Article Figures & Data
Figures
- Fig 1.
What makes the NHS an anchor institution? Reproduced with permission from Reed S, Göpfert A, Wood S, Allwood D, Warburton W. Building healthier communities: the role of the NHS as an anchor institution. The Health Foundation, 2019.
- Fig 2.
Life expectancy at birth by area of deprivation deciles and sex, England, 2016–2018. Adapted with permission from Marmot M, Allen J, Boyce T, Goldblatt P, Morrison J. Health equity in England: The Marmot Review 10 years on. Institute of Health Equity, 2020.
- Fig 3.
Five principles for moving anchor institution work towards equity.
Tables
Beyond equality to equity and justice
Beyond individual projects to intentional and integrated anchor approaches
Beyond solely local to equitable and proportionate
Beyond traditional patient involvement to community partnership
Beyond short-term and immediate to long-term and wider impact
East London NHS Foundation Trust (ELFT) is a community and mental health trust that has been adopting anchor institution principles since 2019. Across the anchor institution work, there has been a focus on equity, community co-production and integrating with wider trust strategy. Given that the risk of mental health conditions is higher in marginalised and disadvantaged groups in society, ELFT's mental health service users often face additional barriers to entry to the labour market. ELFT prioritises employment of its service users and, over the last 2 years, have recruited at least 112 service users (there may be others who did not choose to share their service user/lived experience status at recruitment).
There is now a 15% weighting for social values in the ELFT procurement process. The proportion of ELFT suppliers who pay the real living wage has increased from 22% in 2020 to 61% in 2022. There has been a £185 average monthly increase in take home pay for a domestic cleaner or porter on a new soft facilities contract.
The People Participation Programme at ELFT is led by people with lived experience of mental health. This team has been involved across the anchor work; for example, they helped to develop the social value priorities for the trust, sit on the employment steering group and co-produced information for other service users to help them get into work, including support on how to explain gaps in a CV and how to cope with anxiety before interviews.
A focus on working with and learning from voluntary and community sector partners has resulted in a £1.8 million grants fund for voluntary and community sector organisations that are addressing inequalities in local communities.
Anchor work aligns with other trust priorities, including work that ELFT are doing with the UCL Institute of Health Equity to become the first NHS ‘Marmot trust’, aiming to reduce health inequities through action on the social determinants of health.
From personal communication with Angela Bartley and Una Geary, East London NHS Foundation Trust.
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