Published by – New Local Government Network (NLGN) and Collaborate

Date of publication – March 2016

The starting point for the Place-Based Health Commission is to challenge the assumption that the future of the health and care system rests with those who currently lead it… instead of a system dominated by NHS structures and technocracy, we need one which puts local people themselves in the lead.

The more I work in commissioning, the more I believe that local and place-based approaches are the way forward to cut across vertical service silos and create systems that work horizontally towards common locally owned outcomes. ‘Get Well Soon‘ champions this line of thinking, both in a strategic and practical sense and provides robust evidence and recommendations to help us collectively shift in this way.

…place matters – and if we are really serious about reorienting our health and care model around the grain of people’s lives, assets and ambitions, then we need to take it seriously as a starting point for reform.

Moving away from institutions and services towards people and places

The report puts forward the case for moving away from institutions and services towards people and places, starting the conversation with ‘what would help you enjoy life more’ rather than ‘what health services do you want’. It supports this case through a combination of existing international evidence, expert analysis from the commission members and practical learning on the ground from four areas in the UK where the process of change has already begun. There are a number of sections that I particularly like in the report:

• It puts forward an honest picture of the current state of affairs and why, despite a number of innovative projects getting off the ground (including the Vanguard sites), the idea of place-based health is not being properly embedded and change of practice remains elusive.
• It argues for the need for a systemic shift in culture and practice towards early intervention and prevention which goes beyond the health and social care sectors and includes the broader roles of housing, local businesses, voluntary and community sector and citizens themselves (see page 11).
• It recommends the active recruitment of system translators and commitment devices to drive and incentivise this shift and highlights the more often ignored need to understand the culture and relationships at the heart of the infrastructure as well as the infrastructure itself (see page 56 and 60).
• It highlights the need to break through the ‘evidence paradox’ whereby innovation and the development of new approaches is stymied by the lack of robust evidence to support it. It recommends the creation of a more permissive environment for innovation and transformation enabling prototyping and building in evaluation at a local level (see page 20 and 45).

This report will be very useful for senior leaders and commissioners alike and provides further evidence and support to the growing movement towards co-production, social action and locally grown solutions.