The crisis across the health and care system has been the backdrop to the Hewitt review into integrated care systems, which began recently.
It is hard not to admire the work of dedicated professionals across the NHS and care system as they cope with intensifying challenges: more patients or service users than ever before, along with increasing rates of illness and complexity of cases.
The system was creaking amid rising demand even before the pandemic, and district councils acknowledge the difficulties faced by our county council and NHS colleagues as we strive to protect and support our local populations.
However, so many of the resources across the system are tied up in treating illness rather than preventing it.
While some ill health is unavoidable, a focus on eliminating preventable illness is essential, both to conserve the resources of the health and care system and to enhance wellbeing.
Much of the required integration of care and improvement of population health will happen locally, in places people live, work and access important services.
That’s because the wider range of factors that affect our health and wellbeing fall under the responsibility of district councils.
It is district councils that are responsible for leisure centres and recreation; we are housing authorities charged with ensuring dwellings are safe and conducive to good health; and we oversee green open spaces – the lungs of a place.
Our benefits and welfare work supports the most disadvantaged members of society who often experience the worst health – and we run environmental health.
But it’s our work beyond the provision of statutory services that is essential in a health system that prioritises prevention and moves towards an early intervention mindset.
We are on the frontline when it comes to addressing today’s complex needs and preventing them from escalating into the social problems of tomorrow.
Examples of our early intervention work include South Norfolk and Broadland Councils’ ‘community connectors’, who offer social prescriptions from GPs’ surgeries – a non-medical solution to an array of social, emotional and practical problems that would otherwise impact on health.
My own council, Breckland, is working in partnership with the mental health charity Norfolk and Waveney MIND to develop ‘mindful towns’, and we’ve trained more than 250 mental health community champions.
The localised scale of district councils gives us a unique convening power, enabling us to work innovatively with community bodies on solutions that meet the needs of individual communities and individual people, which have not typically been provided by more remote bodies.
North West Leicestershire District Council, for instance, works withfoodbanks to provide pathways of support away from poverty, including a low-cost cookery course and support managing household budgets.
Working in partnership with GPs, Reigate & Banstead Borough Council has created new health networks, including an Asian women’s group and community health champions, encouraging residents to take ownership of their health.
District councils do not have the biggest budgets or the highest profiles in the local system, but our small scale and our localised expertise gives us unique strength to focus on prevention.
Our work is integral to bringing about this desperately required shift in approach across health and care. We look forward to sharing our expertise with that of our partners as the Hewitt review charts a path to a genuinely integrated care system.
