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Realising the value: Ten key actions to put people and communities at the heart of health and wellbeing

Across the country, the NHS is changing as the vision of person- and community-centred care comes to life.

We are coming to realise that over-medicalisation is not just wasteful, it is often harmful. We are beginning to understand that people living with long-term conditions are themselves the experts in living with their conditions – and that they can teach others to do so. And we are starting to recognise that although clinical outcomes are important, for most people living with long-term conditions, it is their own sense of wellbeing that is most important to them.

In short, we are waking up to the fact that the roots of health and wellbeing lie not in our hospitals but in our communities. And although medicine and hospitals make an important contribution to our health and wellbeing, so does a sense of being connected into a thriving community. And it is not just our sense of wellbeing that improves as a result - clinical outcomes improve as well.

Ninety years ago, a group of pioneering GPs in Peckham demonstrated all of this but, ironically, the advent of the NHS heralded the end of the ‘Peckham Experiment’. Recently what has become known as social prescribing has been rediscovered and now over 400 general practices across England regularly refer patients to walking groups, gardening clubs and other forms of group activities.

But we also know that more formal group education for people living with long-term conditions can help as well, as does peer support. And we also know that health coaching has an important role to play. Finally, the evidence tells us that access to all these approaches is reliably provided by systematically putting in place personalised care and support planning.

Thanks to the work of the Realising the Value consortium, we now have the evidence and the practical examples that show us how to link all of these ways of working into a system of care. And not only do we have the evidence that these approaches add value to people’s lives; we know that they help create social value and they provide value for the taxpayer.

Given this evidence, NHS England is committed to providing leadership for the NHS to engineer Realising the Value principles and practice into the way it works. Over the next three years, we will work with other arms length bodies to provide support for local health and care systems to come together with the communities they serve and the voluntary sector. We will support them to create thriving social networks where people living with long-term conditions feel confident to manage their own health and wellbeing and live independently. In short, putting in place Realising the Value will go a long way towards delivering the vision of Chapter 2 of the Five Year Forward View.