Good neighbours
Partnership working between all parts of the NHS, local government and our partners is key to delivering health reforms.
This article was first published on 17 September in the LGA’s First magazine.
The government has, with its 10 Year Health Plan for England, put the establishment of a neighbourhood health service front and centre of its ambition for health service reform.
All eyes are now on implementation, with the National Neighbourhood Health Implementation Programme, rolling out this month, accelerating the work already planned or underway in many parts of the country.
This shift aims to deliver a model of care that is preventative and better supports those most in need, including those with long-term conditions.
“Health does not begin in hospitals – it begins in homes, streets, parks, and schools”
The LGA and the NHS Confederation have welcomed many of the plan’s proposals, including the drive to end ‘hospital by default’. But we are clear that close and equal partnership working – between all parts of the NHS, local government and our partners – will be crucial to creating the neighbourhood health services capable of delivering these pivotal shifts.
Health does not begin in hospitals – it begins in homes, streets, parks, and schools – and the NHS cannot deliver a healthier society on its own.
Moving to a neighbourhood model of care has to mean resetting the relationship between the NHS, the wider public sector and communities. To move to a truly preventative model of care, the health service needs to change how power and resources are distributed.
Sustainable, long-term reform requires resources and responsibilities to be shifted to neighbourhoods and communities. We all need to work more closely together, with government, to co-design a modern health and care system that is rooted in prevention, community-led solutions and long-term wellbeing, and that addresses health inequalities and low life expectancy.
“…neighbourhoods are where the most impactful interventions can be made – in collaboration with communities, who are key to creating good health”
Councils and their NHS partners are already leading bold, local solutions that work, and are key to building a modern, joined-up health system that delivers for our people.
The LGA believes a ministerial forum, bringing together national and local politicians, would help drive real reform and deliver neighbourhood health models built from the ground up – based on what our communities need and what already works – that put prevention and place at the heart of public services.
The NHS Confederation is clear that neighbourhoods are where the most impactful interventions can be made – in collaboration with communities, who are key to creating good health.
There are numerous examples of communities being at the heart of this shift to a more preventative model of care. The NHS Confederation is currently working in partnership with the charity Local Trust to explore community-led, hyperlocal approaches to health.
Meanwhile, there is a lot going on in both our worlds – not least the abolition of NHS England and the restructuring of integrated care boards, alongside devolution and local government reorganisation.
The opportunity to ensure these changes result in better alignment of mayoral combined authorities’, councils’ and health organisations’ geographical boundaries is a significant prize that would cement closer partnership working.
There are many other public sector reforms impacting on us, from the Department for Education’s Best Start Family Hubs and the Cabinet Office’s thinking on community hubs for adults with complex needs, to still-evolving plans for neighbourhood area committees in new unitary council areas, and the Casey review of adult social care.
Putting neighbourhoods at the heart of health and care is not a minor tweak to the current model of NHS governance, nor is it a radically new blueprint, with many areas already working in this way.
With significant change underway in both our sectors, we must commit to ‘rewire together’ and not turn inward into silos when it comes to developing the neighbourhood health services that can deliver on our ambitions for our communities.
Lord Victor Adebowale CBE is chair of the NHS Confederation. Councillor Louise Gittins is chair of the LGA.
