System stories

• Six years of partnership working
• Surrey VCSE alliance and four place-based partnerships
• Town-based economy with proximity to London 

History and context

Organisations across the NHS, local government and VCSE sector in Surrey Heartlands have been working in partnership since 2017 to improve the lives of people in their area. With 27 towns serving as hubs for social and economic development, the proximity to London is another factor of the economy. 

Four place-based partnerships (in East Surrey, North West Surrey, Guildford and Waverley, and Surrey Downs), a Surrey VCSE alliance and neighbourhood teams, provide structures and mechanisms to bring partners together to foster social and economic development across and within different levels of the system. 

How it works

The history of partnership working in Surrey Heartlands provides a solid base for collective action aimed at improving social, economic and health outcomes. The partnership, and culture change required for integrated system working, can be witnessed in different ways with the embedding of the VCSE alliance into ICS governance, the appointment of VCSE chairs in local health partnerships, and the presence of numerous shared roles across the NHS and local authority.

What has been achieved

At system level, the Surrey Heartlands Health and Care Partnership strategy development process helped partners to agree their common purpose and shared priorities in addressing the root causes of ill health and driving innovation and research within health and care. The Health and Care Partnership has also used its convening power to define an operating model for the system that fosters conversation and enables organic activity to contribute to progress.

Crucially the approach empowers local partnerships within the system to take action, prioritises the involvement of residents and communities in the design and delivery of programmes and services, while also providing seed funding to support community activity. Furthermore people within parts of the system – like GPs  – are allocated dedicated time to make connections and build relationships within and across communities, which can lead to new opportunities for partners to support social and economic development. A system leadership training course on asset-based approaches to community development played a pivotal role in catalysing this culture change within the system.

While all partners agree there is opportunity to do a lot more, including to ensure that good practice exists across all communities and institutions in the system, the current approach of establishing partnerships at different levels, agreeing the strategy and creating an enabling operating environment is already helping the NHS to support social and economic development.

Next steps

Activity highlighted to build on includes things like Growing Health Together in East Surrey, the Spelthorne Healthy Communities Partnership, NHS anchor institutions like Ashford and St Peters NHS Foundation Trust and the development of community diagnostic centres and the green tech sector.   

Moving forward, Surrey Heartlands Health and Care Partnership will monitor and measure their progress through metrics captured and shared via the Health and Wellbeing Dashboard on the Surrey Index. This includes metrics linked to life expectancy, employment and happiness. However, partners recognise that alongside metrics and hard data it is important to also capture people’s stories and share relevant case studies across the system. These will therefore also be used as a tool for monitoring and measuring progress alongside quantitative measures. 

For more information, contact Surrey Heartlands Health and Care Partnership and Surrey County Council’s Health Integration team through health policy adviser Mairead Rooney.

• Diverse economy across urban, rural and coastal areas
• Four-year focus on social and economic factors
• Nine place-based partnerships and community action

History and context

The Cheshire and Merseyside Health and Care Partnership covers a diverse geography, ranging from bustling urban areas like Liverpool, to coastal communities and rural areas. Its 2.7 million population includes some of the wealthiest and poorest people in the country.  

How it works

Over four years ago, health and care leaders together with a broader set of partners started to consider how they could create more social value as institutions and work together as a system to shift focus towards addressing the underlying social determinants of health. Supported by the Institute of Health Equity, partners identified the necessary steps to improve the social and economic drivers of ill health and become a Marmot Community. The result  – All Together Fairer – was launched in May 2022 and forms a substantial part of the wider strategy for supporting social and economic development, alongside action by institutions within the system.

To progress its ambitions the system has clearly identified its role, which involves connecting, convening and catalysing activity to support social and economic development, rather than controlling it. The system empowers the nine local place-based partnerships, like Warrington Together, to form the bedrock of the system’s activity on social and economic development. These partnerships build upon longstanding structures in local authorities involving the NHS, council, VCSE, police, housing, business, schools and other organisations. Additionally, the system also plays a role to share information, connections and good practice across its institutions and nine places, whilst also ensuring priority and progress on key issues like achieving net zero emissions, promoting diversity and inclusion.  

Crucial to the system’s ability to foster progress is its investment in dedicated roles, like the Executive Director for Partnership and place-based partnership directors, that have the time and skills to ‘agitate for action and knit things together’. The encouragement of a system leadership approach is another characteristic in this system. People are encouraged to ‘champion others rather than boss it’ and understand the important of ‘putting jeans and T-shirts on and getting out of the office into the community’. 

What has been achieved

While partners recognise that this work is not quick, or short term, and the implementation of new governance structures for health and care and the restructuring of operational models is delaying decision making, the partnership’s sustained focus on social and economic development is enabling tangible action. This includes the adoption of the Fair Employment Charter across all areas of the system, sign up to the social value portal, the expansion of solar panel installation and LED lighting replacement across the NHS estate, action on poverty, employment and housing and changes to procurement to enable increased local business and VCSE organisations in local supply chains.

