England’s top A&E doctor has called on health and local government leaders to seize what he calls “the greatest opportunity in 70 years” to remake the NHS and local authority partnership and improve the health of their communities.
Professor Keith Willett said the two sectors had historically struggled to overcome their financial, cultural and operational differences preventing them from adapting to public need. However, changing health and care needs, the imperative of financial pressures, and the advent of integrated care systems means the conditions are right for a major shift in attitude.
Positive results from joint working over the past year have now cut hospital delayed transfers of care to their lowest level in over three years.
With 100,000 beds and 1.3 million workers in the NHS versus more than 300,000 beds and 1.5 million workers in social care Professor Willett said the two sectors were becoming increasingly interdependent.
“Many in the NHS and social care have no idea of the complexity of the other care system yet we are interfacing with them all of the time.
“You can’t understand the complex needs of people until you’ve listened to a patient or carer talking to their GP or ringing 111 or 999 for a local mental health response or to sort out a care issue for an elderly person who then ends up going into hospital.
“The NHS traditionally presents change from an evidenced-based and population-benefit perspective, and local government often sees such change from the individual constituents’ day-to-day life circumstances and their holistic social need.”
Professor Willett launched a new web film showing how a council in Sussex is working with the NHS to help older people stay healthy.
He said this illustrated how joint working is doable and predicted that NHS and local councils that failed to establish effective partnerships would face increasingly hard questions from the public. “The status quo is looking less and less attractive to more and more people,” he said.
Professor Willett also highlighted five other schemes, identified with support from the District Councils’ Network, where local authorities and the NHS had formed partnerships that had improved services in their communities. These include health coaches, social prescribing health hubs and housing schemes to support people at home keeping them out of hospital.
Interviews with more than 50 council CEOs, directors of social care, public health, children’s services, local councillors and officers, Mayors and many others all stressed the benefits of taking a ‘place-based’ approach to the provision of services, talking about co-production, being engaged early, working as partners, building understanding of structures and constraints, using their experience and expertise effectively, giving clarity over the direction for STPs and building mutual trust.
Professor Willett said the NHS, local government and clinical leaders often underestimated how much they needed to learn about each other.
