Anchor working provides system partners with an opportunity to come together around shared ambitions for a healthier, more prosperous local population, and work together to engage with communities to shape the response to health and wellbeing challenges. National policy thinking around anchors is shifting away from 'anchor organisations' towards 'anchor systems', recognising the importance of wider determinants of health and wellbeing such as skills, income, infrastructure and housing, and the diversity of the organisations locally which contribute to such aims.
However, setting priorities, and more importantly, measuring their impact, cannot be achieved by the NHS on its own. Understanding how people articulate what they want from the place where they live is critical to designing an approach which achieves these aims.
NHS England's guidance on working in partnership with people and communities sets out a series of principles for ensuring that systems meet their legal duties for public engagement, and that communities have a meaningful stake in decision-making for their local area. Imperial College Healthcare NHS Foundation Trust undertook a programme of community engagement, in collaboration with Westminster Council, to develop an approach to halving the gap in life expectancy across the borough of Westminster by 2035.
Case study
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust (Imperial) has committed to working with local cross-sector partners and communities to improve the health, wealth and wellbeing of the people who live around its hospital sites. Westminster has stark health inequalities, for example, a baby boy born in the north of the borough has an average life expectancy of 78, while a baby boy born in Knightsbridge and Belgravia has a life expectancy of almost 92. The trust took inspiration from international examples of 'place-based' anchor working, for example the work of Rush University Medical Center in Chicago, to develop their '#2035collaborative'.
Working with partners across the borough, such as Westminster City Council and the voluntary and community sector, this collaboration was launched with the shared aim of halving the gap in life expectancy across the borough of Westminster by 2035. Partners asked members of the community about the things that really matter to them, giving them a better understanding of what local residents see as their unmet needs and the things that would best help them and their families to thrive. These included the topics of:
- housing and homelessness
- money, local economy, jobs and training
- communities and connections
- neighbourhood and environment
- crime and safety
- health, wellbeing and healthcare
- tackling racism, discrimination and digital inclusion.
To meet these needs of the community, the #2035collaborative has agreed four founding principles:
- focusing on health inequalities through systems thinking, levelling-up to create a fairer Westminster
- putting residents at the centre and working together on the challenges they prioritise
- creating proper partnerships in place, working with residents and across agencies to solve problems and adapt solutions to local condition
- mobilising a movement for change where "we all teach one another, and all learn from one another".
To achieve this the partners will work together to apply #2035collaboration tools to listen more effectively, connect initiatives proactively, amplify what works, and accelerate improvement for specific localities. Alongside the #2035collaboration, Imperial aims to apply the same principles to their wider anchors work. Through the Paddington Life Sciences (PLS) development for example, the trust is working with Westminster council, life sciences organisations, and NHS partners to explore how to widen access to quality work within the life sciences sector, as well as address emerging issues such as the cost-of living for those living in the vicinity of the development. A dedicated social purpose workstream across all PLS partners is focused on a collective effort to develop local education, training, skills and employment opportunities, ensure digital inclusion and understand and mitigate against fuel poverty in the Paddington area around St Mary's Hospital.
As part of this, Imperial are establishing a 'community learning lab' which will allow them and Paddington Life Sciences Partners to effectively engage and build trust, co-create and test solutions to problems in a community setting.