Key points:

Anchor institutions are large, public sector organisations that are unlikely to relocate and have a significant stake in a geographical area. The size, scale and reach of the NHS means it influences the health and wellbeing of communities simply be being there.

Our report identifies five ways in which NHS organisations act as anchor institutions:

• employment
• procurement and commissioning for social value
• use of capital and estates
• environmental sustainability
• as a partner in a place

The conclusion sets out actions and opportunities for the NHS to harness its considerable influence to have an even greater impact on the health and wellbeing of communities.

Anchor institutions are large, public sector organisations that are called such because they are unlikely to relocate and have a significant stake in a geographical area – they are effectively ‘anchored’ in their surrounding community. They have sizeable assets that can be used to support local community wealth building and development, through procurement and spending power, workforce and training, and buildings and land.

This report explores how NHS organisations act as anchor institutions. It gives examples of what anchor practices look like in a health care context, and how anchor institutions can maximise their influence on the wider determinants of health, as follows.

• Chapters 1 and 2 introduce the concept of anchor institutions and set out the case for change.
• Chapter 3 discusses employment, and how the NHS can widen access to quality work for communities furthest from the labour market, and be a better employer and place to build a career for more local residents.
• Chapter 4 looks at how procurement and commissioning can derive greater social value by shifting more NHS spend locally and towards organisations that provide greater community benefit.
• Chapter 5 considers how the NHS can make better use of its capital and estate by supporting the development of community assets like affordable housing and creating community spaces for local groups and businesses.
• Chapter 6 looks at how the NHS can promote environmental sustainability in its own operations and in the broader community.
• Chapter 7 discusses how the NHS can accelerate progress and impact at scale by working more effectively as a partner across a place, both within its own structures and with other anchor institutions in the local economy