The contribution of the health and care system to improving health

As part of our work to support improvements in health care, we have been exploring the wider contribution that health care services can make to improving health through an increased focus on prevention, health inequalities and tackling the social determinants of health. We are also interested in the potential of more integrated care to support improved health for populations and communities in local areas.

We have identified four ways in which we think NHS staff, organisations and health and care systems can have a positive influence on health and wellbeing: as a direct provider of health care; as a role model employer; as an anchor in the community and as a system leader and partner.

We are testing these areas and developing and supporting work to build the evidence, support and spread good practice and identify the key enablers and barriers to a more preventative health care service that reduces health inequalities and partners with others to tackle the social determinants of health. 

Why are we doing this? 

The quality of, and access to, health care is estimated to account for 10-20% of what contributes to people’s health. While this is important, we believe that NHS staff, organisations and health and care systems can have a broader impact on health by thinking differently about their role, how they design and deliver services and how they work in partnership with others to maximise the opportunity to support good health. 

There is a growing policy focus on how NHS organisations can do more to support prevention and population health although there is more work needed to understand how best to implement changes in practice. 

We want to build on learning from evidence and research and from the teams (funded by the Health Foundation and others) who have shown it is possible to refocus health care to support greater prevention, improve population health and tackle inequalities.

Key work areas

We are currently undertaking and supporting a number of pieces of work on how health services can do more to support the wider health of their populations and communities. This programme of work is still in the early stages and we will be adding new projects and activities as the work evolves. 

The NHS as an anchor institution 

We are working to understand how NHS organisations act as anchor institutions in their local communities and can positively influence the social, economic and environmental conditions in an area to support healthy and prosperous people and communities. Find out more

Sarah Reed and Dr Dominique Allwood wrote a piece in The HSJ: The NHS as an anchor – taking forward the long term plan

The NHS as a direct provider of care

Health and care organisations can contribute to improving health and wellbeing for its patients and populations by building prevention into services and pathways and understanding the impact of the social determinants, such as poor housing, poverty and lack of social connections, on the health of the people coming into contact with health care services.

The Health Foundation has supported a range of projects where teams have sought to implement new ways of thinking about prevention and the social determinants of health and we intend to build on this work to better understand how the providers of health care services can maximise their impact on wider health outcomes. 

The NHS as a role model employer

As an employer of 1.6 million people in the UK, the NHS has an opportunity and a responsibility to prevent ill health by influencing and improving the wellbeing of its own workforce. This benefits not just the individual staff but can also support staff to be more confident in having conversations with patients about improving their health and wellbeing. 

Centre for Sustainable Health care

We have given a grant to the Centre for Sustainable Healthcare (CSH) to undertake an evaluation of activities at three of their NHS Forest sites to identify whether greenspace at NHS sites can play a role in improving the physical and mental wellbeing of NHS staff through its use during the working day. The research will provide in-depth case studies of three sites covering a general hospital, a specialist cancer centre and a mental health hospital.  

The NHS as a system leader and partner

Health and care services can also have a positive impact on the wider health of communities by thinking of its role as a partner and leader within the wider health and care system. An increased focus on integrating health and care services across local areas of places provides an opportunity for health care services to have a much wider impact by working with others to focus on improving population health. 

Faculty of Public Health 

We are supporting the Faculty of Public Health to undertake work on the Role of the NHS in Prevention. This work seeks to: build a better understanding of how the NHS is currently delivering prevention; explore ways that the NHS can maximise or expand its prevention and improvement role; determine prevention priorities for NHS leaders, clinicians, and the wider public health community. As part of this work, the Faculty are engaging with senior public health and NHS leaders through workshops, interviews and surveys and will be publishing their findings through a series of discussion papers and a final report in Autumn 2019.