Mark Swift on Systems Change

I believe we will have achieved systemic change in healthcare systems when we have successfully integrated the social dimensions of health and wellbeing in all clinical and social care pathways.

Compelling scientific evidence tells us that health is socially constructed through the conditions in which we are born, grow, live, work and age. Healthcare systems will integrate social approaches alongside clinical interventions as part of a broader, holistic response to treating symptoms and addressing ‘the causes of the causes’ of poor health. Every patient will receive a holistic wellbeing assessment alongside an assessment of clinical need which will address the wider determinants of health like housing, relationships, employment, educational needs and access to opportunities. Moreover, patients will have access to community-centred health approaches like social prescribing, community navigation and volunteering opportunities to connect people to social support. Healthcare systems will invest in the sustainability of community assets like parks, community centres and the voluntary, community and social enterprise (VCSE) sector which have a critical role to play in promoting and protecting individual and population level health and wellbeing. This may come about through new forms of collective ownership of community assets, for which health and social care systems will have a stake. Finally, I believe we will know when we have achieved systemic change because patients and the wider community will no longer but seen as purely the recipients of healthcare services, but as assets in their own right, co-designing and co-delivering healthcare services and leading the change they want to see to support happier, healthier and longer lives in their community.