CommunityHealth

07 Aug 2015

Written by Adam Micklethwaite

Last week Nesta published a report setting out a vision of the NHS in 2030. The immediate context for the report is, of course, the continuing debate about the gap in NHS funding, which depending on the assumptions made could be as much as £30 billion by 2020/21; and the resulting need for efficiencies. But the report argues for a longer time horizon against which to plan medium-term service transformation.

One of the ideas Nesta explore is a social movement for health, where people are more deeply involved in managing their own care and supporting the care of others. They note that the contribution of “people power and knowledge power” will be “unusually important” for the NHS during the next 15 years, and is sometimes neglected in public debate. They also highlight the obvious importance of digital, noting its “immense and growing power”. But they make three important points about “community-led care” and technology, which they note have had a mixed record of driving cost improvements in the NHS:

  • “Self-management and peer support must translate into reduced demand for primary and acute care services.
  • Greater personal responsibility for health must result in the prevention of people developing lifestyle-related health problems.
  • [These changes] must be done at scale. Efforts so far have largely tinkered at the edges of mainstream activity.”

I strongly agree. And I think we can use digital technology and community action to begin creating the social movement for health now. In the same week that Nesta published their report, I attended an event at the KIA Oval as part of the NHS Test Beds programme*, to present an idea designed to do just that.

CommunityHealth is a proposed new programme combining technology for primary care and mental health with the community power of Good Things Foundation's network of organisations and volunteers. The concept works with three brilliant innovations: webGP from Hurley Group, Big White Wall, and HealthTouch - all very much worth a close look whether you're a CCG or local authority.

Building on our award-winning Widening Digital Participation programme for NHS England, CommunityHealth will train people without basic digital skills to use these online services, but go further by creating 'community health networks' that make the adoption of health technology irreversible and sustainable. Many healthtech innovations have failed either because they created work for health professionals rather than saving time, or because patients and professionals weren't strongly enough informed and connected to make the technology stick. By bringing GPs and social care providers together with the people they serve to promote, discuss and use new technology in community settings; and by mobilising a network of volunteers who support their neighbours in maintaining healthy lifestyles and accessing health services online; we can create the social capital required to address this challenge once and for all, moving the adoption of technology for primary and social care past the ‘tipping point’.

Getting this right has the potential to unlock a transformed and more efficient model for primary and social care based on informed and empowered patients, mutually supportive community care and greater self-management of conditions. It’s something we’re already starting to see through Widening Digital Participation, and our report on Years 1 and 2 of the programme, published this week shows how strong community partnership models can create new relationships between patients and professionals that improve health outcomes.

Nesta’s report rightly notes the challenges the NHS will face in transforming - it will take time, the accumulation of evidence, and balancing experimentation with efficiency. But the NHS Test Beds programme is starting out on the right track. And with political commitment, the right upfront investment, and the best healthtech innovations, professionals and communities across the UK can start exploring and creating the ‘social movement for health’.

*The Test Beds programme is an important part of the NHS Five Year Forward View, and will test how combining (rather than layering) new health technologies can improve patient outcomes whilst improving efficiency.