Anchor institutions by their nature have the potential to significantly enhance their neighbourhoods. But networks of anchor institutions with shared objectives and effective methods of collaboration can increase that impact significantly, achieving more for local populations and saving money through best use of resources.
Integrated Care Systems (ICSs) are ideally placed to foster and lead this collaboration, enabling public sector organisations to shift away from firefighting towards a more proactive, preventative approach to services.
Like any task that promises big rewards – the path ahead is not straightforward. However, we are starting to see real progress in some areas of the country where ICSs are successfully drawing together anchor institutions to deliver social value shared priorities. For many ICSs, a positive first step is to agree an anchor framework or charter which galvanises each individual organisation’s social value priorities into an agreed set of overarching objectives for the system. This provides flexibility for partner organisations to achieve their own goals, while feeding into a broader set of outcomes for local communities across the patch.
There are many factors to consider when embarking on a system-wide anchor framework. From our experience of working with ICSs and anchor institutions, we have seen five core themes emerge that are key to successful collaboration.
- Clarity and capacity
Start by defining what an anchor framework means to you and your system. Consider what you are seeking to achieve and the stakeholders and processes that will be needed to create that framework. For example, in Coventry and Warwickshire ICS, the ICB is drawing on partners’ roles as anchor institutions to tackle health inequalities. Partners include local authorities, housing associations, voluntary, community, faith and social enterprise sector organisations, and NHS organisations.
Executive leadership is essential to sponsor the project and demonstrate its value to the system, but this needs to go hand in hand with capacity in both the ICB and partner organisations to do the work required. Thinking ahead about which partners you will engage, how and securing the necessary time will make the whole process much quicker and more efficient, leading to more timely objectives that are rooted in current priorities.
2. Using data to drive commitment
Anchor frameworks should reflect existing strategies and priorities rather than being established as a separate, standalone initiative. Make them relevant for each part of an organisation or system by drawing on the data already used to inform their priorities. By considering how each partner’s existing strategies can be enhanced or accelerated through a collaborative anchor framework, you will be providing a hook to encourage engagement and strengthen support for collaboration. This tactic has underpinned the Coventry and Warwickshire approach, enabling each partner organisation to do what it needs to do to meet its own requirements while still contributing to a wider strategy to deliver a more proactive and sustainable health and care service.
3. Community engagement
Ultimately, the beneficiaries of social value are members of the public – the communities ICS partners serve. Giving communities a say in the overarching principles that will drive collaborative initiatives across anchor institutions helps ensure organisations are focused on actual rather than perceived needs, and tailored to specific localities or community cohorts as required. Local authorities are typically well versed in community-led decision-making, with neighbourhood plans being a good example. Sharing this learning across partners can help improve community engagement across the system as well as informing anchor framework priorities.
4. Governance and accountability
Being accountable to both partners and communities is essential in understanding and celebrating success, as well as identifying opportunities to improve. Some ICSs such as Cheshire and Merseyside have developed effective ways to share progress and challenges such as an annual anchor assembly as well as dashboards reporting on specific projects. This type of collaboration is still relatively new, so being honest about the challenges you have faced and the reasons why goals may not have been reached is just as important as the ‘you asked, we did’ style of positive reporting.
5. Incremental goals
One of the biggest pitfalls we come across is a tendency to be over ambitious at the start. By trying to change the world, people can quickly disengage when it seems there is little progress. Having realistic targets that are achievable and can be incrementally stretched allows you to build momentum and commitment through early success. Focusing on net zero initiatives (an NHS requirement) and/or investing in the local community through employing local people and using local suppliers where possible are often good places to start. Whatever the goal, it’s important to consider how it will help deal with issues facing your communities and how you will capture its impact.
Most of the partners that make up an ICS qualify as anchor institutions, and together they have the potential to make positive inroads into tackling the wider determinants of health. Working collaboratively brings other benefits too. If one anchor institution commits to paying a real living wage, an unintended consequence could be that other local institutions lose staff to that organisation, negatively impacting some services. If all partners commit to paying a real living wage, the competition between partners is reduced, and the whole area becomes more attractive to employees. Consequently, we could expect to see higher staff retention, more jobs filled by local people, more money being spent in local shops and businesses, improvements in living standards and even reduced emissions from commuting. The ripple effect of these changes should, in time, lead to reduced burden on health services from illnesses caused by poor housing, poverty and pollution.
Clearly, the reality is not quite so simple or clear cut – but the potential is there. And who among us wouldn’t want to be part of that success story?
More information and free resources can be accessed via NHS Arden & GEM’s Social Value Network workspace on NHS Futures.
