BUILDING SOCIAL VALUE
The NHS estate – not all about bricks and mortar
Associate director at AA Projects, Sarah Butler, discusses a new resource, ‘Building for Health: The role of Estates in reducing health inequalities’, created by NHS England, and developed through desk-based research and engagement with a range of stakeholders. Its principal aim is to demonstrate how, as an anchor organisation, the NHS can use and manage its estate ‘as a catalyst to boost social value, address local priorities, and enhance the wider determinants of health, contributing to the reduction of health inequalities’.
The NHS is one of England’s largest land- owners. As an anchor institution and as a partner in its local community, the NHS can strategically and intentionally manage its land and buildings in a way which adds social value (positive social, economic, and environmental impacts), enhances the wider determinants of health, and reduces health inequalities.
New resource created To help realise this potential, increase awareness, and inspire action, NHS England has commissioned the creation of a new resource called ‘Building for Health: The role of Estates in reducing health inequalities’ to support the reduction of health inequalities. The content has been developed through desk-based research and engagement with a range of stakeholders from across the NHS, the wider public sector, and the Voluntary Community and Social Enterprise (VCSE) sector. The resource covers the following:
n Understanding the foundations – setting the context for health inequalities, the role of Estates, and the NHS as an anchor.
n Building blocks for impact – The 10 ways that NHS estates can help to reduce health inequalities.
n Being inspired – 10 case studies. n Putting it into practice – A checklist and top tips to use at each stage of your project.
n Creating the landscape for change – A call to action.
Equipped to act This article is an extract of what this work will provide to NHS estates teams, so they feel equipped to act. Firstly, it is important to understand what health inequalities are in order to take action in minimising them. Health inequalities are unfair and avoidable differences in health across the population, and between different groups within society. These include how long people are likely to live, the health conditions
38 Health Estate Journal January 2023
The employment aspect of the St Basils / Sandwell and West Birmingham Hospitals NHS Trust’s Live & Work scheme offers training and follow-on paid apprenticeships in a potentially wide range of NHS skills.
they may experience, and the care that is available to them. The conditions in which we are born, grow, live, work, and age, can impact our health and wellbeing. These environmental, social, and economic factors are often referred to as the social or wider determinants of health. These determinants are often interlinked. For example, someone who is unemployed may be more likely to live in poorer quality housing, with less access to green space, and to fresh, healthy food. This means that some groups and communities are more likely to experience poorer health than the general population. These groups are also more likely to experience challenges in accessing healthcare or having a good experience.
How can estates contribute to reducing health inequalities? A well-maintained, resilient estate is the bedrock upon which clinical services are delivered. It is essential that the buildings used by the NHS meet current and future service needs, provide a good patient experience and quality healing
environment, and support the NHS and Government’s Net Zero carbon strategies. As an anchor organisation, the NHS can use and manage its estate as a catalyst to boost social value (positive social, economic, and environmental impacts) in order to address local priorities, and enhance the wider determinants of health, contributing to the reduction of health inequalities. Examples of how this is achieved could
be through: 1. Delivery of new healthcare buildings, e.g. the New Hospital Programme, and development of community diagnostic centres (CDCs).
2. Modernisation of NHS facilities. 3. Use of NHS buildings and spaces to support community development.
4. ‘Disposal’ of facilities the NHS no longer needs.
5. Addressing estates workforce needs, as set out in the NHS Estates and facilities workforce action plan (2022).
Strengthening relationships Integrated Care Systems (ICS) present an opportunity to strengthen relationships
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