The future of healthcare services must be shaped by the identity of places
Updated: Jul 18
As the NHS shifts towards a great emphasis on place-based collaboration, John Copps argues that NHS providers will miss a huge opportunity if they don’t recognise the power of local identity to create stronger relationships and win the support of patients and staff.
A few weeks back I found myself waiting for a blood test in my local health centre and, as I looked around, it struck me that I could be anywhere in the country. The noticeboard telling me to make sure I’d had my vaccinations, the generic disinfectant smell and the standard-issue plastic chairs, gave no insight into my whereabouts.
As the NHS moves to a system focused on collaboration at a local level, the importance of ‘place’ is growing.
Whilst this shift might feel novel, the concept of place – ‘where I live’ – has always been the lens through which patients see their care. Researchers over the years have repeatedly found that patients want their health needs to be met by people they recognise, in environments that they know.
Healthcare leaders seeking to respond to this new emphasis on place will make a mistake if they simply equate place with location.
Location is only one factor that defines place. Among the other things that are important is identity.
If location is about ease of access, logistics and cost, then identity is much more complex. Identity might sound abstract but it is a powerful enabler and motivator of concrete action.
This applies to both patients and staff, as we are reminded every time a major reorganisation of local provision is attempted. People like to feel they belong somewhere, take pride in their local services and build an emotional connection.
NHS organisations are anchor institutions in our towns, cities and communities that inspire loyalty and pride. They have storied histories as care-providers, employers, customers of local services and as a physical part of the landscape. It matters to people that they were born in their local hospital, that they attend the same GP as their mum, or that a renowned doctor, new drug or groundbreaking therapy was pioneered in their patch.
But local identity is almost always something missing from the planning and management of healthcare.
There is no mention of it in any of the NHS England guidance documents on integrated care, and it is not a core theme to emerge from the ICS strategies published so far. I worry that the Whitehall view is that ‘place’ is simply a conveniently sized managerial unit.
One of the reasons that this is ignored is that there’s no clear answer to how you recognise identity in healthcare planning. Any response must be shaped by the place you are in.
What strategies can be used? Appealing to historic ties and memories can help win arguments or address health disparities by attracting hard-to-reach patients. Visual cues and branding can play a part. An obvious approach is for ICBs and ICPs to ensure that the NHS has genuine, meaningful collaboration with local government - because as ‘guardians of place’ they understand their local areas as well as anyone.
Over the next five years, the way healthcare is organised will change. To prepare for this, investment in understanding, building and nuturing a connection to local identity will be time well-spent. For NHS providers, this will help create stronger relationships with local partners, win the support of patients and staff and prevent the risk of becoming remote bureaucracies. Conversely, NHS leaders that don’t get this will squander an opportunity to provide a better service and be part of a real, meaningful pride in place.
For more on MV's work on integrated care and health collaboration click here.