For the past year, the NHS Confederation has been working with Yorkshire and Humber AHSN and Yorkshire Universities to understand in detail the nature of the relationship between health and growth, both at a strategic, conceptual level but also in everyday practice across the region’s towns, cities and rurality. Here, Michael Wood shares the findings of the work as the partnership publishes a new report. The report forms part of the NHS Reset campaign's focus on economic and social recovery.
While ‘god’s own country’ is a special place (and case) for many, it would be wrong to think the lessons we have learned in developing the Levelling Up Yorkshire and Humber: Health as the New Wealth Post-COVID do not apply elsewhere.
The central drivers for the report were relatively simple: as a region, Yorkshire and the Humber punches below its weight in terms of its health and economic outcomes and how much health research it attracts. We didn’t believe the three to be coincidental and wanted to develop a detailed look at the interrelations in a way which could support the region’s leadership in articulating a new vision for Yorkshire’s future, and which would outline to government the importance of health in their plans to ‘level up’ the country.
As a national body, the NHS Confederation is primarily focused on the latter, but by making the case in association with empowered and engaged local leaders, we wanted to create a much stronger, more coherent argument.
Yorkshire may have particular strengths and challenges but it is certainly not alone in facing widening inequalities. The UK is the most centralised state in the OECD yet remains one of the most regionally imbalanced. Across pretty much every measure, control from Whitehall has not led to prosperity, growth and fairness in large parts of the country. Immediately prior to COVID-19, Professor Sir Michael Marmot warned us that people can expect to spend more of their lives in poor health; improvements to life expectancy have stalled; and the health gap has grown between wealthy and deprived areas. He was also clear that place matters. If COVID-19 has further exacerbated these health and other inequalities, then it has also shone a light on the role of health in the wider economy, which our report strongly advocates.
Nationally, we would hope COVID-19 brings a greater emphasis on funding for public services (as part of the foundational economy) being explicitly recognised as an economic investment, with more appropriate measures of productivity reflecting this. Don’t simply give the NHS money and ask for efficiency savings. Similarly, it’s possible we will see a growing campaign for national measures for economic progress emerging that cover a much wider contribution to what we value, including wellbeing, resilience, caring and volunteering, rather than simply GDP.
The national recommendations in the report echo strongly these statements – championing health as the new wealth. We are calling for health to be embedded as a priority for all government departments, local leaders to be empowered with the tools to improve health outcomes and deliver inclusive growth and wider prosperity, and for health be included as an outcome in all economic development policies. It’s not simply Yorkshire that will benefit from these demands.
Locally too, there is much in our report that stretches beyond the moors to the north and the coalfields to the south. Leeds has led the way in showing the power of a network of anchor institutions to shape and deliver local transformation in population health and inclusive growth. There is strong interest in replicating this model elsewhere and partners in Leeds are very happy to share.
Supply chains, or the lack of them, were one of the more noticeable aspects of the COVID-19 response. In every part of the country, NHS leaders should seek to understand, diversify and strengthen local supply chains for key health and public services.
The challenge of how to work with partners is a common one that often hinders collaboration on the ground. We believe that commitments to supporting jointly-funded posts, secondments or exchanges between sectors will go some way to deepening collaboration and thus delivering inclusive growth and better health outcomes.
Finally, our report suggests that Yorkshire should look to strengthen its joint analysis and foresight through the establishment of observatories (or similar structures) in order to inform effective public policy and interventions by sharing local data and other evidence from across sectors. This, like the other regional recommendations, provides a path for other areas to follow to align health with wealth.
The aims of the report are two-fold: to build a collective vision among Yorkshire’s leaders for the role of health in driving economic and inclusive growth, and to highlight to government the intrinsic and unbreakable link between health and wealth. Wherever you are in the country, we believe this is an important story to tell.
Michael Wood is head of health economic partnerships at the NHS Confederation. Follow him at @NHSLocalGrowth
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