Health June 5, 2019
See how HEE’s Health Alliances are strengthening Africa’s healthcare ecosystems

By Thomas Hughes - World Healthcare Journal

 

Health Alliances offer an effective approach to coordination and collaboration for increased impact and strengthening health systems, says Thomas Hughes, Chief Policy Officer for Health Education England Global Engagement.

 

The NHS has always been a global organisation. Often this is articulated in commercial terms and, while there are clear successes in this area, supported by HCUK and DIT, it is not the only engagement that the NHS makes overseas. For many organisations and individuals, the motivation to engage globally comes from the same motivations that lead to them joining the NHS - compassion, self-betterment, portfolio learning, leadership, metacognitive development and the desire to promote research, lead change, and improve lives.

 

A significant number of UK health organisations work in Low and Middle Income Countries (LMICs), including NHS national bodies, NHS providers, international NGOs, professional colleges and associations. Through the DFID Health Partnership Scheme alone, more than 2,000 NHS staff have volunteered overseas and, in turn, trained 93,112 health workers across 30 countries in Africa and Asia.

 

NHS Health Education England (HEE) is an Executive Arms-Length Body of the Department of Health and Social Care. It is the workforce planning and education and training body of the NHS. HEE’s Global Engagement directorate (GE) works to support health worker mobility, enabling non-UK nationals to work and learn in the NHS; NHS staff to work and learn overseas; and bilateral and multilateral collaboration on Human Resources for Health. NHS Health Education England (HEE) is an Executive Arms-Length Body of the Department of Health and Social Care. It is the workforce planning and education and training body of the NHS. HEE's Global Engagement directorate (GE) works to support health worker mobility, enabling non-UK nationals to work and learn in the NHS; NHS staff to work and learn overseas; and bilateral and multilateral collaboration on Human Resources for Health.

 

 

Working globally and with partners in Low and Middle Income Countries, we recognise the sheer number and range of UK organisations involved in any given country can lead to fragmentation, high transaction costs, a lack of coordination, and even duplication of work. HEE has worked with organisations, supported by DFID and their country offices, and responded to the need for better coordination of UK health organisations active in several countries. By working closely with a capacity building partner, the Tropical Health and Education Trust, it has established bilateral Human Resources for Health ‘Alliances’ in Uganda.


 

The Alliance Model

 

The Alliance model supported by HEE in Uganda, and latterly Myanmar, works to bring together a diverse group of stakeholders in the UK and Uganda. These include NHS trusts, international NGOs, commercial organisations, and Diaspora communities to share learning, to coordinate their activity to avoid duplication, and to collaborate on thematic areas where pooling resources will lead to the most effective delivery.

 

By encouraging alignment of all actors behind strategic areas explicitly linked to the priorities of the partner governments, Health Alliance offer an effective approach to coordination and collaboration for increased impact. It is also a successful method of ensuring that all the activities of organisations involved support partner countries own health system strengthening activity.

 

The Alliances also promote the development of commercial partnerships and investment. As well as creating a network and mechanism for ministries of health to engage with a network of UK suppliers, the Alliances also support Ugandan suppliers to engage with UK health organisations.

 

Diaspora Engagement

 

A key part of the Alliance model is engagement with diaspora communities from Uganda living in the UK. Often these are individuals working in the NHS and engaged in the work of the Alliance and its members. These individuals and groups offer a unique understanding of the culture and health systems challenges in both the UK and their country of origin, and possess a strong commitment to enable positive change.

 

The UK government has previously recognised the positive economic, social and political   diaspora have with their countries of origin can be ‘an engine of development’, ensuring their engagement seeks to maximise the Alliance members’ impact.

 

Overseas Volunteering – why should the NHS support overseas work?

 

As well as supporting alignment with strategic priorities of the government, Alliances can create the right environment and conditions for high quality global learning opportunities for the health workers from the UK as they seek to work and learn overseas.

As well as supporting alignment with strategic priorities of the government, Alliances can create the right environment and conditions for high quality global learning opportunities for the health workers from the UK as they seek to work and learn overseas.

 

 

Global volunteering has a clear link to UK efforts to support health system strengthening activity overseas. Just as crucial to the NHS rationale of supporting international volunteering programmes is the development of the existing and future NHS workforce. If the acquisition of volunteering outcomes is realised, the NHS can accrue a productivity increase of between 24 and 41%, with a value ranging from £13,215 to £25,934 per volunteer.

 

Key to realising these gains for the individuals - and critically for the NHS as a whole - is ensuring a high quality in-country learning environment, ensuring that individuals are well supported ahead of, during, and following their work overseas. The Alliances, with their close links to a range of organisations in-country, can play a key role as an in-country agent to support overseas volunteers and the programmes of work they deliver.

 

Where now for Alliances?

 

A 2017 review carried out jointly with two other bilateral alliances, the Zambia UK Health Workforce Alliance and the UK Sierra Leone Health Partners, found that the Alliances were highly valued for providing a platform for connecting with others doing similar work in-country. The links between Ministry of Health and UK organisations operating in-country and raised awareness about national priorities and the importance of better alignment were also highly regarded.

 

Alliances can be a key catalyst for global partnerships. The aim is to ensure UK actors working in LMICs are as impactful as possible and aligned to national priorities. As a mechanism for supporting the NHS, they can also offer NHS staff consistently high quality learning and development opportunities in those partner countries. Moreover, they ensure close alignment with national priorities and mitigate risks of duplication of effort and unnecessary transactional cost. They are a lean mechanism for delivering sustainable and measurable improvements in global health and prosperity abroad, and support the NHS in its offer of health-focused commercial activity.

 

HEE will continue to work closely with DFID, FCO and DIT through our in-country activity to strengthen coordination efforts and to explore opportunities for further future mutually beneficial partnerships focused on Human Resources for Health.


Thomas Hughes, Chief Policy Officer for Health Education England.

E: thomas.hughes@hee.nhs.uk


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