The Health Foundation has set out the five priorities that it believes the next government should focus on to build a healthier UK, and shifting the focus towards prevention is a significant theme running through them.
Investing in health as an asset and a priority for cross-government action
The NHS was not set up to go it alone, and improving people’s health depends on a wider system of public services and support including local government, housing and social security. Insufficient emphasis is placed on prevention, leaving too many people with preventable illness and increasing demand on the NHS. A new approach is needed that values the role good health plays in the prosperity, resilience and fabric of the nation, places it at the heart of national policy decisions and takes a holistic approach across government to coordinating action.
Improving people’s health and tackling inequalities
Successive governments have shied away from taking the bold action needed to improve the population’s health and tackle inequalities. Record numbers of people are out of the workforce due to ill health, while the number of people in work who report work limiting health conditions has increased significantly. This is shrinking the labour force and holding back economic growth. Local government has a vital role to play in creating healthy places and communities, but public health budgets endured severe cuts during austerity. Business also has an important role to play by addressing the commercial determinants of health and promoting healthier workplaces. Experience suggests that it is possible to make significant gains in improving population health and tackling inequalities if bold and coordinated action is taken.
Strengthening capacity and resilience in the NHS
Health systems across the world face significant challenges and have been disrupted by the pandemic, but the causes of the NHS crisis pre-date this. Going into the pandemic, a decade of low spending growth and a focus on relieving short-term pressures at the expense of long-term investment, left the health service with chronic staff shortages, insufficient capacity and inadequate buildings, equipment and IT. At the same time, a larger proportion of the NHS budget was spent on hospital care and a declining share on prevention, primary and community care. All of this has reflected in recent years, in struggles to increase productivity, but the public still strongly support its founding principles and there is no case for radical changes to its funding model. There are no quick fixes, but the NHS can recover with a mix of policy change and investment over the long term.
Transforming care through innovation, technology and reform
Stable, sustained investment in capital and infrastructure, more staff and the adoption of new technologies are critical, but on their own will not be sufficient to deliver the changes needed to transform services and meet future health and care needs. Previous reforms to the NHS have focused too much on top–down structural changes and not enough on changing how care is delivered and experienced. Radical innovation and improvement is therefore needed to deliver on longstanding policy objectives to provide more coordinated care for people with multiple conditions, focus on prevention and deliver more community and home-based care. This should be based on supporting health and care staff to innovate, with a focus on speeding up testing, evaluating and spreading improvements in care. It will also be vital to harness the potential created by advances in AI, data and technology to improve productivity, as well as the quality and experience of care, and support the shift to a more preventive and personalised health and care system.
Reforming and investing in the adult social care system
The adult social care system in England is in desperate need of reform, and pressures in social care have a knock-on effect on the NHS, contributing to delays in patient discharge and bed-blocking. The sector is also facing a workforce crisis with high vacancy levels, poor pay and conditions, and care workers experiencing high levels of poverty and deprivation. Despite the pressing need for change, successive governments have failed to reform social care, leaving a catalogue of broken promises, delays and abandoned manifesto commitments. Continued inaction, the Health Foundation says, would mean choosing to “prolong one of the biggest public policy failures of our generation.”
