‘Saving lives and minds: Understanding social value and the role of anchor institutions in supporting community and public health before and after Covid19’

There are great disparities in health between places in the UK. People living in poorer areas are dying on average 9 years earlier than wealthy areas, largely due to regional economic differences, including high unemployment, low wages and social inequality, unrest and injustice that accompany economic disadvantage. Preston in the north-west of England, has been developing a community wealth building project known as the Preston Model, which shows signs of successfully increasing and retaining local wealth. The anchor institutions – large local organisations that are ‘anchored’ in place, such as hospitals, universities, housing associations and local government – have developed social value policies and policies of co-operation with their communities that attend to a heightened awareness of corporate social responsibility and enhanced working relationships with local communities in order to turn around local fortunes in an allied economic and health initiative. Corporate social responsibility is the essence of co-operation and co-operatives, and is a central feature of the Preston Model. Ultimately, CSR within the Preston Model is concerned with quality employment. The pandemic has highlighted the need for CSR and co-operation. This chapter brings together researchers from the University of Central Lancashire, Lancaster University and stakeholders from two of the anchor institutions – the Lancashire Teaching Hospitals NHS Foundation Trust and Community Gateway Association – to combine an academic framework, including local responses to interviews and participatory community groups in Preston, with two major anchor institutions as case studies. The chapter will investigate a broad range of initiatives, from directly focused health policies, such as social prescribing, to wider, ‘softer’ approaches, such as developing participation, co-operation and democracy within and between organisations, groups, teams and communities and the corresponding networking and mutual support systems that may affect greater agency, empowerment and enhanced mental health outcomes among people in Preston and Lancashire, ultimately transferable to other UK regions. Introduction The idea of Corporate Social Responsibility (CSR) has a history stretching back to Bowen (1953) who asked the fundamental question that underpins all subsequent discussions to this very day, ‘What responsibilities to society may businessmen reasonably be expected to assume?’ (Bowen, 1953, p. xi). The archaic use of the term ‘businessman’ aside, this question still holds today, as long as the society we are discussing is designed along capitalist and neoliberal lines. When working in a framework of corporate social responsibility, it is the corporation as a legal person that assumes responsibility, with all the patriarchal implications of dependency extending to a sense of charity that this entails. Although this may at first sight appear to be obvious, it is nevertheless important to point this out, since in much of the discussion of CSR, (Carroll 2021), this framework is taken for granted. There are signs that this securely rooted approach in capitalism has been shaken by recent events, not least the Covid 19 pandemic, and that the pandemic may be only the explicit manifestation of a systemic revolution that challenges how people work and how businesses function in a world that is facing multiple catastrophes. In his ‘guarded’ considerations of the future of CSR, Carroll (2021) suggests that even before the pandemic, there had been a shifting away from a hard core financial and economic focus of businesses to an approach that fulfils an evolutionary sequence identified by Visser (2011), who ‘maintains that we have moved through the ages of greed, philanthropy, marketing, management, and now responsibility’ (Carroll 2021, p. 1270). Maybe such an optimistic stance on evolutionary responsibility must always be limited by the system. Indeed, some of the literature interprets changes in CSR as being profound and systemic as opposed to a constant refining of the capitalist system (for example, see Mason 2015 and Blakeley 2020, among others, for a popular and political interpretation of systemic reactions to the economic collapse of 2008 and the recent pandemic, as well as Trebeck and Williams, 2019, among others, for academic perspectives on the potential for systemic change beyond the capitalist paradigm). It is beyond the scope of this chapter to discuss such a radical possibility of change that explicitly rejects capitalism through a total reconceptualisation of systems of work and life that are encapsulated in terms such as ‘degrowth’ (Vandeventer and Lloveras 2021) or ‘post-growth’ (Banerjee et al 2021; Pansera and Fressoli 2021). Nevertheless, such radical change as potential and possibility should be noted as a significant background to our discussion of the role of CSR or its redefinition as ‘social value’ in the context of the emergence of community wealth building projects in the UK, and in the specific case of this chapter, the context of the Preston Model (PM) (Manley and Whyman 2021), which is the focus of our study. If we were to pursue an analysis of the meaning of ‘post-growth’ in the context of this chapter’s focus on social value, we would adopt the ‘co-operative economics’ of Novkovic and Webb (2014). This is because our chapter considers the substantial shift in organisational strategy in two anchor institutions in Preston, UK, under the influence of the PM, which has its roots in the theoretical and practical applications of cooperative principles and values, whether through the creation and promotion of actual cooperative businesses or simply through an emphasis on cooperation as a vague, quasi-philosophical, yet valuable, approach to society and economics, which provides the motivational inspiration and drive for the PM to continue to thrive. Within our consideration of these two case studies – the first from the Lancashire Teaching Hospitals NHS Foundation Trust, and the second from Community Gateway Housing Association – this chapter asks to what extent the lively social value engagement by these two Anchor Institutions could positively enhance health outcomes for communities in Preston. The two in-depth interviews that form the basis of the responses below are taken from interviewees holding senior positions in our two anchor institutions case studies in this chapter. They have been selected from a series of interviews belonging to a wider research project, in progress at time of writing, which seeks to assess the public health impact of the Preston Model and community wealth building initiatives in the UK