How collaboration and community engagement can help create a stronger NHS
How can we tackle the growing crisis in the NHS? TPXimpact’s Iain O’Neil says shifting towards community-led approaches can help make integrated care work, protect the NHS’s future and improve health for all.
As many of us know or have experienced, the NHS is facing a range of increasing pressures. Whether it’s growing waiting lists or staff shortages, the health service is up against it, both at a national and local level.
These growing challenges now mean that we as a country are at a pivotal point when it comes to the NHS, especially around the systems and processes we choose to implement so that our communities can receive the best care possible. From resource allocation to service delivery models, we need to act fast and be bold if we are to get the health service back on its feet.
We need to act fast and be bold if we are to get the health service back on its feet.
In my view, one of the biggest choices we need to make is how to effectively deliver care at a local level. The government did start to take steps to give more power to regions when it comes to healthcare through the creation of integrated care boards (ICBs). Initially, I was optimistic about their creation, believing they would give local decision makers more control over funding and healthcare decisions. However, from what I’ve seen and heard from those working at ICBs, it seems that instead of being able to focus on local care needs, they are being asked by the centre to find efficiencies due to national budget pressures. The irony of adding a new layer into the system only to ask them to find efficiencies seems to be lost on those who control funding.
The irony of adding a new layer into the system only to ask them to find efficiencies seems to be lost on those who control funding.
Naturally, this change of focus, especially as ICBs are still forming in many places, is distracting the new care boards and affecting their ability to improve the quality of care their communities receive. It’s hard to talk about new models of care or service provision when the focus is already on cost reduction.
Sharing is caring
So, with changing requirements and mounting pressures, what can ICBs and communities do to improve healthcare in their regions? If local boards are to drive transformative initiatives that improve the quality of care, they need to be building relationships and establishing channels of communication that allow them to share ideas, share the load and work together.
There are many people and bodies across the country that have implemented new systems or alternative ways of working which have improved care in their area, but the eternal struggle is how to scale and replicate these successes. Instead of setting targets and seeking refunds, the centre could be putting in place systems, both physical and virtual, that allow these success stories to be shared widely, incentivising people to collaborate, pool resources, share knowledge, and experiences.
Increasing autonomy and community engagement
At the same time, healthcare needs are not universal and vary on a region to region basis. If ICBs were given more power to operate autonomously, as was initially proposed when they were conceived, this would better enable them to prioritise the needs of the communities they serve.
However, it’s not the case that giving more power to ICBs will produce instant results. ICBs must use this increased autonomy to truly engage with their communities to be able to understand and identify the healthcare needs of their population and address these accordingly. At the same time, this engagement needs to be supported by data, with ICBs using the information they have on their communities to make informed decisions on where priorities and funding should be allocated.
We can try to find efficiencies driven by tackling systemic problems – not by giving budgets a trim.
The challenges faced by the NHS demand a fresh perspective and for choices to be made on how care is provided going forward. The current “managed decline” is only going to end one way. By shifting towards community-led approaches while fostering greater autonomy, collaboration and engagement amongst ICBs and other local services, we can try to find efficiencies driven by tackling systemic problems – not by giving budgets a trim. We can try to stop the growth of long term health conditions through improved local services that support better health and well-being. We can use technology to support new care models that are designed locally, with clinicians, staff, patients and service users.
And we can enable the NHS to take significant strides towards providing more equitable and resilient care for all. Together, we can build a stronger, more inclusive health service that leaves no one behind.
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