Placement: Brown University School of Public Health
Mentor: Ashish Jha, M.D., M.P.H., Dean, Brown University School of Public Health
Co-mentor: Vincent Mor, Ph.D., Professor of Health Services, Policy and Practice, and the Florence Pirce Grant University Professor, Brown University School of Public Health
Project: Approaches to Implementing Local Community Health Improvement Programs in U.S. Health Systems
Emily Hough was a 2021–22 U.K. Harkness Fellow in Health Care Policy and Practice. At the time of her fellowship, she was Director of the Acute Provider Alliance for the NHS in North East London, where she supported collaboration across three NHS Trusts working to improve quality and access to care, with a focus on COVID-19 recovery. Hough previously spent three years as Director of Strategy at NHS England and NHS Improvement, where she led a strategy team helping to solve some of the most complex problems facing the English healthcare system. She contributed to the development of the NHS Long Term Plan and the NHS Five Year Forward View, the most recent national strategies for the future of healthcare in England. She has overseen the delivery of national programs looking at how the NHS can play a greater role in improving the wider social determinants of health, including NHS Healthy New Towns, Health and Work and the Greener NHS program. Additionally, she established the programme to develop the “NHS as an anchor institution,” working in partnership with the Health Foundation to consider how healthcare can create social value in local communities. Hough’s experience also includes advising the first NHS Trust Special Administrator and supporting the implementation of a major service reconfiguration in North Central London. She began her career as a management consultant, having studied Psychology at the University of Edinburgh.
Only around 20% of a person’s health outcomes are driven by the health services they receive. To improve the health and wellbeing of a population or community health systems are looking beyond the core healthcare services they provide to find ways to tackle the wider social determinants of health in their local communities. Doing this requires an understanding of a local population and their specific needs, so that support can be targeted appropriately. This local focus is potentially counter to the recent trend for hospital collaboration, or even merger. Across both the US and the UK provider collaboratives are looking at how they can increase standardization of care to improve quality and reduce costs.
This study aims to learn from health systems in the US that include at least three hospitals — and are therefore collaborating at scale — but also implementing local projects and programs to improve the health and wellbeing of their local communities. Through a series of semi-structured interviews across six core themes, this study hopes to draw out insights on the drivers and enablers that health systems are deploying, creating a framework to help other provider collaboratives in the US and the UK that are looking to implement similar initiatives to improve local community health and wellbeing.