Turning uncertainty about a community hospital’s future into a place-based vision
The Challenge
I was originally asked to help answer a seemingly straightforward question: “What is the future of Crawley Hospital?”
At the time, there was significant uncertainty about the hospital's long-term role. As I reflected on the challenge, I concluded that this was not the right starting point.
It became clear that decisions about its future could only be made through a deeper understanding of the health and wellbeing needs of Crawley's population. Making the case for a different approach required a significant shift in thinking and sustained engagement with senior leaders.
The town faced significant deprivation and health inequality, and improving outcomes required multiple organisations to work together, each bringing different responsibilities, perspectives and priorities. Without a shared understanding of the real problem, there was a risk that decisions would focus on services and buildings rather than the needs of residents.
My Approach
I reframed a debate about a building into a shared conversation about population need, creating the basis for collective action across organisational boundaries.
Working with NHS organisations, primary care, local government, voluntary and community organisations, community representatives, business leaders and other partners, I brought together different perspectives to create a shared understanding of the challenges facing Crawley.
By focusing on residents’ needs rather than organisational interests, I established a common purpose, developed collective leadership arrangements and aligned strategy, service development, estates planning and implementation.
The Result
By starting with the needs of the population rather than the future of a building, partners developed a shared vision for health and wellbeing in Crawley and created a neighbourhood health programme that aligned strategy, services, estates and investment around a common purpose.
A strong focus on inequalities and community engagement helped shape the programme's priorities and design, ensuring that local voices influenced both the overall approach and specific areas of delivery. This included the development of multilingual information and access resources, helping local residents better understand and navigate health and care services.
The programme developed a population health-led approach to estates planning, ensuring investment decisions were driven by community need rather than individual buildings or services. This secured over £10 million of investment, delivered new services and infrastructure including a Community Diagnostic Centre, improved access to diagnostic and maternity services, strengthened collaboration between health, housing and financial advice services, and piloted an integrated neighbourhood mental health model that was subsequently adopted across Sussex.
Perhaps most importantly, the work created a sustainable neighbourhood model that strengthened collaboration between NHS organisations, general practice, local government, voluntary and community organisations, and local communities themselves. The approach informed the development of neighbourhood health arrangements across Sussex, demonstrating how a focus on population need can drive system-wide collaboration, investment and sustainable transformation.
“The focus of this work was to better understand the population of Crawley, their needs and their access to health services, directly leading to the provision of new health facilities and services in the town.
The understanding, relationships and partnerships developed by Fouzia from that assignment were then used to make Crawley a frontrunner for the Neighbourhood Health agenda.
Fouzia's collaborative style and ability to help others navigate complex systems were central to allowing real alignment across health and local government.”