What have we learned from our learning network?
When we first launched the Health Anchors Learning Network (HALN) back in February 2021, we’d been tasked by The Health Foundation and NHS England and NHS Improvement to answer some important questions about anchor work.
These questions were broadly around:
the ambitions and goals of the NHS in relation to the anchor’s agenda with a focus on enhancing the social determinants of health and reducing inequalities
how anchors get started and approach this work
which partners the NHS needs to work with
the system conditions needed to help this happen.
Our four-month codesign phase had already generated significant interest in anchor activity and revealed examples of good work. Since launch, we’ve been delighted by the level of engagement in HALN from people working in, or responsible for, anchor activity in their organisations.
So far we have:
facilitated over 600 attendees from across the four nations to share and learn from each other at online events with topics including environmental sustainability, and lessons from COVID 19
supported our first three groups of learning set participants from trusts, Integrated Care Systems (ICS)s, councils and voluntary groups to start their anchor journey
considered what NHS anchors can learn from housing associations, with over 200 attendees at four sessions with HACT
helped anchors create frameworks and consider the role of Integrated Care Systems in anchor work through new tools and resources
shared ideas and resources in our monthly newsletter to over 1,100 recipients and on our FutureNHS workspace with 310 participants
engaged over social media with nearly 700 followers.
While the breadth of activities and the depth of engagement tell a positive story about HALN’s relevance, what have we learned from our work which answers the questions posed to us?
1. Where in the system and for what reason is anchor work being undertaken?
Four different levels of anchor work have emerged.
Hyper local: where anchor organisations are working at an estate or ward level to tackle a really specific local issue that affects or matters to the residents, often driven by inequality or pockets of deprivation..
Local: where anchor organisations are working with local partners such as the council, Voluntary Community and Social Enterprise (VCSE) or other anchors in the place (often a town or city) to tackle things that affect the local population.
System/county: working with other anchors (often at an Integrated Care System level in England) to tackle issues where economies of scale can lever better outcomes for the economy or population including focusing on reducing health inequalities.
Regional: working across the region to lever social, economic or environmental development opportunities across a large population footprint on shared priorities.
2. At what level can the NHS best use the anchor mission to lever impact?
Having worked closely with a large number of different participants, working at different levels of the system we have found that there appears to be no best level - each level of anchor work has evolved to meet a specific need and to respond to a different set of challenges and drivers. We will continue to test this question through year two of the network.
3. What are the practical examples of NHS organisations implementing an anchor mission?
From our various events and activities we have been able to showcase a range of different examples of anchor work across the UK and internationally. Looking back on the participants and their work we have learned that anchors institutions in the NHS fall into three different categories:
those who have been doing local work for a long time and are making use of the anchor framing as a way to further embed this work
those who started due to the 2019 Health Foundation report and are early in their journey
those who are responding to the growing interest in anchors within the NHS and are just starting out.
We will continue to showcase and share examples through our events in year 2.
4. What could encourage anchor work and how important is leadership?
We’ve seen initiatives - such as COVID 19 recovery, organisational change, a move to net zero - give people an entry point to anchor work, helping them make that critical shift from a project approach to a more considered anchor programme.
Much anchor work has emerged organically without explicit leadership but, for anchor work to thrive, leaders need to embed anchor approaches into organisation-wide strategies and operations. We’ve seen four themes emerge about what’s needed from leadership.
Intentionality: consciously adopting an anchor mission.
Shepherding culture change: explaining and encouraging a ‘think anchor’ mindset at every level of the organisation.
Facilitating culture change: embedding a ‘do anchor’ approach at every level of the organisation.
System leadership: coming together with other anchors and giving up power in order to align to shared goals.
In year two, we will see changes in legislation in England that promote the key role of Integrated Care Systems in both reducing health inequalities and supporting social and economic development. It will be interesting to see how this both drives and shapes the anchor agenda over the next year.
5. What’s next?
Our learning has shown we’re supporting anchors during the early stages of their journey, helping them answer the questions which we were set originally. We also have some barriers to help them overcome around: accessing time and resources; managing priorities; and making the case for long term culture change when there’s a short-term problem to solve.
We’re inspired by - and grateful to - everyone who’s committed time and energy to HALN over the past year. We hope these early insights give the network a framework to continue its own learning journey.
There are a range of ways you can get involved.
Share examples of your anchor work - help us gather examples of anchor work that is happening all over the UK, whether you have stories of successes or failures.
Stay in the loop about what’s happening by signing up to our newsletter and following us on Twitter @haln_uk.
Sign up for FutureNHS for our online discussion forum to share your learning and get advice and support from other network participants.
Take a look at our tools to get you started and read our blog.
Sign up for future events.