The document discusses the role of the NHS as an "anchor institution" and ways it can use its influence and spending power to improve health and social outcomes for the local community. It provides examples of NHS trusts that have successfully implemented social value initiatives around local employment, procurement, green space development, and environmental sustainability. While many practices have evolved organically, there is potential to build on this work by establishing clear leadership, metrics to evaluate impact, and networks to share learning between organizations. The document calls stakeholders to action to further develop the anchor role of the NHS at both local and national levels.

1. The NHS as an anchor
institution
Laura Wallace
@LWallaceTHF

2. 10.06.19 The Role of the NHS as an anchor institution

3. Widening health and wellbeing gap

4. So what is an anchor institution?

7. Health employment as
% of total
employment by STP

8. Widening
workforce
participation
Targeting positions for local
people
Understanding local
demographics
Creating pre-employment
programmes and volunteer
work experience
Building the
future workforce
Engaging young people
and supporting career
development
Increasing the number and
types of apprenticeships
Being a good
employer
Supporting health and
wellbeing of staff
Supporting fair pay and
conditions of employment
Supporting professional
development and career
progression

10. Procurement spend of East Lancashire and
Leeds Hospitals
Procurement
spend
Percentage
spend in local
authority
Percentage
spend in wider
region
Percentage
‘leakage’
outside wider
region
Leeds Teaching
Hospitals NHS
Trust
£482m 28% (Leeds City)
31%
(West Yorkshire
including Leeds)
69%
East Lancashire
Hospitals NHS
Trust
£117m
19% (Burnley
and Blackburn-
with-Darwin)
23%
(Lancashire)
77%

11. Shifting more spend
locally
1.Building local capacity
and supporting local
supply chains
Embedding social value
into purchasing
decisions
1.Prioritising and
monitoring social value
1.Building
organisational
capability and capacity
for social value

12. Case Study
• Changed its approach to procurement of catering services to purchase
more food locally.
• In 2018, 54% of its food spend went towards local produce.
• Awarded Food for Life certification by the Soil Association, recognising
excellence in catering that provides environmentally sustainable and
ethical food.
• They audited to identify what produce was available locally and the
financial implications of switching suppliers.
• They removed certain menu options (lamb) that could not be sourced
within a 50-mile radius. This increased costs slightly: for example, beef cost
1p more per meal when sourcing from a local and organic provider.
• Supported by senior stakeholders from the start, who looked for savings
from elsewhere to offset the increase.
North Bristol NHS Trust - local food procurement

14. Expanding community access
to NHS property
Enabling local groups and
businesses to use NHS estates
Converting and selling estate for
community benefit
Supporting access to affordable
housing or housing for key workers
using NHS estate
Working in partnership across
a place to maximise the wider
value of NHS estates
Developing accessible community
green spaces

15. Case Study – Green Space
Bromley-by-Bow Centre - Bobs Park
• GP practice and community charity based in a socially deprived area in east
London – owns 3 acres of land that it has worked with the community to
develop into green space accessible to all, with a children’s play area, an
allotment and garden.
Sunderland Primary Care Centre - Community garden
• Staff worked with NHS Property Services and a local charity, Groundwork,
to convert derelict space into a community garden and allotment. The
space is now used to run a gardening course as part of a community mental
health recovery programme.

17. Adopting sustainable
practices within the NHS
Developing
leadership and
staff buy-in for
environmental
sustainability
Influencing sustainable
practices in the community
Helping shape
community
environments and
behaviours and
influencing
local suppliers

18. Case Study – Environmental Impact
University Hospitals of North Midlands NHS Trust and Beat the Cold
• An initiative to establish more sustainable and affordable energy sources
• Recognised the links between hospital readmissions during winter and poor heating and living
conditions,
• Crowdfunded for 1,100 solar panels, installed on NHS hospital buildings.
• Reinvested savings in the community
• The trust saved nearly £300,000 that was invested into Beat the Cold, which tackles cold-related
sickness and fuel poverty.
• This initiative has helped strengthen relationships between the trust and residents.
• Reduced the rate of readmissions, particularly among elderly people and other vulnerable groups.

19. Case Study – Environmental Impact
Sussex Community NHS Foundation Trust
• Care without Carbon strategy at Sussex Community NHS Foundation Trust is
working with suppliers to reduce carbon emissions
• Suppliers emissions make up 60%–70% of the trust’s overall carbon footprint.
• They embedded sustainability criteria and metrics into the tendering process
by setting targets for suppliers to reduce their vehicle emissions over the
lifetime of the contract.
• Care without carbon is more than just a procurement policy they are working
the change the culture and empower staff to make sustainable choices.
• https://carewithoutcarbon.org/about/

21. 1.Partnering with other
anchor institutions across a
place
1.Developing
anchor
collaboratives and
networks to
support shared
approaches locally
Partnering with other NHS
anchors
1.Developing
networks to
support shared
learning and
spread good
practice

22. Emerging challenges and opportunities
• Practices tend to be
discrete rather than part of
a central or organisational
approach
• What support is needed to build
organisational capability around
the anchor mission?
• Practice has evolved in spite
of clear policy barriers
• How much does policy need to
change, and what can be done
within existing context?
• The evolution towards STPs
and ICSs creates new
opportunities
• How to harness this and who
takes the lead?
• Anchor as an organisation
vs. a health system vs a
partner across a place
• What can the NHS do itself,
with other health partners,
and with anchors across a
place?

23. Opportunities for action?
• Our report identifies six opportunities for stakeholders to engage in at
local as well as national levels.
• Build a baseline
• Develop metrics and evaluate interventions
• Establish clear leadership
• Enable staff
• Support sharing through networks
• Engage proactively with communities

24. What you can do in your organisation
• Share our report and join our webinar
• Advocating for anchors to be a core part of your organisational
strategy
• Developing partnerships across a place
• employment
• procurement and commissioning for social value
• use of capital and estates
• environmental sustainability
• as a partner across a place.
• Tell us about any activities you are undertaking in this area