“It ain’t (just) what you do..” Perspectives on Social Sustainability Sara Bordoley, CSR Manager, 1 July 2014

NHS England The main aim of NHS England is to improve the health outcomes for people in England staff nationally Improving patient experience Commissioning Technology, systems and data Partnerships and relationships Direct commissioning Quality improvement and clinical leadership Our governing frameworks Patient safety Patient involvement Strategic and Operational Planning 2014 to 2019 Emergency Preparedness, Resilience and Response (EPRR) “ The NHS belongs to the people.” The NHS Constitution

Why does NHS England consider (social) sustainability important? Our organisation and healthcare has impacts - can be positive or negative Managing these impacts positively is important to us - responsibility, legal, image, financial, staff retention…. But because it makes sense….

safety Ensuring a Strong, Healthy and Just Society Meeting the diverse needs of all people in existing and future communities, promoting personal wellbeing, social cohesion and inclusion, and creating equal opportunity for all. Social sustainability education self esteem ethics equity cohesion resilience social capital housing employment mental and physical health community wellbeing inclusion living wage participation environment economy access poverty

safety Determinants of health education self esteem ethics equity cohesion resilience social capital housing employment mental and physical health community wellbeing inclusion living wage participation environment economy access poverty Supports mental and physical health and wellbeing

What can we do? (The main aim of NHS England is to improve the health outcomes for people in England) Goal 3 - Every opportunity contributes to healthy lives, communities and environments NHS England Health care services The way we do it Health

It’s the way you do it.. Its ain’t (just) what you do…

1. HEALTHCARE

Models of care

Central to our ambition is to place the patients and the public at the heart of everything we do.

‘We encourage patient and public participation in the NHS, treat them respectfully and put their interests first. This allows us to develop the insight to help us improve outcomes and guarantee no community is left behind or disadvantaged’. Patient and public involvement Youth Forum NHS Citizen Engaging the transgender community in developing the medical model 22 Voluntary Sector strategic partners Guidance - Transforming Participation in Health and care, 2013 Processes are collaborative (way you do it) System leadership

Utilising assets and developing capacity

Equity

2. COMMISSIONING How we commission - Social Value Act 2012 All public bodies in England and Wales, including local authorities, are required to consider how the services they commission and procure might improve the economic, social and environmental well-being of the area. “Social value” is a way of thinking about how scarce resources are allocated and used. It involves looking beyond the price of each individual contract and looking at what the collective benefit to a community is when a public body chooses to award a contract. Social value asks the question: "If £1 is spent on the delivery of services, can that same £1 be used to also produce a wider benefit to the community?" Direct commissioning (aprox £20 billion) Indirect commissioning (aprox £80 billion)

Embedding the Act Funded by the London Borough of Lambeth and NHS Lambeth Clinical Commissioning Group. Supported and grown by the people of Lambeth Provides a real opportunity to make positive change in the local community, encourage partnership/ whole systems approach and develop resilience. Good examples Awareness Application/good practice Measuring (commissioner and provider)

Global supply chains

3. OPERATIONS – part of the community Socially responsible employment -Staff -Employability schemes e.g. apprenticeships, work experience Employee volunteering Local economy and procurement Local community impacts NHS England is a national organisation

Scale and impact of the NHS NHS deals with over 1 million patients every 36 hours ( NHS Confederation, 2014) 8 % GDP at a national level (Kings Fund) 1.4m employees (2011) 50.6 % qualified clinical staff (NHS Confederation, 2014)

Challenge to understand outcomes and impacts Positive vs negative Location specific How, who and when (boundaries and knock on effects) How measure? How do we know we are making a difference?

Personal perspectives on social sustainability Its what you do (thing) And the way you do it (process) Locally appropriate - who says what's right? Moral and ethical angles We are talking about individuals We are talking about people over short and long time periods in complex global systems. There are knock on social, environmental and economic effects What are the absolutes? Sara Bordoley CSR Manager, NHS England