Next steps

Looking ahead, partners see many opportunities to do more, especially through enabling increased grassroots activity in communities that can help people address housing, poverty, work and money issues.  For now, a dashboard of indicators measuring progress on social and economic issues is considered at every health and care partnership meeting. However, partners are also looking to develop a common system-wide criteria for anchor institutions related to things like the real Living Wage, net zero, the shift of funding into prevention and communities, and apprenticeships being offered.  

For more information, contact Cheshire and Merseyside Health and Care Partnership’s director of partnerships Dave Sweeney.

• Co-terminus and devolved city region
• Many years of partnership across NHS, local councils and VCSE sector
• Five-year focus on employment and health

How it works

Cross-sector partners in the Greater Manchester city region have built strong relationships and new ways of system working to develop a social model of health as part of a unified public service model. With nearly a third of Manchester’s 10 per cent productivity gap related to health problems and people with health problems or caring responsibilities often excluded from the workforce, all partners agree on the pivotal relationship between employment and health. As the central approach to achieving its purpose of social and economic development, one of the ICP’s core missions, as set out in its strategy, is therefore to help people get into and stay in good work.

What has been achieved

Building on a new approach piloted in 2018, the Working Well: Work and Health Programme with DWP and primary care partners are now strategically co-investing and aligning outcomes around the whole employment and health agenda. Data research and evidence plays an important role, with analysis showing that mental health is now the number one reason for work absence.

Learning from programme evaluations demonstrate the difficulties people with health conditions or caring responsibilities have in maintaining work and managing their health. Analysis of different communities show the clear link between employment and health issues in more deprived communities and sectors of the economy, like the service industry, logistics and retail. Being armed with this knowledge enables partners to target their actions to have the most impact on their mission.

Partners have also had success with working with external experts and national bodies on specific issues – like the Jobcentre Plus, and the Centre for Ageing Better on supporting people with health issues over 50 to stay in work. 

While significant progress has been made, and Working Well has supported over 25,000 people back into work, there is recognition that the size of the challenge needs a focus on scaling and spreading what works, especially in more deprived areas. Across the NHS and combined authority, alongside Working Well there are a host of different initiatives coming at the issue from multiple angles.

For people with multiple, chronic or complex health and care needs there are programmes such as the Fit for Work programme, the Individual Placement Service and Early Help Hubs.  The Good Employment Charter is working to increase the supply of good quality work across the city and there are local recruitment events for health and care like Step into Care. The first Good Employment Week seeks to increase the public’s awareness of their rights and the support that is available.

Next steps 

As next steps, partners are focused on engaging people and communities in more targeted ways through the VCSE sector, employers and primary care. As a system Greater Manchester is also preparing for its next stage of devolution and the opportunity of having more local control over the Department for Work and Pensions portfolio.

For more information, contact Greater Manchester Integrated Care’s director of strategy and planning Paul Lynch.

• 1 million people
• One integrated care board, three councils and six locality partnerships 
• City of Bristol, coastal town of Weston-Super-Mare, mix of urban and rural and of affluent and deprived areas
• VCSE alliance being developed to facilitate strategic engagement with the ICB

History and context

Partners have been working together across the footprint for over five years. The different geographies and populations across the system include the diverse urban area of Bristol, coastal town of Weston-Super-Mare and a mix of urban and rural and of affluent and deprived areas This means that activity to support social and economic development looks and feels different across the system.

How it works

To support social and economic development, partners across the system have been working to build on existing relationships and partnerships in each of Bristol, North Somerset and South Gloucestershire and establish new routes for relationship building and partnership at system level. This includes through things like joint appointments, co-location of services and opportunities for NHS staff working in locality partnerships to spend time in the local community. 

With the focus on developing a new relationship with the VCSE sector there is understanding that action on social and economic development crosses over into volunteering, asset-based community development, social justice, social determinants, diversity and inclusion, action on poverty, action on climate change, tackling health inequalities, and more.

Partners therefore recognise that support for social and economic development goes beyond work with large employers in the system and must involve smaller organisations that may not badge their work in this way.  To that end, partners have been working hard to establish a new VCSE alliance bringing together the thousands of different organisations – from small grassroots to larger specialist providers and everything in between, across Bristol, North Somerset and South Gloucestershire. 

What has been achieved

Investing in the needed infrastructure for coordination across the VCSE sector, embedding the VCSE at every level of the system and committing to co-production and asset-based community development as key principles and ways of working is at the core of the approach to support social and economic development. Crucially this approach seeks to increase the economic and ethnic diversity in the workforce and boost social and economic development from the ground up.

