This year's most important health strategy is the one you might not read

The run up to the autumn Budget in November will see many health service colleagues, quite rightly, making the case for additional resources to get through the winter, invest in capital and prop up social care.

Addressing the here and now will be the priority, but if we allow ourselves to look beyond our current “to do” list we have the opportunity to make a much bigger impact on our future service financing, provision and staffing. 

The Industrial Strategy White Paper is expected to be published around the same date as the Chancellor’s 22 November statement. The word “Industrial” in the title probably means that both NHS leaders think it’s not for them and industry leaders think it’s not for us. In fact, both would be wrong.

Challenging trickle down public finance

The context for the white paper is an economy more regionally imbalanced than any other in the Organisation for Economic Cooperation and Development.

Places and people have been simply “left behind” in many parts of the country, with the regions least productive and most dependent on EU sectors those which voted heavily to leave. Put simply, there are parts of the country where it is irrelevant what the NHS does by itself to manage demand – it can’t and won’t work.

This is where public service reform – funded, of course, through taxation raised – needs a greater focus on place. The white paper should provide this.

The white paper will call for local industrial strategies to be developed, largely along existing Combined Authority or Local Enterprise Partnership geographies

The Industrial Strategy White Paper will call for local industrial strategies to be developed, largely along existing Combined Authority or Local Enterprise Partnership geographies.

While these geographies are not exactly co-terminus with our Sustainability and Transformation Partnership footprints, the potential is clearly there to align strategies if the leadership so desires.

Local Industrial Strategies

These LISs (for want of a better acronym) will not simply focus on industry but should assess the wider societal and economic needs of its area. On their radar will be several areas of importance to the NHS – including skills, innovation, R&D, procurement, capital, housing, transport, social exclusion and financing.

Let’s take skills for example. Your LIS will outline as one of its key priorities how it intends to address known local skills shortfalls, including through sector and employer led lifelong learning, better use of the Apprenticeship Levy and a new focus on creating Institutes for Technology.

Fewer people are now moving for employment and sectors are competing in an increasingly shallow local talent pool. Only by engaging with the industrial strategy at a local level can STPs hope to influence the future health and care workforce.

Innovation is another important area. The Life Science Industrial Strategy published in August called for greater public private risk sharing and digitisation. The white paper will go further. The NHS – largely through Academic Health Science Networks – has been involved in tens of millions of pounds worth of life science, digital and medTech projects funded by the EU or national government.

If the NHS is to secure sustainable financial settlements from the Treasury it needs to show the totality of the economic value it brings in a much more coherent way nationally but also locally

It is these new LISs that will prioritise the areas where future monies will go. This is on top of the new Industrial Strategy Challenge Fund which has already announced significant funds for areas such as cleantech, robotics and leading edge healthcare and medicine.

Looking at the more social aspects of the local economy is always tricky but this can no longer be ignored. New metrics are being developed to measure more “inclusive growth”, which strongly correlates health inequalities with wealth inequalities.

It’s not just mental health colleagues calling for greater investment in their services, but also increasingly business and civic leaders who see poor well being as one of the single biggest barriers to regional productivity.

Finally for now, let’s turn to the financing. If the NHS is to secure sustainable financial settlements from the Treasury it needs to show the totality of the economic value it brings in a much more coherent way. This needs to be done nationally of course but also locally.

The Treasury agreed to the devolving of a range of powers to city regions such as Greater Manchester because it believes local growth will get more money flowing into its national coffers. A more strategic approach to local economic partnerships enables us to both provide our primary health and care services and convince partners we are an investment, not a cost.

Picking up the phone

There is still some time before the Industrial Strategy White Paper is published but a selection of areas are already pressing ahead with their thinking.

The changing governance across England means that the person in charge depends on where you are – it could be the newly elected Metro Mayor, a Combined or Local Authority leader or the LEP.

Whoever it is and wherever it is, the onus is on the NHS to reach out and explain why it’s not just industry that is responsible for the prosperity of this country.