Health hubs a quick route to reducing health inequalities

I’ve said it many times but it’s worth repeating – prevention is the key to the NHS fulfilling its aims to improve population health and closing the health inequalities gap.

This goes back to the NHS Long Term Plan where commitments were made to the prevention agenda. These included the development of the standard preventative services and their response to local health needs, incorporating smoking, sexual health, obesity, alcohol use and anti-microbial resistance.

But the Long Term Plan went a step further and said the focus shouldn’t all be on stopping people becoming unwell in the first place; there should also be a focus on reducing unnecessary appointments, referrals and non-elective admissions to hospitals.

So where do Pharma, MedTech and Devices companies fit into the plan?

Self-care - one of the keys to prevention

To understand that, you have to go back a bit.

When the Long Term Plan adjusted its focus, the dialogue around prevention changed – patient self-care became important, as did raising patient awareness of the conditions they have, learning how to live with those conditions and getting the best from the medicine and support on offer.

The point is to ensure that when people do need access to the NHS, they are directed to the right services.

The Long Term Plan talked about closing the inequalities gap and tackling unwarranted variation between providers. That’s where you have three hospitals within the same integrated care board delivering similar services but in different ways - resulting in different patient outcomes, or five general practices within a primary care network, all delivering services in different ways.

The systems were asked to demonstrate the key areas of inequality they would tackle and the NHS also wanted to upskill teams via learning and education to better manage patients and improve outcomes – a gilt-edged opportunity for Pharma, MedTech and Device firms to exploit.

Read my blog on navigating the NHS maze here.

Hubs cut out so much expenditure – of time and money

The prevention agenda has never been more applicable and there’s a really good document here about health hubs which perfectly highlights that point.

It also very strongly plays to that agenda of the systems working with their hospital trusts, general practices and their voluntary sector organisations to achieve a shared goal of better outcomes for their communities and offering what is often described as the holistic package of care and the community centred initiatives that really provide those preventative measures.

That means looking at the whole patient and not treating them condition by condition. In those health hubs, we have multidisciplinary teams that can better manage the patients and avoid unnecessary appointments, referrals, and admissions.

Imagine that empty shop as a pop-up GP

The document looks at the creation of health hubs, explains what they’re like and how they can improve access for groups who face the challenges of health inequalities head-on and the broader social and economic determinants of the health outcomes that they lead.

It encourages the hospital trusts to get on board. It talks about the need for health hubs to be a collaboration between the system and the partners, including the voluntary, the community, the faith and the social enterprise sectors, and, of course, the patients in the community themselves to really start to transform everyday spaces into healthcare services.

We then have a health hub that can offer multiple services to the community in one convenient location.

So, if we think about another of NHS England’s big agendas, the Core20PLUS5, which targets accelerated improvement to tackle health inequalities, this is another great way of engaging with that programme.

The health hub document contains many examples like that, and there is a great opportunity here for the Pharma, MedTech and Device companies to get involved in exploring with their hospital trust customers whether or not they’re developing health hubs and what services they might place in there.

The next step is to work out how the industry might be able to support them and deliver these services because they’re out in real community hotspots—shopping centres, places of worship, leisure centres, libraries—and the document provides some really good examples of how that can work.

Making healthcare accessible for isolated communities

The piece also talks about a mobile health hub to try to attract people who really struggle to access healthcare, perhaps because they’re homeless or part of the Gypsy, Roma and Traveller community. That’s another angle the industry can work from.

Health hubs can really help give access to groups facing inequalities of care. The document references an excellent King’s Fund paper that discusses how these physical spaces have to be accessible, open at the right times, and sensitive to patient choices.

Where industry is working with primary care networks, the ability of social prescribing services to connect individuals with the right healthcare providers is also talked about in this document.

Imagine if there was a health hub which also had social prescribing services connected to its local primary care network. That’s another great angle for industry to work from.

How’s your sales pitch? Read my blog on refining it here.

Some people can’t afford to get to the GP

One of the other issues this piece highlights is one that we often don’t consider, yet I’ve had it often come up in my work – transport poverty.

This is where people know they need healthcare, but they haven’t got the ability to make the necessary journeys for it, usually due to income, the price of travel, not owning a car or just that there’s no decent public transport system in their area.

I worked on a project a few years back in the east side of Lincolnshire. Patients had to travel to Nottingham for healthcare, and they wouldn’t make the 90-minute journey because some of them just couldn’t afford it.

So they had to think about how they could create a more convenient service. That project had an industry partner as part of it, helping them create an environment in the east of the county, taking the barriers to healthcare down and making access just that little bit easier for everyone.

That’s the ultimate goal of a health hub, to offer services right at the heart of a community, as close to the people who need it as possible, in an environment that’s familiar and convenient.

It makes the appointments easier and cheaper to attend and the likelihood of missed appointments is reduced.

How does a ￡26million saving sound?

The knock-on effect of delivering a service like that is savings for the patients and the healthcare service because we get early and correct diagnosis, leading to early and correct treatment of health issues, which reduces the need for costly treatments associated with more advanced conditions which people turn up with much later.

The document highlights that, on average, an integrated care system could save ￡26million per year by getting their trusts to work with other system partners to implement the health hubs.

Savings like that are hugely significant when you consider the NHS is really struggling at the moment to deliver financial balance.

So these health hubs can play a hugely important role in bridging the communication gaps between patients and health services in attracting people to come in for screening, diagnosis, and treatment of conditions that otherwise would present much later.

The reason I’m flagging it to the Pharma, MedTech and Devices companies is it’s yet another way for health outcomes to be shaped by a wide range of determining factors involving system-wide stakeholders from the hospital trusts into primary care and general practice and into the community and voluntary sector.

The document flags that trusts have got a key role in developing that agenda and really should at least consider the development of a health hub.

So my message to industry is: whenever you’re in discussions with the NHS, start a dialogue about whether the establishment of a prevention-led health hub has been considered and go prepared to discuss how you can be involved in delivering that.

Scott McKenzie offers coaching, training, and consultation services to pharmaceutical, medical technology, and appliance firms to help increase revenue by getting their products and services in front of the right NHS decision-makers. If you want to get your products fully embedded into treatment pathways Scott can help. Scott has doubled revenue for his clients and is happy to share these processes with you too. Follow Scott on LinkedIn for regular updates.