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Almost every day we see scary headlines about the imminent financial collapse of the NHS. But could the media be looking at only one side of the coin? We think we’ve found an important part of the solution – and our NHS clients seem to agree.

Groundswell’s NHS social and environmental responsibility team has identified ways to produce considerable improvements in health outcomes at very little cost to the NHS. In fact, using the bootstrap model we have developed, even modest investment from the health system can produce remarkably rapid improvements and up to forty times the return. Not only that, these timely investments can help to future-proof the NHS so that improvements continue to increase long after our team has moved on.

In a sustainability study commissioned by one NHS trust, we discovered a hidden goldmine of superb environmental improvement initiatives already going on. All that was needed to increase the return on these existing investments was to ‘join up the dots’. We went on to facilitate sustainability innovation groups and a whole range of inspired new ideas came to the surface from among the trust’s own employees. In these cases, all we need to provide is facilitation and initial project management while in-house teams are trained to take over. These ‘quick wins’ free up money for more ambitious projects that can improve healthcare and finances on a larger scale.

The media doesn’t make money by telling us good news; this means that we don’t hear much about the huge strides made by the NHS in delivering some of the best – and some of  the best value-for-money – healthcare innovation in the world. The US healthcare system, with its private sector-led, for-profit model, spends almost twice as much per capita as the NHS and achieves less successful outcomes[i]. (Rightly or wrongly, we are also spending significantly less than our European neighbours – but that’s another story.[ii])

In a sense, the healthcare system is a victim of its own success: we now typically live fifteen years longer than in the late 1940s, when the NHS was founded[iii]. But better management and medical science are not the only things that are counter-intuitively creating challenges for the health service.

It’s true that the NHS is struggling to make ends meet but the responsibility for this lies, to a very great degree, on our wealth and our behaviours. These can be improved enormously by introducing what we like to call ‘evolutionary enterprise’. It costs very little and pays back handsomely and quickly.

Some say that Britain is under-investing in its health service as part of an insidious plot to privatize the system. Again, counter-intuitively, we have found ways to persuade private sector partners in other sectors – like food retail, sport, construction and leisure – to fund community health improvement initiatives as part of their corporate social responsibility programmes. They are then paid back in other areas, such as reputational capital, staff pride, productivity and innovation, all of which have been proven to be capable of increasing net profits considerably.[iv]

These ‘win-wins’ in turn free up more funds for even more ambitious schemes which we call ‘pioneering wins’. PWs can be truly transformative and we’ll be talking more about them in later posts.

The NHS then simply leverages all this social investment in a deft strategic move that helps to avoid the risk of privatisation. The savings made from environmental improvements, community-based preventive health measures and elsewhere can then be continually re-invested in an ever-evolving NHS that is better placed to do what  it was always designed for: to provide healthcare for everyone, regardless of wealth, free at the point of delivery.


[i] http://www.forbes.com/sites/danmunro/2014/06/16/u-s-healthcare-ranked-dead-last-compared-to-10-other-countries/#a34db651b96f

[ii] https://www.kingsfund.org.uk/blog/2016/01/how-does-nhs-spending-compare-health-spending-internationally

[iii] http://www.localhistories.org/life.html

[iv] http://engageforsuccess.org/wp-content/uploads/2015/09/The-Evidence.pdf


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