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In this blog by Kerry Beadling-Barron, Director of Communications and Corporate Affairs at the Health Innovation Network (HIN) South London, argues why a more nuanced approach to engaging with the private sector could result in a big gain for the public, and actually be more popular than policy makers realise.

Neighbourhood health has become a favoured phrase in recent weeks while people try to second guess what may be in the upcoming 10 Year Health Plan. What it’s trying to achieve is clear – care closer to home and delivered in a way that stops people becoming more ill. However, its definition is less clear – at what level does neighbourhood sit? Is borough level too high, should it be at PCN or is that too low? Who should lead it – primary care, community care, a mix, an acute provider organisation? Who does it involve (local authorities, voluntary and community sector organisations, charities)?

It’s this last question I want to tackle. While there is a lot of talk about breaking the barriers between health and social care and the importance of involving the third sector, there is much less noise in the role of the private sector. Traditionally we can see that there is less trust from the public in the private sector involvement in the NHS – the London Health Data Programme public deliberations over the years have found that the public do not instinctively trust commercial companies with the idea of accessing data. When it comes to trust the recently released Ipsos Veracity survey instead shows nurses as the most trusted profession (with doctors third most). The public trust the NHS with the NHS and are wary of others getting involved.

But I think this is a broadbrush approach that misses a critical nuance in the argument. For example with data, the lack of trust is usually aimed at large pharmaceuticals or insurance companies. There is current private sector involvement in healthcare that most people trust (shown through footfall if nothing else). On the high street in towns across the country people are having eye tests and ear checks at national chains or at local privately owned versions. Many have been paying for private dental care for decades and people by in large trust them and go back. A recent YouGov survey shows four in five people want pharmacies to provide treatment for additional conditions and the national Pharmacy First programme has delivered two million consultations in its first 12 months. So what is the difference with these versions of the private sector? It’s the high street. There is a familiarity that has been built up with these businesses and brands, either through direct experience, or the experience of family and friends that mean they don’t feel like faceless organisations, they feel part of the community.

Given this, shouldn’t we include these organisations in any conversation about neighbourhood health, in the way we would include GPs? How can local areas galvanise the expertise on their high streets to support with this? If it means people could go somewhere local that they trust to get care quicker, shouldn’t that be an option? We know that continuity of care is important to addressing health equalities. Therefore it feels like an option that allows someone to build a therapeutic relationship over time with a pharmacist who might be more culturally sensitive, should not be viewed with more suspicion, purely because it involves the private sector.

Then there are the opportunities where innovation is trying to support our health street such as SiSU Health who provide screening/health checks integrated with local primary care services in settings like supermarkets.

Traditionally it has been thought too difficult to involve the private sector wholescale in the provision of NHS care because of perceptions that there is a lack of trust from the public. However as the Government has made clear, we cannot continue to provide care in the same way and change is needed. If that is the case, surely we should look at all options, included trusted experts on our high streets to support with that?