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In this reflection we hear from Donna McLaughlin, Director of Social Value at the Northern Care Alliance NHS Group (NCA) about her thinking as to why and how the NCA is embracing the ‘Anchor’ agenda by committing and acting to reduce poverty, support workforce challenges and transform individual lives. Aqua has being privileged enough to support the NCA on their journey so far with a partnership built on a ‘living lab’ principle of exploring and learning in the real world.
‘I have spent 25 years in the NHS. A decade of which I was a Director of Ops, where it was my responsibility to ensure swift, timely access to treatment for those who are acutely unwell. That’s my dance space. But hospitals are not islands. They are part of the civic fabric of the community. That relentless feeling in the pit of your stomach have you enough beds for the night? What about granny in A&E? Inevitably, comes back to what else can the NHS do? I believe all sections of the NHS must take responsibility for rising demand. Alongside the moral argument surrounding social value there is also a business one – improving the economics of communities, increasing household income and reducing inequalities will support a reduction in healthcare demand– and for me there is nothing more powerful than your heart and your head ruling an approach.
We have lived through an incredibly challenging period of our collective history. Pre-existing racial and socio-economic inequalities have not only been made more visible by the COVID-19 pandemic, but they have also been made worse. Structural inequalities drive poverty which is one of the major contributing factors to poor health. Like the virus, the economic and social consequences of this pandemic are having a disproportionate impact. How health and social care systems use and invest their resources has an important impact on the resulting economic, social and human benefits. By utilising the resources and assets within local communities and by taking responsible approaches to employment, job creation and the production of goods and services, local health and social care systems can transform local economies to work for everyone.
Trickle-down economics is failing to address inequalities. At the beginning of this journey I had an inspiring conversation with Neil McInvoy and have drawn heavily on CLES (the national organisation for local economies) thinking on community wealth building (https://cles.org.uk/community-wealth-building/what-is-community-wealth-building) together with the Health Foundation 2019 report (https://www.health.org.uk/publications/reports/building-healthier-communities-role-of-nhs-as-anchor-institution ). In essence, this is about investing as much public sector money as possible into our communities as an economic stimulus rather than relying on traditional regeneration funding.
The NCA has a strong history and continued commitment to integrate our health and social care services. Our novel-place based organisational form places our Care Organisations at the heart of the communities we serve. Our social value ambitions are an extension of that commitment to place based leadership and to quote the NCA outgoing Chief Executive Officer (Sept 2021) Raj Jain:
“We at the NCA know we cannot deliver on our potential without the expertise, experience and support of our partners in place. But our potential to make a difference to people’s lives beyond our normal caring services is significant. At this time of national crisis the NHS must stand up and do more than its brilliant work in caring for the sick” – Raj Jain, Chief Executive Northern Care Alliance NHS Group 30th October 2020.
For a moment take off your healthcare provider hat and consider your social and economic power; think about the number of people employed; the goods and services; the use of our estates and buildings. What if we made all these decisions through an anti-poverty lens?
We have called our approach to social value a ‘mission’, akin to a social movement.
However, this has not been, or will continue to be, a journey in isolation. The Aqua have supported our early development by adapting their Integrated Care framework to reflect the work of Anchor Institutions. This was critical to ensuring we took a place-based approach, with support functions including recruitment and procurement involved. And, whilst I have liked our approach to a social movement, there is data to monitor our progress within each of the pillars. These including a swing towards local procurement and an increase in local people being employed. I guess once a Director of Ops always a director of ops. I still like a good trajectory!
The results particularly for local employment are encouraging. In July 2019 45% of our workforce lived within the NCA footprint of Bury, Rochdale, Salford and Oldham. Aug 2021 it was 58%. We have extended our pre-employment programme to 320 COVID-19 secure learning opportunities, doubling our previous years offering. We have also changed our internal recruitment process to guarantee paid employment / apprenticeships for these learners, engaging with the Prince’s Trust ‘Get Into the NHS Programme.’ These opportunities change lives and how better to show? let some of our learners tell their stories………
The first story is Ellie. She did not engage well at school, struggled with mental health issues and left without doing any exams. She is the sole carer for her dad who has several severe medical problems. Prior to starting our programme, she had no digital device and was not really motivated to do anything for herself. Within 12 weeks Ellie has passed her written driving test, started college to gain English and Maths qualifications and secured paid work with the NCA in health records.
She says “I have gained a lot more confidence since starting the programme, especially during the placement. I have learnt a lot about the NHS, and I am continuing to learn new things. I am very proud of myself and so is my dad.”
The 2nd is an email;” Last time we spoke I was working on the vaccinator program, which is amazing, and doing an access to higher diploma course on the side [as a result] I am on my way to university to do nursing. I wanted to thank you as you played a huge part in making this happen for me, the courses you provide are and have been so successful for me. We are all doing well and thriving in our new home. Next time you see me I will be in a blue uniform!”
For more information contact; firstname.lastname@example.org.
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