The new Labour government’s first budget made crystal clear that the NHS is one of its top priorities, with Prime Minister Kier Starmer saying that we, collectively, need to move to a much more preventative approach to healthcare.
This was the message that our MAD World keynote speaker Luciana Berger predicted would take centre stage in the government’s thinking, when she closed the Summit.
What was also obvious was that the government sees employers as an essential part of the plan to start turning the struggling NHS around, not least because the funding for this is largely coming from the business sector; Chancellor Rachel Reeves increased the rate of employers’ NICs by 1.2% to 15% generating an estimated extra £20 billion.
But what is the longterm strategy?
This new funding will predominantly be used to boost the NHS, investing in things like new machinery and improving access, to reduce overflowing waiting lists.
What is less clear, however, as Business for Health’s Chief Executive Tina Woods says is how, exactly, the government plans to create this preventative culture:
“It’s been talking about prevention, but when you look at the budget, there’s not really very much in there about any sort of longterm preventative approach.”
Employers should have their say
Given that employers are “shouldering significant commitments now made to the NHS”, Woods believes it is only fair that businesses get their voices heard about the future preventative strategy:
“If businesses are going to be asked to make this contribution, they should really be listened to on how that money is being spent. After all, they’re effectively investing in fixing this machine and it’s fair to ask about a return on their investment. I think it’s a good moment in time for the business world to really make their views known about how they can actually engage, and work effectively with government, in the preventative health agenda.”
It is also a good time for businesses to take more of a lead on the nation’s health because, as the Edelman Trust Barometer shows, business is now the only institution people see as “competent and ethical” and trust it more than government.
People trust employers more than government
The 2024 report concludes: “As the most trusted institution, business should leverage its comparative advantage to inform debate and deliver solutions” and “business and government can build consensus and collaborate to deliver results that push us towards a more just, secure, and thriving society”.
Over half (55%) of people said they believed their employer for health advice ahead of the government (50%), in Edelman’s 2022 survey.
Woods would like to see employers and businesses recognised for theirmore proactive role in prevention, working in partnership with the NHS, which, after all, mostly functions at the other end of the spectrum, when people are already ill:
“I worry that too much is talked about in terms of health being about the NHS, and fixing the NHS. The reality is that the biggest impact we can have on health is going to come from addressing the wider determinants of health – coming from local service improvements, housing, food. 80% of the determinants of our health lie outside of the care we get from hospitals and doctors.”
Business boosts community health
Already we are seeing how businesses operating in a community can have a positive health (and economic) effect, not only by providing jobs but also from investment in the local area. This all correlates with improved health and wellbeing levels of residents, showing how companies can “anchor” with wide influence in the community.
Longterm system change focussed on prevention will drive positive health outcomes and businesses can have a huge impact on this front, says Woods. But she urges all stakeholders to “think much more creatively” than we’re seeing at the moment:
“It’s one thing for businesses to support the NHS with employer NI contributions, but it’s quite another for businesses and the government to work in partnership, which I’m hearing the government wants to do more.”
Businesses need to get creative
She welcomes initiatives like health food brand Holland & Barrett’s move to train their sales employees to be health coaches; with its local branches being on the High Street, it’s perfectly placed to normalise these health conversations in the heart of communities, and make a meaningful impact..
Creative examples of businesses working in partnership preventatively with the NHS are also starting to emerge. We showcased one impressive case study at this year’s MAD World when Jaguar Land Rover Chief Medical Officer Dr Steve Iley talked about opening up the company’s sites to the NHS to do health checks and scans for their employees, but also their families and the wider community.
“The NHS often wants to deliver services to communities but has problems of access and follow up, and people don’t want to go to appointments because it’s difficult. If we do them on site, we only lose the individual from work for about half an hour, as opposed to half a day or a full day, so it’s a win win,” he says.
Challenges of working with the NHS
However, while it’s a “win win” that’s not to say there are not immense challenges to working with the NHS. The biggest of these is finding the right person in the sprawling multilayer organisation to speak to about partnership.
“The NHS is incredibly opaque to those outside it. Finding the right contact is key but very difficult,” says IIey. “Local connections are usually needed as it is geographically very variable, and even challenging within the same ‘patch’ as to who owns or delivers what.”
Another obstacle is the mindset of those in the NHS. As IIley says, “sometimes they seem to think we are just giving them work, as opposed to trying to help” and “the NHS doesn’t think as a provider outside of their NHS contract”.
Government needs to address NHS mindset
The government will have to address this detrimental mindset if it wishes to achieve better health outcomes, through partnership with employers, and successfully shift care out of hospitals into the community. This is another topic which businesses would do well to voice their concerns about at this pivotal point.
“If there was a way of approaching it [partnership] in a systematic way, that was easy to navigate, that would help,” says IIey.
Someone well versed at working in partnership with the NHS is Ellie Orton, Chief Executive of NHS Charities Together, which has a special relationship with the NHS as the charitable arm of the service.
Vision for ‘neighbourhood health’
She believes in the government’s vision of “neighbourhood health” but thinks it should go further than just bringing clinical expertise into a corporate space.
“It’s also about how we can build community resilience in each of us, to care for ourselves and each other,” she says. “How do we know what to do to prevent burnout in ourselves? To understand our own wellbeing and mental health? To do our own check-ins? To spot early signs?”
One way to do this is by partnering with business to skill up the community, as NHS Charities together has done with Omaze, a for-profit entertainment company with a social purpose. This partnership is funding, not only medical equipment and training for ambulance services, but also training for Community First Responders and members of the public in lifesaving skills.
Opening up corporate spaces for community health
Orton also cites the example of Starbucks, with which her organisation has a partnership, which sees local NHS charities collaborate with its cafes. This can mean the space is used for bringing the community together to have talk about health matters. “People can gather around a cup of coffee, relax, have a conversation with somebody and support each other,” says Orton.
As part of the Greener Communities Fund, Starbucks also funds community access to health benefits from nature by creating and improving greenspaces in the UK. The cafe brand raises these funds via proceeds from its 5p cup charge.
As Orton says, in order to stop the current backlog of waiting lists and move to this desired preventative culture, we need to create new behaviours and cultures in our communities. The big question for her, and for all of us who want to see the NHS and our people thrive, is:
“How do we collectively – between individuals, government and employers – move to being generators of our own good health, rather than passive receivers of treatment for ill health?”
