Building healthy cities: the role of universities

It is no secret that the National Health Service is under immense pressure. An ageing and expanding population, combined with increases in chronic illness and multiple disorders, is placing strain on services and pushing up costs. There is a gap between spending and demand. Yet to meet the Government’s expectations, NHS England must make savings of £22 billion by 2020. At the same time local authority funding continues to be squeezed, as an area of unprotected spending, with implications for public health and social care. A perfect storm is heading our way unless we can find innovative ways of improving the health of our nation quickly, reducing the demand on our already stretched services.

In response, health leaders are having to work smarter and more creatively, harnessing technology where possible, to achieve efficiency and productivity gains. They are also shifting the focus of services towards prevention, rather than cure, to relieve pressure on services. This means addressing public health challenges like obesity at source instead of dealing with the higher costs of medical and surgical interventions down the line.

How well this is working in practice will vary across the country. But it is possible to observe some good examples of the NHS and local government working effectively with others to promote health and wellbeing. The crucial part about this is the “working with others” – because that is the only way to achieve impact on the scale required. In a new report from University Alliance, the first in our four-part Regional Leadership series, we examine the contribution of universities.

As the main suppliers of doctors, nurses, allied health professionals, health scientists and social workers, universities have long been instrumental in health and social care policy and planning. Collectively, we turn out a vast volume of health relevant research and innovation and are responsible for many of the lifesaving technologies used in clinical settings. But less acknowledged, perhaps, is the contribution universities make as anchor institutions within local health economies.

In this unique role, universities are able to unite the complex array of organisations that make up the ‘health ecosystem’ within a city or city region. They can then help to make health and wellbeing provision more efficient and more responsive to the needs of the surrounding population. In Bristol, where my institution UWE is situated, there are positive signs of this happening. Through Bristol Health Partners, for example, the city’s universities have joined forces with providers and commissioners as well as Bristol City Council to integrate provision and improve health and wellbeing through innovation, research, adoption and spread.

Our report also identifies how the research capacity of universities is being harnessed to produce healthier communities. The scope of this activity is exceptionally broad, covering everything from applied clinical medicine, to studies on improving the urban environment through effective planning, to the development of robots that enhance patient care or assist those with permanent health conditions.

Because of the cross-cutting nature of health and wellbeing challenges, there is a growing volume of interdisciplinary research at UK universities. Many institutions also work closely with non-academic partners including businesses, charities and social enterprises.  Incubation spaces on campus enable entrepreneurs to design products and innovate with the support of specialists at the university. This type of engagement will be further enhanced by the soon-to-be-opened University Enterprise Zones like the one at UWE which will focus around MedTech, Robotics and Autonomous Systems.

Finally, university research and innovation and the funding that enables it has the added benefit of supporting local services. Clinical research, for example, will often involve observing and trialling treatments with patients in a local hospital. From the perspective of providers and commissioners, this represents an investment additional to that coming directly from government. Similarly, university-based health academics are often specialists within a particular field of medicine, surgery or other health-related discipline. Through what is effectively a joint appointment with the NHS, their contribution is essential for maintaining the quality of clinical services in the region.

The health challenges Britain faces are multifarious, and it be would be disingenuous to suggest that universities hold all the answers. However, as this exercise proves, universities can and do make significant contributions to the well-being of surrounding populations. They are also major employers and influencers. Our staff and student populations are significant and many universities are working hard to create healthy working and living environments for staff and students alike.

The Healthy University movement is spearheading work-based health living approaches to improve the physical and mental health and well-being of university communities and importantly playing a part in spurring behavioural change in generations to come through education and action. At a time when the NHS and local government are becoming increasingly overstretched, the significance of universities in this space is likely to grow.

As published on WonkHE 25 February 2016