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Michael Wood, the Head of Health Economic Partnerships at the NHS Confederation discusses the links between population health and economic growth.
The emergence of population health as the key mission guiding integrated care systems (ICSs) is a fascinating development. The issue is quite rightly seen as a critical enabler to achieving the aims of the NHS Long Term Plan but is also one on which the NHS (and indeed the wider health and care sector) cannot hope to address by itself. In this case, we should be asking ourselves how much we really know about our neighbours.
An important starting point for local population health discussions is that the NHS is not the only one that benefits from a healthy population. With this mind, how we can share the local risks for our services in failing to address this challenge with the rewards of those whose business we are supporting?
It’s all about productivity
Although we have record levels of employment, UK productivity levels are roughly what they were after the 2008 financial crash. This represents over a decade of stagnant economic growth, which has limited the government’s ability to invest more resources in public services and has eaten into personal living standards. This low productivity is amongst the worst in the OECD and shows no sign of abating. As a nation, if the pre-2008 trend had been maintained, output per hour across the economy would be over 20% higher by now. This is a significant gap.
More importantly still, this isn’t simply a national issue. While London and the wider south east continues to grow, the rest of the UK lags well behind. Many parts of the midlands and the north of England, for example, are now amongst the poorest in Europe, with this low productivity manifesting itself in poor infrastructure, health and educational standards, as well as other indicators of poor social cohesion, such as increased child poverty, reducing life expectancy and rising crime rates.
Building an inclusive economy
This stark economic position is focusing the minds of our economic leaders. Pick up any local economic strategy and you will find reference to the critical need for a healthy population to support local productivity. This is certainly the case with the Local Industrial Strategies currently being developed in every part of England. In this instance, Mayoral Combined Authorities and/or Local Enterprise Partnerships (LEP) are now in the process of developing a long-term strategy to increase local productivity and turn around their own economy.
While many will strongly believe population health should feature in addressing these economic needs, the good news is that a version of it probably already does.
The concept of inclusive growth is now dominating economic development discussions and will be a key priority for every Local Industrial Strategy. Inclusive growth aligns health inequalities with wealth inequalities, focusing on spreading prosperity much more evenly across society. While this will vary according to local need, inclusive growth strategies will typically focus on recognising and promoting ‘good employment’, connecting people to the labour market, tackling health inequalities and addressing low pay and in-work poverty. Expect metrics to be developed and sustained investment to be placed into these areas in an attempt to grow the local economy. The links are clear and the timing is not far from perfect. It is also positive to see many in the NHS playing our part.
For example, Dorset LEP is co-developing a ‘Health Deal’ with its ICS that places its demographic at the very centre of the county’s new economic thinking. The combined might of the West and North Yorkshire LEPs are discussing with their respective ICS how MedTech strengths can support better connectivity, inclusion and employment. The West Midlands Combined Authority has established an Inclusive Growth Unit, which has identified several health-related priority issues on which to develop and test new approaches with local public, private and Voluntary Community and Social Enterprise (VCSE) partners. This form of partnership working understands that the ‘place’ is greater than the sum of its parts. To discuss what you can do locally – and to whom to talk – simply get in touch.
Health for growth?
The very purpose of our economy is to increase prosperity and wellbeing, but stagnant productivity and weak growth makes our job that much harder. Whether we refer to population health or an inclusive economy, we are in many respects trying locally to achieve the same thing and should pool our ideas, people and resource to best effect. Looking further ahead, we are hopefully approaching a time where it is deemed incomprehensible that our local health and care plans could be developed that do not have as their starting point local economic performance, and vice versa.
Hear more from Michael Wood on why aligning health and economic growth is important in our next podcast on integrated care, coming soon.