Delivering social value could easily fall prey to the more immediate challenges of day-to-day care when it is just one of many items on the ‘to-do’ list for Integrated Care Boards (ICBs).
But embedding social value in system-wide planning is not optional. Net zero carbon targets are already baked into NHS plans, with procurement contracts assigning at least a 10% weighting to social value and all NHS suppliers needing to demonstrate carbon reduction plans by April 2024.
And this is just the start. The long-term intention behind social value is to build stronger, more resilient communities to reduce the burden on public services and minimise our collective impact on the environment. Reducing our carbon footprint doesn’t just help the planet – it will reduce the number of pollution-related illnesses and deaths. And that, in turn, will release some of the pressure on NHS services.
This goes right to the heart of the role of ICBs as anchor institutions. When you consider the number of people employed and services provided by the public and voluntary sectors – and the resources and expertise required to deliver sustainable services – it’s clear that ICBs are uniquely placed to tackle urgent environmental, social and economic pressures.
Knowing where to begin
The challenge for ICBs is knowing where and how to start, particularly amidst so many competing priorities. Delivering social value is complex, not least because the potential remit is so broad.
In our experience, a good place to begin is to develop a system-wide ‘charter’ that sets the vision and priorities for achieving social value. For example, what values and behaviours do you want to set for your system? How will that change the way you commission services, and what metrics will you use to determine your progress? Once these foundations are in place, it’s easier to define, implement and measure initiatives across all partners.
Social value isn’t a new concept – some systems have been developing this agenda for some time. Cheshire and Merseyside, for example, has been a social value accelerator site since 2018 and has already developed a social value charter, anchor framework and social value award.
Recently, as a part of our work in the ICB, we built on this foundation by engaging with colleagues and local communities and working with the Social Value Portal to become the first system in the country to develop a system-wide set of themes, outcomes and measures (TOMs). All parts of the Cheshire and Merseyside system have signed up to the wide-ranging TOMs to track and evidence social value progress. They are all aligned with the social value charter and anchor framework to ensure they continually move forward and raise the bar.
Fostering collaborative approaches
ICBs across the country are looking to develop their own themes, outcomes and measures to support social value. Some are more advanced than others. The NHS has a strong track record of sharing expertise to fast-track improvements, and there is value to be gained from applying a similar approach here.
While each system has its own unique characteristics, there is much to be gained by sharing information and ideas, especially when system-wide working is still relatively new. ICBs can support each other to achieve ambitious climate targets and start making serious inroads into the causes of health inequalities. Arden & GEM is supporting Integrated Care Systems to do this through a not-for-profit collaborative network designed to accelerate progress, with expert input from those further along on their social value journey.
How social value is delivered on a practical level will vary based on population needs and priorities. For example, an initiative to curb car use may be achievable in urban areas but much more challenging in rural communities. And paying all staff a real living wage may be more accessible for organisations with set pay bandings but more challenging in social care or the voluntary sector.
This is where the combined input from different individuals, communities and organisations is crucial to finding workable solutions that may deliver multiple benefits, improving patient outcomes and delivering wider societal advantages.
Engaging with our communities
Importantly, we must also strengthen how we engage with our communities to identify creative and holistic solutions to solve specific needs as well as bring wider long-term benefits.
Social prescribing is just one example of this. Prescribing someone a bike or other exercise equipment, rather than anti-depressants, helps tackle mental health or social isolation and reduces reliance on medication. It also delivers greater health and wellbeing benefits through improved fitness and socialising. This, in turn, can help to grow social networks, which supports an individual to become more self-reliant and less dependent upon public services. Ultimately, it could lead to a reduction in the high number of GP appointments that are linked to loneliness.
Alongside identifying new initiatives, we also need to consider measures or priorities that may work against social value principles. For example, a target to increase income from NHS car parks may be important to support a Trust’s income, but it sits uneasily alongside policies to reduce reliance on cars.
Aligning these different priorities won’t happen overnight. But when faced with mounting evidence of the harmful impacts of climate change, rising respiratory and heart disease levels, and increasing pressure on public services, it’s clear that social value deserves its place at the top end of the ICB ‘to-do’ list. Progress has to be made.
Becky Jones is Social Value Lead at NHS Arden & GEM CSU
Arden & GEM is holding a free lunchtime webinar on 16 March about social value, including speakers from NHS England and Cheshire and Merseyside ICS. To book visit: https://www.ardengemcsu.nhs.uk/showcase/news-events/news-events/event-understanding-the-importance-of-social-value-in-the-public-sector/