The COVID-19 pandemic continues to test our health services to their very core. At the outset the whole nation held its breath to see if the virus would overwhelm the NHS. A concerted national effort – the kind not seen since the Second World War – took place to help save lives.
Effective and swift joint planning and delivery between local government, the NHS and the community and voluntary sector was the hallmark of how national and local services worked together freeing up capacity at the moment it was most needed. Within the health and care sectors, services were quickly adapted and delivered in different ways, with a significant shift to online support. This was seen across GP services, outpatient consultations and mental health services resulting in increased capacity and convenience for patients.
We must harness and build on this to re-shape the health and wellbeing landscape. Our focus needs to be on prevention, on strengthening wellbeing, resilience and independence rather than just treating illness – helping to protect our NHS into the future. We need an all-encompassing approach to health which is fundamentally preventative. This requires place-based leadership to address the basic health inequalities which exist and inevitably lead to uneven life chances within our communities. Place-based leaders, including GPs, councillors and community leaders are the future architects of this. Only they can truly build from the neighbourhood, ward and practice level up. It is this localised view which will get to the very heart of local health problems. There is no one-size-fits-all solution to the existing health inequalities which blight the life chances of so many people. But a localised solution will deliver hope to people across the country – levelling up opportunities.
Councils and the NHS must work together as equal partners to give their communities choice and true engagement in their local health services. It will be crucial for issues around information sharing and inter-operability between the NHS, councils, providers and the voluntary and community sectors to be addressed, as well as addressing concerns over confidentiality and privacy.
The last few months have highlighted the importance of social care having parity with health and on investing in prevention to reduce the burdens on the health service. Councils want to retain and build on the progress in joining up health and social care achieved during the pandemic. Councils and their health partners need a more flexible and locally-led approach with a stronger emphasis on partnership and place-based leadership, with health and wellbeing boards taking a leading role. As we and the NHS move forward with the NHS Long Term Plan, we need a new emphasis on place and neighbourhood, with system-wide plans needed to build on and knit together place-based plans and neighbourhood delivery. The principle of subsidiarity is crucial – that decision-making is taken at the most locally appropriate level.
In this way we can build the healthcare services we need for the future and give assurance to communities that their specific needs are understood and will be effectively addressed.
To collaborate and work jointly with NHS partners, not only with frontline staff but also around commissioning and planning to ensure that more care and support is planned and delivered as close to home as possible.
To ensure that system-wide plans of integrated care systems and sustainability and transformation partnerships build on and knit together place-based plans and neighbourhood delivery. The NHS needs to work closely with health and wellbeing boards on local transformation and sustainability plans, incorporating the whole of health, social care and public health.