Radical changes needed to tackle stalling health improvements

The King’s Fund has warned that, without radical change, progress in improving the population’s health is at risk of grinding to a halt.

Health improvements over the last century have meant that each generation has lived longer, healthier lives than their predecessors. But in a new report, The King’s Fund argues that this can no longer be taken for granted, highlighting a number of key measures against which progress has stalled.

• Improvements in life expectancy are grinding to a halt – although this is happening elsewhere, the slump is more pronounced in the UK than most other countries.
• There has been little or no improvement in how long people live with illness and disease since 1990. 
• Infant mortality rose in 2015 and 2016, as the UK slid further down the international rankings on child health.
• According to the OECD, our adult obesity rates are among the worst in the developed world.

The report also warns that the yawning gap in health outcomes between rich and poor areas is widening again. A woman in Wokingham can now expect to enjoy nearly 17 more years of healthy life than a woman in Manchester.

Ahead of the forthcoming NHS long-term plan, the report argues that these challenges cannot be tackled by the NHS alone. With many people living for years with preventable health conditions, it makes the case for a new approach that moves away from diagnosing and treating sickness towards promoting wellbeing and preventing ill health.

The report authors call on the Government to use next year’s Spending Review to reverse cuts to public health grants. Currently, local authority spending per head on public health services is on track to fall by almost a quarter in real terms between 2014/15 and 2019/20.

Other recommendations to improve the population’s health include:

• introducing binding national targets for improving health, backed by a new strategy to reduce health inequalities.
• making bolder use of tax and regulation to support public health, learning lessons from the successful approach to cutting smoking and the recent levy on soft drinks.
• strong political leadership to ensure improving the population’s health and reducing health inequalities are priorities across government, as well as the health and care system.
• local politicians should champion population health by working with the NHS and other agencies to improve the health of their constituents.

David Buck, Senior Fellow at The King’s Fund and lead author of the report said:

‘After a century of improving health, progress on key outcomes are grinding to a halt. Life expectancy is stalling, our health outcomes are mediocre compared with similar countries and health inequalities are widening.

‘A new vision for the population’s health is needed that pays more attention to the wider determinants of health and the role of people and communities. The NHS long-term plan is important to this, but can’t do it alone. The Government must also reverse cuts to local government public health budgets and make tackling health inequalities a central aim. Our new report provides a framework for charting a new course towards reducing inequalities and achieving health outcomes on a par with the best in the world.’