Anchored in our community: The role of the NHS in addressing health inequalities

This year has been one of the most challenging years in the NHS’ history. Last Sunday, the nation came together to reflect on the commitment, courage and sacrifice shown by so many across the country. Throughout the last few months we have seen countless examples of people doing their best and achieving amazing things to support their neighbours and their communities. As the NHS calls on people to continue or embrace positive changes to Live well, Work well and Care well, we too must ensure that we are taking positive action to support our staff, patients and the communities that we serve.

The pandemic has shone a light on some of the underlying disparities faced across the country. COVID-19 has disproportionately impacted those who are older, those from Black, Asian and Minority Ethnic (BAME) groups and those living in more deprived areas. These inequalities replicate existing inequalities in mortality seen across England and reinforce the importance of tackling underlying health inequalities, as set out in the NHS Long Term Plan.

The NHS has a core role to play in addressing health inequalities in the way that we provide services and support an increased focus on prevention. However, our role can, and should, go beyond the direct provision of care to create social value in local communities. In many parts of the country the NHS is a significant, or even the largest, employer, purchaser and estate owner. The decisions the NHS takes can therefore help shape a place, impact local socio-economic conditions and tackle the underlying drivers of poor health development. In doing this the NHS can act as an ‘anchor institution’. In recognising its role as an anchor, the decisions the NHS takes can have an impact in areas of deprivation, and in doing so support the government’s commitment to levelling up.

Across the country there are already examples of NHS organisations that have committed to an anchor mission. Examples of this were highlighted in the Health Foundation’s report: Building healthier communities: the role of the NHS as an anchor institution. Through the COVID-19 pandemic other trusts have sought new creative and innovative partnerships to support NHS staff and local employment, such as the partnership between Northumbria Healthcare NHS Foundation Trust, and a network of local businesses and partners to ensure a sustainable supply of personal protective equipment for NHS staff across the North East and Yorkshire.

NHS England and NHS Improvement are stepping up how we work with and support NHS organisations develop their role as an anchor in their local community, helping reduce health inequalities, while contributing towards local economic and social recovery from the impacts of the COVID-19 pandemic.

I am therefore delighted to announce that we are working in partnership with the Health Foundation to create a UK-wide NHS Anchors Learning Network. This network will seek out examples of best practice and build capability and capacity across NHS organisations, to embrace their roles as anchor institutions and work effectively with partners to impact the upstream wider determinants of health, reduce health inequalities and improve population health. Today, the Health Foundation have published an Invitation to Tender for a partner to help design and deliver this network, which will be built on principles of collaboration, inclusivity and being action-focussed.

The national NHS Anchors Learning Network will work with and complement local partnerships and networks, which are forming to support regions and systems establish and deliver their local ambitions. Building on lessons from social value accelerators, such as the one in Cheshire and Merseyside, the network will accelerate learning between organisations and regions and further highlight the positive role the NHS can have in encouraging inclusive growth and enhancing equity through coordinated partnerships at a system or regional level.

Nationally we are also taking action to better understand and address the drivers of health inequalities, to support and complement these local and regional approaches. This includes our recently launched NHS Race and Health Observatory, which will investigate the impact of race and ethnicity on people’s health and For a Greener NHS, which is reducing the harmful health impacts of climate change and air pollution which often impact most acutely on the most vulnerable.

The country’s social and economic recovery following the COVID-19 pandemic will not be straightforward or quick. But by embracing NHS organisations’ role as anchor institutions and working with system partners, we can develop healthier, more inclusive communities in every region of the country. Wouldn’t that be worth celebrating at next year’s anniversary?

If you are interested in finding out more, or being involved in this work, please get in touch:

Emily Hough

Emily joined NHS England’s Strategy Group in 2014, taking over as Director of the Group in July 2017. The Strategy Group is focused on supporting the strategic priorities and sustainability of the NHS and was instrumental in the development of the NHS Long term Plan. Emily has overseen programmes including Healthy New Towns, Health and Work and the NHS as an anchor institution. She has also led strategy contributions to a wide range of projects from the specification for Rapid Diagnostic Centers to plans for improving autism diagnosis and support.

Emily’s previous NHS experience includes supporting a major service reconfiguration in North Central London, advising the first Trust Special Administrator appointed to an NHS Trust in South East London, developing a Commissioning Support Unit’s Strategy and Transformation practice and supporting the development of London’s Clinical Commissioning Groups. Prior to joining the NHS Emily was a management consultant, specialising in strategy.