This week, NHS England announced their long-term plan for the health service — a 10-year strategy for making sure that the NHS is ‘fit for the future’. With increasing demands for the service, the plan’s ambition of more action on prevention and health inequalities is welcome; however, without joined-up thinking between departments and support for health prevention done by local government, it is hard to see how these ambitions will be achieved.
An ageing population, inactivity and poor diet are set to create further pressures for the NHS over the next decade. Illnesses associated with lifestyle currently cost the NHS more than £11 billion each year and could make up 40% of health service burden in England.
The long-term plan sets out ambitious new commitments for prevention in a number of key areas including air pollution, smoking and obesity. These commitments include funding a doubling of the NHS Diabetes Prevention Programme, a 20% reduction in NHS emissions and funded tobacco treatment services for anyone admitted to hospital who smokes.
One of the most positive commitments is the expansion of social prescribing across England with the aim of 900,000 people to social prescribing schemes by 2024. Social prescribing sees health care professionals refer patients to local, non-clinical services such as volunteering, arts activities or gardening. Intelligent Health are at the forefront of social prescribing in the UK following the launch of our bespoke tool in 2018.
One omission from the plan is placing more emphasis on physical activity and how it can be used to help achieve many of the NHS’ long-term goals. The emphasis on reducing obesity is, of course essential, and we know that diet plays the greater role in reversing this trend. However physical activity has a major effect on reducing many long-term conditions without any resultant weight loss due to its effect on reducing chronic Inflammation and neuro-protection that helps to reduce depression, anxiety, dementia and Parkinson’s disease. But physical activity is also vital in building social connections, creating confidence, building strong connected communities and giving people a sense of place.
The report does acknowledge how joined-up care could reduce pressures and workload, but our health service would be even better served by joined-up plans with out governmental departments.
Obesity, inactivity, smoking, gambling, alcohol and drug abuse are much more a symptom of a sick society more than a sick individual and so the treatment is building strong connected communities, supportive places and a sense of purpose that work, education, family and volunteering can provide everyone. Our environment, childhood, education, community and financial state all determine our health and wellbeing — creating joined-up plans across departments such as the Department of Culture, Media and Sport’s recent focus on inactivity, could create monumental changes across the country.
Additionally, while the plan is ambitious, it acknowledges that without the involvement of local government it will be difficult to achieve many of its targets — ‘action by the NHS is a complement to, but cannot be a substitute for, the important role for local government’. Councils across England have seen significant cuts to their budgets over recent years with further reductions set to continue until 2020. Local government is responsible for many preventative health services and without financial protections it will find it increasingly difficult to fund and deliver these services. Local government and the NHS should not work in isolation — joined-up plans are the only way to produce improved outcomes for everyone.
Our programmes at Intelligent Health have demonstrated how working across the five ways of wellbeing with partners in health, transport, sport and education can deliver transformative change. Our Beat the Street schemes work across public health, transport and other teams to create lasting behaviour change for nearly one million people while in Newham, we are working with patient participation groups, local community groups and partners to empower residents to take control and shape services in their area. Shifting the focus of the NHS to prevention is vital but bringing partners along and taking a whole-system approach is needed for the health of the NHS, local partners and us as humans.