Launching proceedings, chair Lord Victor Adebowale focused minds on the task at hand outlining how 90% of NHS contact takes place in primary care yet just a third of funding has followed.

‘We built a system with a centre of gravity entirely in the wrong place,' he said, highlighting that 40,000 hospital beds are being taken up because places cannot be found in the community.

Lord Adebowale called for the ‘deliberate, sustained transfer of resource and power away from acute sectors towards community ones, real money following the model for workforce trade, valued and retained in community roles, commissioning that understands asset based approaches and the political will that does not evaporate the moment an A&E headline appears because there is a structural problem'.

The NHS Confed chair added: ‘Every pound invested upstream is worth many more times more than the same pound spent managing consequences downstream.'

Maria O'Brien, chief executive, West London NHS Trust, warned the left shift would not happen without investment in the workforce, service models, estates and digital.

O'Brien stressed relationships would be key to delivering the shift but added this would take time.

Foluke Ajayi, vice-chair, NHS Confederation, and chief executive of Airedale NHS Foundation Trust, said the leftwards shift would take time and argued league tables were disincentivised the community shift by focusing on acute metrics.

In her keynote speech, DHSC permanent secretary Samantha Jones acknowledged more guidance could have been given on neighbourhood health but would be shortly forthcoming.

Jones urged partners not to wait for guidance, however, and take a lead on delivery where they can.

She acknowledged league tables did ‘taken oxygen away' from what was happening outside hospitals but added the public had been clear on their demands for greater transparency.

Pioneers

There were plenty excellent examples of neighbourhood health in action, including Walsall Together, one of the 43 Neighbourhood Health Implementation Programme (NHIP) pilots.

Founding director, Jack Sallabank, provided fascinating insight into how Future Places Studio is supporting football clubs to act as ‘community anchors' by delivering cutting-edge facilities providing a huge variety of health, education and sporting activities and support.

In another estates innovation, 3Space co-founder, Harry Owen-Jones, highlighted how ‘meanwhile use' contracts could provide an effective solution for neighbourhood health centres.

NHIP lead Dr Kamal Bahia, gave an update on progress at the 43 pioneering Wave One pilots she has been observing across the country.

Crusading zeal

In afternoon panel, Mike Barker, deputy chief executive of Oldham Council, said the real challenge was finding a way of shifting care upstream and moving funding with it.

Barker urged colleagues to be brave, commenting: ‘If we lose courage this is never going to happen.'

Wrapping up proceedings, Matthew Taylor, interim chief executive, NHS Confederation and NHS Providers, said: ‘We have to bring a kind of crusading zeal to this, otherwise it won't happen.

Taylor urged providers and commissioners to keep the centre as ‘far away as you can and get on with it, that's all that you can do because they won't change'.

Taylor closed: ‘It's up to us. Collaboration is everything. We just have to go back and do our very best to make it happen.'