17 March 2016
A new report released today explores how the English system of health and wellbeing could be changed for the better.
The reforms would help people live healthier lives, rather than focussing on treatment.
Entitled ‘Get well soon: reimagining place-based health’, the report has been produced by New Local Government Network (NLGN) and Collaborate, through a new Commission of experts. This included Mike Adamson, chief executive of the British Red Cross.
It supports the idea that poor health can only be effectively confronted in England with a systemic shift in the way health and wellbeing services are delivered.
The approach known as place-based health, is a system of health and wellbeing that allows people to make healthy decisions with integrated local services to support these.
While it is not a new concept, the report offers insight into how this could be realised in practice. It draws on research from areas where the process of change has already begun.
There is widespread consensus that the way in which health and wellbeing services are currently delivered in England is not sustainable.
Demands on services continue to grow and funding for new services is failing to keep pace. It is estimated that the gap between need and resources could rise to £25 billion by 2020.
More funding is necessary. But more money alone isn’t sufficient. Things need to be done differently.
There have been developments to help address these issues, such as the devolution of health budgets to Greater Manchester and Cornwall. But as this new report outlines, these do not amount to the change in culture and practice needed to sustain services.
Time for change
It is well-known that treatment plays a limited role in people’s health and that other factors also contribute. These include lifestyle choices and socio-economic background – things that the current system takes little account of.
Therefore if people are to live healthy lives, they must be supported by a health and wellbeing system which supports them to do so.
Take someone coping with rheumatoid arthritis. They may have been in and out of hospital several times. They have met many different medical staff to whom they had to explain their situation each time from scratch. At home, they feel tired and struggle with basic tasks. This person has lost count of the types of medication they have been given. They are being treated for their condition – but they are far from well.
Now put that person in an area implementing place-based health. Instead this person has a single support plan, assisted through greater collaboration between health and care institutions. These might include local government, housing associations, community pharmacies, and the voluntary and community sector.
A support worker would help them to create their plan which might cover budgeting for flexible care, courses to learn more about managing their condition, and perhaps a support group. The focus is on their wellbeing – the end result is a much healthier one.
A place-based health approach involves a move towards preventative health spending rather than treatment. Data gathered for this report suggests that most local authority and health professionals agree that a place-based system could reduce demand and deliver net cost savings to healthcare.
Making the transition
This report outlines three major shifts that need to take place in order for a place-based system of health to become a reality. It also outlines five steps which would help to achieve it.
Speaking about the launch of the report, Mike Adamson said:
“It is no secret that this country is facing a social care crisis. With an ageing population, we need to act so that our services can meet the growing need.
“We must make sure that people are at the centre of their own care and move away from a one-size-fits-all approach to treatment and support.
"Place-based health is about fully integrating prevention and care into local services – by coming together they can help people better take control of their health and wellbeing.”