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Reflections on NHS ConfedExpo 2022

by | Jun 22, 2022 | Adult social care, Health and NHS improvements | 0 comments

If ‘place’ and ‘place-based working’ is presupposed as a new concept there is a real risk that we lose out on the opportunities that integration affords.

Last week, my colleagues and I attended NHS ConfedExpo in Liverpool; the first proper opportunity since the pandemic to get a whole sector sense of what’s important for the NHS. There was a buzz about all the big changes facing the NHS – the movement to Integrated Care Systems, elective recovery, workforce challenges, health inequalities, digital change, and a proper call to action on climate change. The energy was refreshing, but there was an undercurrent of uncertainty around what the next year holds.

I was lucky enough to also attend the Association of Directors of Adult Social Services (ADASS) Spring Seminar, which had the same energy, but a different focus. While there were some excellent sessions on partnering from colleagues in Essex and North Yorkshire, integration and the ICS agenda was not as high on the list as co-production, equality of outcomes and the raft of reforms coming down the line in the care sector.

This shouldn’t be a surprise. Each event is for a different audience, though the shift towards integration will undoubtedly bring these audiences together more than before. The feedback from both events was clear; the 2023 events must focus on improving outcomes for those receiving care – irrespective of whether this is someone recovering after a hip replacement, or strengthening the independence of someone with a new long-term package of care. And at the heart of both health and social care is ‘place’.

Now while the technical definition of ‘place’ differed at each conference and across policies, the raw understanding didn’t. Place is the level that can best be used to group resources and decision making to support better outcomes.

I naively thought that getting place to work was a matter of getting the geography right – have we got the boundaries on the map right? But having gone to both events and seeing first hand recently working on transformation across the health and care interface, I was wrong. It’s less about geography and more about history.

What became clear is that if ‘place’ and ‘place-based working’ is presupposed as a new concept there is a real risk that we lose out on the opportunities that integration affords; the four aims of changes – better outcomes, better quality, high value for money, and seeing the NHS as an anchor institute for change.

Places aren’t new. At both conferences the effectiveness of partners to work at places for populations was clear. Providers having collaborated for years, the VCSE working to deliver services with the NHS, local government leading on wellbeing changes across place – whether it is on housing, demand services or any of their portfolio.

If we view the 1st July definition of ‘place’ as a newly codified construct  – we’ll go backwards. We’ll look to build something where there is already much working. We’ll lose trust and end up confused, uncertain and frustrated.

Investing and building on what is currently in place will enable policy change to come to life and deliver on what it needs to.

IMPOWER’s Valuing Home programme – a behaviour and culture-led change approach to new intermediate care capacity and effectiveness – brings this to life. Getting people home as quickly and safely as possible needs places working with all partners – family/carers, the NHS, local government, the VCSE – using the asset and strengths they have, rather than a new model superimposed onto them. Starting from behaviour change and culture, then working out across workforce and funding, puts the need of the individual at the centre of place and builds on its what works – its history. Doing this gives the space and confidence for greater integration around a place, working towards better outcomes that cost less.

We’d love to get your thoughts on how places can work better, and share more about what we’ve learnt, so please do get in touch.