Examples of how this is being done include a local NHS recruitment drive with targets to attract employees from more deprived areas, the North Somerset empowering communities programme, a Bristol City Council initiative to increase the number of smaller local providers from diverse communities in the commissioning framework, South Bristol engagement with local community organisations, and research on social, economic and ethnic diversity in the local government and VCSE workforce.

Next steps

Building on existing activity and new partnership structures, partners are excited about the opportunities to do more. A key area of focus is likely to be around employment with ideas currently being explored about how to unlock national barriers to local action, make better use of the apprenticeship levy, better support people with chronic health or complex needs into employment whilst addressing issues within the health and care workforce at the same time. Partners are also focused on looking at how to remove barriers to system working through things like reform of commissioning and procurement to meet the future needs of a system rather than individual organisations.

For more information, on BNSSG’s ICS work on social and economic development contact ICB associate director of partnerships Ros Cox.

• 1.7 million people
• £3.3 billion annual NHS spend
• Seven years of partnership between NHS, local councils and VCSE sector
• Six place-based partnerships and five sector collaboratives including a VCSE collaborative
• Two cities of Hull and York within a large rural area

History and context

Established in 2016, the partnership between the NHS, local councils and VCSE sector in Humber and North Yorkshire is committed to narrowing the healthy life expectancy gap in its population. To achieve this, all partners understand the critical link between health and poverty, which is above average and affects 24 per cent of the population. And with ill health costing the health and care system alone £13 million a year on lost work days, the focus on social and economic development is central to what all partners in health and care partnership are trying to achieve.

How it works

A vital aspect of the system’s development has been the establishment of a strong partnership with the VCSE sector. Initially formed through a VCSE leaders’ group, a formal VCSE collaborative now sits within the governance of the integrated care system alongside other provider collaboratives and six place-based partnerships in Hull, York, East Riding, North Yorkshire, North Lincolnshire and North East Lincolnshire.

Together these structures and mechanisms drive partnership progress on social and economic development. However, it is the work of the VCSE collaborative, out in communities and the voluntary sector, that creates one of the strongest and most direct links for the system to support social and economic development.

 System leaders understand that making progress requires a structural, strategic and operational focus and join up across and within different parts of the system. To this end, a joint chair of the integrated care partnership (ICP) and the NHS integrated care board (ICB) provides link up between strategy and delivery. Additionally, a local government co-chair of the ICP, who is also a member of the ICB, further enhances collaboration. As a system convener, the ICP is working to create the conditions for people, communities and organisations to create the solution they think will work best to improve lives, including through investing in the VCSE sector.

What has been achieved

Underpinning these efforts is significant investment in building a shared understanding of the population’s social, economic and health needs, which has enabled development of the Joint Strategic Needs Assessment into an Integrated Needs Assessment. This now includes additional data and insight from the VCSE sector, as well as findings from focus groups in communities. There are also options to look at data by geographical area, including rural and coastal populations. 

Seeking to further reduce barriers to partnership working, deliberate effort has been made to enhance procurement processes so that it works as well as it can for all system partners. This includes the establishment of a new Grants Framework for the VCSE sector.

While in some ways it is still early days for the new formal structures, the history and strength of partnership in Humber and North Yorkshire, and the attempts to enable, share and celebrate good practice on social and economic development is bearing fruit. Tangible practical action examples include partnership action on the cost-of-living crisis, collaborative green social prescribing to improve mental health and ability to work, a Resilience Hub offering health and care staff mental health support at work, and progress towards achieving net-zero emissions across the system.

Next steps

In the immediate future, the system’s focus is on minimising the impact of the current economic situation on the population. Looking further ahead, despite the challenging context, partners remain optimistic that they have the building blocks in place to make progress towards reducing the gap in healthy life expectancy across the population through their work on social and economic development.

For more information, on Humber and North Yorkshire’s Health and Care Partnership work on social and economic development contact executive director for corporate affairs Karina Ellis and head of VCSE Gary Sainty.

• 1.4 million people
• £3.9 billion health and care spend
• Seven+ years of partnership working
• Four local authorities, two NHS provider collaboratives, a children and young people’s alliance and a VCSE alliance
• Diverse urban areas of Barnsley, Doncaster, Rotherham, Sheffield

History and context

South Yorkshire, a region with higher-than-average levels of deprivation, has some of the poorest health outcomes in the country. Its residents live shorter lives and live in poor health for longer than they should. This not only affects people, those that care for them and the communities in which they live, but also has an impact on the health and care system, with high rates of absence in the workforce.

The economy suffers as well, with lower-than-average productivity levels which is partly attributed to ill health. In response to this, for partners involved in the integrated care system, a focus on social and economic development is at the heart of what they are trying to do.

