While the NHS’s impact on local economies is self-evident, the health service’s engagement with the leadership and management of local economic growth is inconsistent.
The imminent launch of the £5 billion European Structural and Investment Fund (ESIF) programme 2014–20 at the start of the 2015 parliamentary term (England is running about 12 months late!), is an important opportunity to redress any NHS local growth deficits. Indeed, agreeing and thereafter delivering 'win-win' improvements in health and economic outcomes (with local economic leadership teams) should become an increasingly mainstream goal of clinical commissioning groups (CCGs), trusts and local delivery bodies.
Health and social care is the largest employment sector in the national economy, amounting to more than 4.1 million jobs producing over 8 per cent of GVA (‘gross value added’ – a measure of economic value). It was the fastest employment growth sector in the 15 years to 2012, and this trend is forecast to continue. Latest Working Futures projections
show a net requirement for 2.5 million health professionals and caring occupational staff to 2022, in the face of growing demand and notwithstanding public expenditure pressures.
In terms of economic growth, the Government has prioritised health and life sciences and a number of 'great technologies' (such as genomics and regenerative medicine, as well as enabling technologies, like big data) with primary applications in the healthcare sector. This is as much for UK international business (and export) purposes than as to meet national demand. Bridging national and local healthcare innovation, the 15 academic health sciences networks (AHSNs) represent probably the first time NHS bodies have included wealth creation and innovation-led growth as part of their primary purposes.
With this scale and significance of economic footprint, it is unsurprising that local enterprise partnerships (LEPs) – designated by Government to provide local strategic economic leadership of growth – have articulated a major interest in health and life sciences investments. This interest focuses on exploiting the value of public, business, academia and third sector healthcare activity as a driver of local employment and economic growth.
For the rest of the decade, one of LEPs’ main instruments for leveraging this activity is ESIF resources of £5 billion, delegated to them by Government. The amounts available range from €750 million in London, to a very modest €14 million in Buckinghamshire, but average out at around €111 per head of population across England.
In practice, these amounts will be matched by local and national resources to fund major investments in skills and employment programmes, physical infrastructure and property, and a number of business growth, ICT and low carbon initiatives. Given these sums should be aligned with national priorities (including health and life sciences) the case for NHS involvement is powerful.
There are 39 LEPs across England, chaired by and with a majority of 'business' members, but typically shaped and supported by local authorities (LAs). LAs are accountable for public money invested by LEPs. Almost all LEPs have a local university vice chancellor on their board, and many will have a prominent health and life sciences private sector board member/champion. But very few to date have attracted NHS membership at board level.
However, local NHS bodies can and do get involved in employment, skills, and innovation sub-committees, and various task groups and programme boards. They may also be able to participate in the management committees being established to oversee ESIF programmes. Nationally, preparatory work has been undertaken by the NHS European Office positioning the NHS as a key partner in ESIF innovation investments – so the groundwork should have been done for local involvement.
There are a number of exemplars of NHS local partnership programmes (skills, employment and innovation) that may well successfully attract ESIF investment: from 'Care City' and 'Med City' initiatives in London, to the mainstream work of the AHSNs, university teaching hospitals, to social enterprise healthcare providers and their intermediaries. However, these opportunities may pass many areas by, without proactive initiative and intervention.
CCGs, trusts and other local providers need to recognise their position as major role players in the creation of successful places – in economic, social and environmental terms, as well as health. They can and should influence the 'civic mission' of their locality and wider catchment – delivering physical investments, business relations, skills and employment opportunities, even local expenditure multipliers, that have positive economic impacts in addition to health outcomes.
These are the 'win-wins' to which this blog alluded above. Nurturing relationships and developing this economic literacy and intelligence is a substantial undertaking in an era of unprecedented demand, service and financial pressures. But economic growth can deliver healthier populations, more skilled and productive health workers, and more rapid dissemination of research and innovation – dividends the NHS increasingly requires if it is to meet the challenges ahead.
Moreover, 'win-win' cuts both ways. This type of engagement will, in my experience, bring committed LEP, business, academia and local government partners to NHS health agendas through new channels, in novel, creative ways.
In many areas, NHS and LEPs are already alert to the opportunities of health and local growth collaboration. The impending ESIF launch can prove a catalyst to deepen and broaden this 'good practice'. It is an opportunity well worth the effort of realising.
David Marlow is chief executive of Third Life Economics. Follow him on Twitter @DavidJMarlow
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