colleagues to help them achieve this will be appreciated. The chosen priorities for local growth in any area will be based on competitive advantage, selectively targeting our finite investment to bring the biggest benefit to the population. Play your part and explain why health should be involved.

”Before we take a quick decision to sell off an old hospital site, have we considered that one man’s junk is another man’s treasure?”

Partnerships before product: focus on a product and you will, hopefully, get that product. Focus on establishing and maintaining new relationships and the potential products are limitless. To be an investment partner you need to have serious ideas, of course, but you also need to be open-minded to the concerns and ways of working of others. You may not care what GVA or FDI mean but your Local Enterprise Partnership (LEP) does - so work with them to help them understand how investing in the health sector can address their own measures of success.

Everything is an asset: we have a tendency to look only as far as our cash will stretch, yet often forget about things like our workforce, estate and brand - all fantastic assets that others will value. Before we take a quick decision to sell off an old hospital site, have we considered that one man’s junk is another man’s treasure? Do we understand which businesses LEPs are trying to attract to the area? Is your local authority under pressure for housing? Solving your problems may solve those of others, too.

Manage the message: what your partners know about the NHS will come from the media. While this is a rather uncomfortable thought, we can do something about it. First the tricky bit - deciding who should take ‘leadership’ for the health economy in conversations with partners. The strength of the NHS’ offering is in its sheer breadth and scale - having direct implications for LEP strategies around the critical areas of innovation, skills and employment and social inclusion. To maximise this though requires a level of coordination and strategy that not every health economy currently exhibits.

”Partners will demand commitment to each other and more importantly to the communities they serve and there should be no easy exit clause from that”

Risk and reward: one of the biggest criticisms of the NHS from local partners is that it still operates in isolation. Certainly where the NHS is involved in devolution deals this will have to change. Partners will demand commitment to each other and more importantly to the communities they serve and there should be no easy exit clause from that. On the wider point, if we are not playing a role in helping bring new investments to an area then we cannot also be asking partners to co-invest with us.

The national bodies have a clear role in this too, and so I have added one short final point just for them.

Match funding: I was asked by a colleague from another sector why we keep launching (non-clinical) national funding calls within the NHS, rather than seeking match funders. There wasn’t a satisfactory answer. My national wish therefore would be that all arms length bodies consider - before launching future competitions - whether this really is just an NHS issue, or whether we can utilise the resources of other sectors. Thereby putting the NHS in wider growth strategies, not drip feeding growth into the NHS.

These ideas may sound rough and ready and that’s because they are. They need reflecting on and contextualising both within, and across, the 39 LEP geographies. Nationally too, there is a need to provide support and to share examples of how these relationships work in practice.

As times get tough, we inevitably consider circling the wagons. That’s fine, just remember yours are not the only wagons defending your community.

Michael Wood is the NHS Local Growth Advisor at the NHS Confederation. Follow him on Twitter @mjwood00.

www.nhsconfed.org/localgrowth