How it works

To catalyse action, the integrated care partnership strategy is using its convening power and the strategy development process to set specific ambitions around early intervention, children and young people and employment and workforce. Underpinning this is an approach based on building the relationships, culture and structures for a partnership that promotes a sustainable and inclusive economy and improves health and wellbeing.

Crucial to this, the regional mayor, elected on an ambition to make South Yorkshire the healthiest area of the country, is chair of the ICP. There are also joint roles across the councils and NHS and an active focus on embedding and strengthening the VCSE sector as a partner. Representatives from the VCSE sector are members of the integrated care board, there is a programme director dedicated to the VCSE sector and funding to enable participation of VCSE organisations in system planning and decision making.

Furthermore, the integrated care partnership has adopted a system operating model rooted in co-production, co-design and co-delivery of support and services, with people with lived experience, in diverse communities and the wider VCSE sector.

What has been achieved

System leaders understand the role of data for both developing a shared understanding of the population’s situation and needs and measuring progress as a system. A comprehensive needs assessment and data dashboard has been built by bringing together social, economic and health data held across the partnership. This has been developed pragmatically, based on data that can be shared for now, as something that can be built on as the system matures. The aim is to identify one version of the truth that enables targeted and impactful operational activity.

There is also a charter for anchor institutions which is currently being piloted in Rotherham and a focus on establishing health as a leading industry within the local economy through investment in health research centres and cancer centres of excellence. An example of how the different social, economic and health strands can be brought together to have impact is the diagnostics centre on Barnsley High Street. This new way of doing things is offering people an alternative avenue for meeting their health and care needs, creating a desirable work environment for staff and contributing to the revitalisation of the local high street and economy.

Next steps

With the strategy and structures in place, partners are now developing their operational plans. Part of this includes looking at how to systematically enable VCSE partners to share insight from their engagement with people and communities through a central depository and insight bank that the system can draw from.

For more information, on South Yorkshire Integrated Care Partnership’s approach to supporting social and economic development contact the executive director for strategy and partnership Will Clearly-Gray.

• 2.4 million people
• Seven+ years of partnership working
• Five place-based partnerships and Harnessing Power of Communities VCSE Programme
• Diverse urban areas including cities of Bradford, Leeds and Wakefield

History and context

The West Yorkshire Health and Care partnership covers a large geographic area with an ethnically diverse population in its many towns and cities. There are significant health inequalities and deprivation in some areas.  Working together, partners across and within the NHS, local councils, the combined authority and VCSE sector in West Yorkshire see collaboration as key to improving social, economic and health outcomes.

How it works

Acknowledging the vital role of the VCSE sector in providing social and economic support, particularly in the most deprived communities of West Yorkshire, the system has invested in VCSE sector partnership infrastructure and delivery through the Harnessing the Power of Communities Programme.  This is seen by system partners as a direct contribution to social and economic development in West Yorkshire given the VCSE sector’s significant social and economic value.

The ICB has also put the financial security of the VCSE sector on the ICB risk register, recognising the impact on people and communities if these trusted organisations are unable to carry on their valuable work.

Information, data, and research have played a crucial role in guiding the system’s decisions about supporting social and economic development. Recently published research shed light on the role and value of  the VCSE sector across the Yorkshire and Humber region.

Another approach to support collaboration and progress on social and economic development involves a recently agreed Partnership Agreement, which sets key areas for further joint working and jointly resourcing roles between the West Yorkshire ICB and the West Yorkshire Combined Authority. The joint roles – at a senior level - between the NHS and Combined Authority include the Associate Director for Improving Public Health, the Head of Regional Health Partnerships and the Mayor’s Inclusivity Champion.

Furthermore, numerous connector roles working with and within the VCSE sector exist at system level, and within its places and neighbourhoods, enabling further join up of the social, economic and health agenda.

What has been achieved

Recognising both the need for strategic prioritisation and operational implementation, VCSE leaders meet regularly with the health and care partnership chair and chief executive to discuss issues being seen on the ground in communities and challenges faced by the VCSE sector. Tangible practical action is being seen in a variety of ways. This includes a recent investment in the VCSE sector of £1 million to strengthen VCSE capacity and work around health inequalities, co-production of the pathway improving the experience and outcomes for working-age survivors of stroke, and the inclusion of the VCSE workforce in the Mental Health and Wellbeing Hub range of offers including therapies and specific support for men's mental health.

Next steps

Looking ahead, conversations are underway to with the intention of scaling up investment in early intervention, the VCSE sector and its grassroots organisations in communities, simplifying commissioning processes where needed. For now though partners recognise the robust strategic, structural and operational capabilities within the system as a solid base on which to build and achieve the system’s ambitions around social, economic and health outcomes.

For more information, on the West Yorkshire Health and Care Partnership’s approach to supporting social and economic development contact associate director for improving population health Jen Connolly and associate director for harnessing the power of communities Jo Anne Baker.