How universities can act as a lynchpin for community health outlined at Labour Conference

The ability for universities to bring local health services together within communities was outlined by Sherria Hoskins, Provost of the University of Portsmouth, at the Labour Party Conference.

Speaking in the Community Health Revolution: How Community-led Health Can Support Good Growth fringe session, Hoskins outlined how independent research has calculated the benefit and monetary savings that a Portsmouth Neighbourhood Health Hub, facilitated by the university, could have for the local community.

Portsmouth is a ‘dental desert,’ has a shortage of nurses, has more than 23,000 residents who are economically inactive, and has an average life expectancy that is 15 years shorter than the national average, Hoskins said.

“There is a clear link between economic growth and health,” Hoskins noted.

Portsmouth’s medical school is focused on general practice and community care, rather than surgery, and 54% of graduates stay in the area to work, she explained.

Teaching students from different medical disciplines together creates a less siloed workforce, Hoskins believes.

Universities should work to bring the healthcare workforce, integrated care boards and primary care together to create “innovative healthcare that is sustainable,” Hoskins said.

A Portsmouth Neighbourhood Health Hub could see 65,000 people annually, she added.

An independent analysis has found that such a partnership in Portsmouth could save £1.2 million annually, as well as 150,000 emergency hospital admissions.

“This is the difference it could make in Portsmouth,” Hoskins said.

There is a moral as well as an economic argument for these kinds of partnerships, because they have the potential to create “better, fairer health outcomes, for less money,” Hoskins said.

The question of who leads these partnerships is a barrier, she acknowledged, but noted that the University of Portsmouth is strong in this area because it set up its nursing, dental and medical courses with local third sector and primary and secondary care partnerships in mind.

A role for universities

Building healthcare partnerships is both “the biggest barrier and biggest opportunity,” Hoskins said.

"Sometimes it’s like many people coming to a roundabout at the same time: who gives way and who goes first? Who leads?” she said.

“Somebody has got to convene. Somebody has got to put all those people together and say, ‘let’s solve this problem for ourselves.’”

Hoskins added: “If you’ve got a region where those sectors are disparate from each other, you’re not going to solve this problem.”

The most prominent barrier is commissioning, she believes.

“There is going to be no more money, so we are going to have to transition to a different way of commissioning different services, and that means some services are not going to get served, and there will be a lag,” Hoskins said.

“If you’ve got a shift to primary care, with a much bigger community focus and a much bigger neighbourhood focus, that is going to take pressure off our acute services, but there is going to be a lag before that happens.”

Hoskins noted that integrated care boards will take on a “major role” in primary care commissioning.

Hoskins was speaking on the fringe panel alongside Michelle Welsh MP, Professor Geeta Nargund, director of the Create Health Foundation, and Lisa Hollins, executive director of the British Red Cross.

The session was run by the Create Health Foundation and the Good Growth Foundation.

During the session, Nargund emphasised that “inequality in access and outcomes is unacceptable.”

Like Hoskins, she acknowledged that there will be no extra money coming into the system.

Funding currently sits within secondary care and within equipment, Nargund said, adding that it is about “repurposing the money that's in the system” towards the community.

The workforce should be better integrated into the community, Nargund believes.

Students from disciplines including pharmacy and physiotherapy should be brought into the community via an increase in the number of clinical placements, she believes.

"There is a beautiful, innovative model that we can create in our country so that they can serve,” Nargund said.

She noted that many existing healthcare courses may have to change their education model if this community-focused learning is to succeed.

As a result of the General Optical Council’s education training requirements, optometry students are now required to complete a minimum of 48 weeks in clinical practice before they graduate.

Welsh also noted that cultural change is also needed, “So people remember why we are doing it from a moral perspective, as well as the economic perspective.”

She emphasised: “The minute I stop talking about the moral obligation that we have, as a Labour government, based on our values and everything that we stand for, is the minute that that becomes less of priority.

“We have to keep talking about it. We have to keep talking about how health has such a huge impact.”

Systematic change to the NHS is needed before people in communities like her own constituency in Nottinghamshire can be sure that they have full access to it, Welsh said.

Hoskins shared a personal experience of the value of optometry, explaining that her brother was diagnosed with compression on the brain in his early 30s after a routine appointment in an optometry practice.

“Holistic healthcare and community hubs can bring professionals together, desiloised, and treat the whole person,” Hoskins said.

She added: “That is one of the unique, innovative elements of community health.”