The National Health Service is often held up as the defining achievement of the post-war British state. But more than 75 years on from its founding, the NHS is, according to the government, "broken" with a waiting list of nearly 7.5 million patients and public satisfaction at a record low of 21%.
For Health Secretary Wes Streeting, a focus on holistic health provision in individual neighbourhoods represents a pathway to repairing the NHS at the national level. And one such scheme in a deprived area of Birmingham – Washwood Heath – offers a potential blueprint for the rest of the country.
A 'blueprint' for the NHS
Washwood Heath Health & Wellbeing Centre presents Whitehall health policy professionals with a "living, working example" of what neighbourhood health provision might look like, said the BBC.
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A community clinic set up in the east Birmingham suburb two years ago brings together hospital doctors, GPs, nurses, occupational therapists, physiotherapists, council social care teams, mental health professionals and charity staff, all under one roof.
Offering medical services, including ultrasound scans and X-rays, alongside non-medical interventions, the centre's staff work "collaboratively to ensure patients receive the care they need at the right place and time, significantly enhancing patient outcomes and experiences", said the National Health Executive (NHE).
"The target is the most frequent users of health services – and the aim is to keep them well and out of hospital," said the BBC. In practice, this means tackling social issues like access to housing or "arranging support for daily tasks such as washing and dressing", alongside medical treatment.
The result, said the Birmingham Mail, has been a reduction in waiting times and ambulance delays, and a significant drop in local GP calls and hospital A&E admittances.
On a visit to the centre in February, Richard Meddings, chair of NHS England, said, "there is a really good argument this is the model for the future".
The Washwood Heath clinic "combines data about the patients, it connects various parts of the health centre together to wrap care around the patient", he said, as well as helping the NHS "get more of our resources into primary and community" and collaborate more effectively with social care services.
Lorraine Galligan, chief of nursing for Birmingham Community Healthcare NHS Trust, said: "We see it as a blueprint for what the NHS could look like and should look like in the future."
A tough sell
Community-based care was a key part of Labour's election-winning manifesto and health ministers are "keen to see the soundbite being worked up into practical proposals", said Chris Naylor, senior policy fellow at health think-tank The King's Fund.
"Neighbourhood health is not a new 'thing' at all", said Anna Charles, also for The King's Fund, and "this could be one of its greatest strengths". Existing data on community-focused approaches show that improvement "isn't achieved through a single policy solution, but instead through the aggregation of many simultaneous changes to the way in which care is organised and delivered".
Yet there remain huge financial and political challenges ahead. While research suggests that every £100 spent on community care would save £131 in hospital care, "part of the problem with making the whole system buy into it is money", said the BBC.
Those in charge of managing local NHS funding are focussed on "making sure it goes on where they immediately need it," Ruth Rankine, an NHS Confederation primary care director, told the broadcaster.
The other issue is that the hospital sector has, in places, "been a bit cynical" she added. "The problem is that it takes time to get results – you need to invest in front and then it can be years before it has an impact."
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