NHS Reset: Time for the partnerships we always needed

The NHS70 celebrations were less than two years ago but already seem a world away. Understandably, the forward-looking elements of that national party focused more on the potential for technology to transform services and our relationships with them than on the dystopian prospect of the pandemic we’re now living and working through.

That focus, together with the skilful harnessing of our national love for the NHS and its people, enabled the vital change in funding needed to support the Long Term Plan. This year, the response of teams across the NHS has cemented their place in the country’s hearts and the new visibility of those in the eye of the social care storm has finally delivered the respect they have always deserved.

There is a risk that when this is over, that national love might encourage drained and exhausted professionals to want to revert to how things were in an environment with a much slower pace of change. The challenge for health and care leaders, including in the voluntary sector, will be to stop that happening by delivering both the vision and the reality of a new settlement that works better than before.

It’s good to see the NHS Confederation grasping that nettle. The Richmond Group and colleagues across our member charities are standing shoulder-to-shoulder as we look to build a positive future from what we’re learning now. No organisation or sector has the whole solution to our challenges. Everyone has a piece of the answer.

The Richmond Group of Charities brings together a range of major national charities who are all key players in England’s health and care system, investing many millions as significant delivery partners for the NHS and other public services. Together we hear the concerns of and provide advice and information to millions of people. This aspect of our work has accelerated enormously during the pandemic. Our purpose and credibility flow from the shared insights we generate from our substantial individual contributions, through direct service delivery and our own staff and volunteers, our support for NHS services and staff, and our funding for research.

The Group has a particular focus on the needs of people with long-term conditions – especially multiple conditions. We are striving, in this changing world, to develop our own services and activities so that together we can support people with multiple needs more collaboratively with services that recognise and respond to the realities of people’s lives, help people to understand and navigate through complex and scary situations, and model the changes we want to see in others’ policy and practice.

Now’s the time to broaden our conception of what volunteering and peer support can offer. We’ve already seen an outpouring of voluntary effort, organised at speed and scale nationally and locally. As systems build a new future, we’re keen to work with the public sector, including local government, to ensure that there’s a permanent and developing legacy of joined-up volunteer support. From the perspective of people living with multiple conditions, that offers a route to the kind of support described in our Multiple Conditions Guidebook and an opportunity to reap the physical and mental health benefits of volunteering.

We also need to be alive to how the pandemic and the crisis response to it will have steepened the gradient of many of the hills the Long Term Plan set out to climb. Again, the seeds of the necessary changes are often already starting to germinate. For example, last year, with the support of Sport England, we and our charity partners launched the We Are Undefeatable campaign, supporting people living with long-term physical and mental health conditions (43 per cent of England’s over-16 population) to be physically active in ways that are appropriate and safe for them. We’ve reworked the content on our resource site and our campaign advertising to be relevant while people are spending more time at home and while external facilities are closed. We’ll continue to accelerate this work, to help prevent the further health problems that reduced activity levels will bring for this group.

Our member charities have seen huge increases in the numbers of worried and confused people calling their helplines and using their digital information to try to make sense of the inevitably confusing tumble of messages as the system raced to provide advice and support. There’s a huge opportunity in the reset for us to develop new ways to inject these insights where health and care leaders can make effective use of them to deliver better outcomes for people and efficient use of resources.

We may also be seeing an epochal opportunity arising from the relentless spotlight on the relationship between COVID-19 and economic and race inequalities, as well as the impact of employment, housing, air quality and nutrition. If we’re going to use that spotlight to make the crucial shift into action on the social determinants of health, we need to turn previously transactional relationships into a meaningful, equal partnership.

We’ll need the organisational opposite of social distancing, bringing together national and system leaders, local government, civil society, large and small charities, clinicians, managers, individuals and communities. We’ll need to be smart and agile in the way we set about it. Many in the NHS are marvelling at what’s possible when bureaucracy is stripped away and people are allowed to be flexible. That lesson must also apply to the way the NHS and local government commission charities. Reducing the time and energy poured into procurement would unleash the potential of the natural dynamism that’s too often been suppressed until now.

Neil Tester is director of The Richmond Group of Charities. Follow him on Twitter @NTtweeting and the Richmond Group @RichmondGroup14.