The NHS should co-finance its future, not go it alone

By becoming a valued partner in local investments, the NHS can improve its service to the community, have a much greater say in devolved strategic discussions and secure long term, additional funding into the health service.

Chancellor George Osborne gradually fostered the local growth agenda throughout the last Parliament, nudged and cajoled every step of the way by local growth “champion” Lord Heseltine.

As devolution gathers pace and Manchester, Leeds, London and Sheffield – and now counties such as Cornwall – explore their own versions of “home rule”, more local leaders are understanding the need to collaborate economically in order to stay financially competitive.

‘The NHS operates at the heart of communities and local economies, so is perfectly positioned to get involved’

The NHS operates at the heart of communities and local economies, so is perfectly positioned to get involved. It is already a good local employer; whose work ensures a healthy, productive population while stimulating new markets for technologies and other innovations.

A council leader complained to me recently that the NHS “is only interested in us when we talk about social care”. What she wanted was the service playing much more of a part in engaging local businesses and inspiring local people, particularly those leaving school and further education and ignorant of the diversity of career opportunities we offer.

Whether this is a wider held view I cannot say, but it’s certainly not ideal for the NHS to be recruiting overseas while local leaders wrestle with long term unemployment and structural worklessness.

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Community focus

Moving from “core business” to a focus on “community business” enables us to tackle these skills and employment gaps in conjunction with other organisations and in conjunction with other funding. This shared approach can also bring co-financing opportunities in other areas such as housing, technology, transport, research, planning, public health and social inclusion and infrastructure, to name but a few.

Think about big business too. The newly branded Combined Authority areas that you won’t find on a map, such as the Northern Powerhouse and Midlands Engine for Growth, are predicated on attracting regional inward investment from some of the UK’s biggest sectors. It becomes much easier for our local colleagues and beneficial for the NHS when life science or medtech firms can co-locate with our trusts and when we can help upskill and grow their workforce.

‘Local NHS leaders should be reaching out to the 39 local enterprise partnerships in England’

Just like us then, the local leaders of growth are grappling with tough decisions about how and where to invest their combined resources for best return – let’s tell them how we can be of mutual help.

Local NHS leaders should be reaching out to the 39 local enterprise partnerships (LEPs) in England. Working with the full range of public and private partner organisations, the LEPs are involved in all policy areas relating to growth locally while acting as agents for change in influencing future governmental policy.

The NHS belongs at that table. To turn the government’s phrase on its head, “you can’t have a strong economy without a strong NHS”.

As public services struggle to adapt to the new financial and demographic landscape, there is a growing understanding that economic development can actually become a central driver of service change. Many of the ideas sketched out in the NHS Five Year Forward View, such as “test beds” of innovation and healthy towns, are great examples of economic development.

One of the main LEP funding tools is EU money, with large scale economic and social development projects being supported by EU Structural and Investment Funds. The relevance of this funding for our future - sustainable and local - NHS is reflected in its key spending priorities – those of research and development, skills and employment, and social inclusion.

Investment partners sought

England will have a set allocation to spend of about €6bn over the next seven years and LEPs are on the look out for funding partners with which to spend this money strategically, in order to drive jobs and growth. Add to this the local growth fund - worth over £2bn this year - and your local growth leaders are responsible for some serious levels of investment.

Most of this money requires match funding, hence the need for investment partners. Given the importance of the focus on localism, the NHS shouldn’t be looking to fund the forward view. We should be looking to co-fund it.

‘The NHS shouldn’t be looking to fund the forward view. We should be looking to co-fund it’

So, how to get engaged in this agenda?

Well, for a start we probably are – we just don’t think of it. Find out about your LEP and examine its strategy.

Does it mention health? Talk to your colleagues both within the sector and outside.

We already have strong relationships with local authorities, small and medium sized businesses, further and higher education providers, the third sector and so on. They are all involving themselves in the local change being driven by LEPs; we should too.

There are a growing number of examples up and down the country of NHS organisations shaping the future work of LEPs, putting health at the heart of their regional growth plans, and reaping the benefits.

Indeed, our challenge is to grasp the view that economic development lies at the heart of service change, not simply an add on. But of course, for economic development read community development. And what service change isn’t done for the community?

Michael Wood is senior European policy manager at the NHS Confederation. Contact Michael.Wood@nhsconfed.org for more information