Comment / Tower Hamlets’ common ground with New York

03 October 2017 Jason Helgerson

The State of New York is on a journey towards creating a sustainable healthcare system underpinned by value-based payment. As part of an HFMA-organised visit, Jason Helgerson, Medicaid director at State of New York - Department of Health, recently came to the UK to talk with NHS finance professionals and meet officials from NHS England. While here he visited Tower Hamlets to hear about its cross-sector transformation and to share lessons and ideas.

Collaboration.  In New York we have made it our mantra.  You can’t really improve health and social care outcomes unless you are willing to collaborate.  While collaboration is easy to say, it is much harder to do.  Collaboration only occurs when organisations trust each other and are willing to work across system lines.  On a recent visit to East London, I saw true collaboration in the borough of Tower Hamlets.

Tower Hamlets has more than its fair share of challenges.  Levels of deprivation are high with two in five children living in poverty and life expectancy rates among the lowest in England.  Despite these challenges, it was clear during my visit that all of the key players in the community have built trust and are collaborating in meaningful ways. As a result, real results are beginning to show.  Emergency admissions are considerably less than the national average and non-elective bed days have fallen year after year. 

While the statistics are impressive, I was even more impressed by the sense of teamwork I saw in the meeting.  All the key players – health and social care providers and commissioners – were all on the same page and you could feel the pride in the room as they presented their great results. 

System change isn’t easy.  This is especially true in health and social care.  No one sector or organisation can achieve lasting success working alone.  The approach must be cross sector and highly local if it is going to work. 

Our role at the national/state policy level is to put policies in place to support and empower this local collaboration. However, ultimately social entrepreneurs are needed willing to put the needs of the community ahead of their organisational needs.  That is exactly what I saw in Tower Hamlets.

In New York we are on a similar path.  We are bringing together organisations from across the health and social care sectors in communities as diverse and challenged as Tower Hamlets.  We have much to learn from each other as we pursue similar efforts to make health and social care a team sport and to focus on delivering value.  Not everything we try will work, but we must continue to innovate and learn from each other. 

As I flew home back to New York, I began to wonder about the possibility of creating a more structured way to share best practices across national borders.  Cross-national conversations in health and social care are historically rare even for government officials.  While we have crossed that barrier a bit between NHS England and New York, I would like to see more systematic sharing occur between the local innovators in Tower Hamlets and similar pioneers in New York. 

I pledge to work with my NHS England colleagues to see how we can make more ‘cross pond’ learning a reality.

In the meantime… keep going Team Tower Hamlets!  

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