Universal Healthcare

Universal Healthcare Network

The Universal Healthcare Network at LSBU is a network of senior NHS leaders, community leaders, and thought leaders, who have mobilised to address their concerns about the NHS’s provision of Universal Healthcare.

The network aims to make visible the reality of inequalities in service provision, and work through how best to secure services that are designed around health needs.

How we do this:

• Amplify & Make Visible: We collectively make this issue visible, through this network and from the power of our own institutions.
• Community-building: We are growing a community of interest around this issue.
• Convening: We are convening a learning community at the level of place by working with committed health systems to find pragmatic and practical service models to secure universal healthcare. We are answering the question: ‘What if we design health services with a focus on reducing inequalities as a core design principle?’
• Resourcing: We are collaborating to establish a ‘practice network’ on Universal Healthcare.

Click here to watch our Universal Healthcare Propositions

Background

Covid made visible that people’s health is directly linked to their wealth (Marmot et al, 2020), and that the NHS is providing unequal healthcare, an issue previously identified in the Kings Fund’s evidence to the Joseph Rowntree Foundation (Buck and Jabbal, 2014).

The NHS Constitution requires the NHS to provide comprehensive healthcare for all based on need. It starts with the words ‘The NHS belongs to the people.’ In fact it is becoming apparent that is belongs to some of the people more than others. Charlotte Augst from National Voices (August 2021) reminded us that the Pandemic has shown that the NHS is not providing universal healthcare, as the NHS has to ration services.

We know from the Marmot Review (2020) that poverty has had and is having a disgraceful impact on health. But poverty cannot be blamed solely for the lack of universality of healthcare.

The Universal Healthcare Network proposes that the NHS has also been complicit in three ways:

1. Medicalising poverty and providing ‘sticking plaster’ approaches, with the best intentions, that make the problem of poverty invisible.
2. Providing services that are not accessible to all.
3. Not being frank and open about the reality of the rationing of services. The latter is depicted in one of the National Voices ‘I’ statements – I am not forgotten. (National Voices 2020).

Find out more.

Our approach to working with Integrated Care Systems on Universal Healthcare

This 6 month laboratory will make a real shift in the way the health & care system works together and will

• Improve outcomes/experience for local people
• Help people that work in the NHS locally do a good job and improve their experience
• Make best use of what resources are available
• Secure an equitable approach to health services design and delivery

What we have found

• Children are at risk of getting less than adults.
• GP practices in poorer communities receive less funding and have less capacity.
• There is unequal and different care for poorer people.
• The NHS flat offer model is increasing inequalities.
• What is going on in general practice is unknown, (beyond satisfaction with appointments) in terms of equity and universality, and very few practices know their need.
• There is little continuity in primary care.
• There are some fantastic examples of lessons from the vaccine programme sticking, but there are even more where the NHS has reverted to a model of ‘come to us’.

And we need to collaborate with the Voluntary and Community Sector

• The NHS needs the voluntary sector, and should help the VCS be the best it can be (longer contracts, supporting infrastructure). There is work going on in primary care that could be better provided by the VCS.
• The VCS could be the first point of contact for people needing help with their health and care needs - a new front door.

You can find out more here:

Making our Own Luck with the Voluntary and Community Sector [New Page coming soon]

Rethinking Primary Care – Fair Funding for All [New Page coming soon]

We asked our Universal Healthcare places why what works, works - this is what they said:

If you would like to join this community, please let us know at healthlab@lsbu.ac.uk.

Prototyping Change to secure Universal Healthcare

Each place has been developed ideas for change. These ideas came from a series of workshops where people from across the place took time to really understand the issues facing communities, and how best to address the 3 propositions (medicalising poverty, access and rationing). These ideas are being tested as Prototypes – where small changes are made as iterative experiments to see if the idea is viable, possible, worthwhile. It is based on the idea that its better to try ideas out practically before you adopt them.

You can see the ideas for change below:

Hastings Prototypes

Bradford Prototypes