In the Government’s outline for Levelling Up the United Kingdom, two of the twelve ‘missions’ concern health and wellbeing. In this post I summarise the missions, their policy programmes, and what they could mean for the North East.
Health
The Government has stated that the gap in Healthy Life Expectancy (HLE) between local areas where it is highest and lowest will have narrowed by 2030, and that HLE will rise by 5 years in 2035.
The motivation behind this mission is that there are stark disparities in health outcomes across the UK, and that people deserve to have the opportunity to live long, healthy lives wherever they live. Better health will also improve productivity and wellbeing.
People living in the most deprived communities in England have up to 18 years less of their lives in good general health than the least deprived. The North East has the lowest life expectancy in the country and, in its most deprived areas, life expectancy has been decreasing. This is driven by a variety of factors, including smoking rates, alcohol intake, poor diet, quality of housing, and access to healthier food. Access to and quality of health services are also an issue which can vary by area.
Covid-19 has made these disparities even more stark, with hospital admission, mortality rates, and ‘long covid’ higher among more deprived groups. Access to healthcare has also widened in deprived areas, with waiting lists in England having increased by 55% in the most deprived areas. This is compared to only 36% in the most affluent. Ethnic minorities and people with disabilities have also been disproportionately impacted.
The government’s policy programme to improve health focuses on:
- Improving public health
- Supporting people to change their food and diet
- Tackling diagnostic backlogs
Improving public health
The key points:
- Recent launch of the Office for Health Improvement and Disparities
- A new White Paper on Health Disparities in England will be released this year
- The 2019 NHS Long Term Plan
- The Core20PLUS5 Initiative
- Rollout of social prescribing
- A new 10-year Drugs Strategy was published late last year
- A new Tobacco Control Plan for England is due to be published later this year
- The Government is investing £75m in weight management services and support in England in 2021-22
A closer look:
The new White Paper on Health Disparities in England that will be released later this year will set out a strategy to tackle the core drivers of inequalities in health outcomes. It will have a strong focus on prevention and disparities by ethnicity, socioeconomic background, and geography. It will also include new ways to ensure that business plays a part in improving health.
The 2019 NHS Long Term Plan and the Core20PLUS5 initiative each look to level up healthcare. The latter focuses on improving cardiovascular disease, cancer, respiratory, maternity and mental health outcomes in the poorest 20% of the population, as well as ethnic minorities. In the North East, this will particularly benefit Middlesbrough.
In rolling out social prescribing, the aim is for at least 900,000 people to be referred to social prescribing by 2023-24. Social prescribing promotes a holistic approach to people’s health and wellbeing. NHS England has also commissioned an evaluation of this rollout to ensure that it meets people’s needs. There are several social prescribing projects across the North East region, including Ways to Wellness and Zone West. More specifically, the Government has invested in a £5.77m cross-government project aimed at preventing and tackling mental illness through ‘green’ social prescribing. This will look at how to increase connection to the natural environment and will be focusing particularly on communities most affected by health disparities.
Finally, a new 10-year Drugs Strategy was published late last year and outlines a whole-system approach. The most deprived areas in England face the highest prevalence of drug-driven crime and health harms associated with drug use. The Government has stated that they will invest £780m to create a treatment and recovery system to break the cycle of problem drug use. As of 2020, the North East has had the highest rate of drug misuse of any English region for 8 consecutive years. We also have the highest rate of drug misuse deaths.
Food and diet
The key points:
- Upcoming Food Strategy White Paper
- New approach will be launched to assure compliance with school food standards (in collaboration with the Department for Education and the Food Standards Agency)
- Government to invest £5m in ‘school cooking revolution’
- Government to invest up to £200,000 to pilot new training for school governors and academy trusts on a whole-school approach to food
- Aim for every child leaving secondary school to know at least six basic recipes
- 3-year pilot of a Community Eatwell programme (GPs will be able to prescribe fruit and vegetables and food-related education)
A closer look:
The Government states that their upcoming Food Strategy White Paper will attempt to ensure that everyone can access, understand, and enjoy the benefits of a healthy and sustainable diet. This includes looking at how consumers access information about food. It will support eligible children and families in some of the most disadvantaged areas to learn and improve their knowledge of health and nutrition.
While the project launched between the Department for Education and the Food Standards Agency will engage with multiple local authorities, it does not appear that any will be in the North East. The project aims to promote accountability and transparency of school food arrangements by encouraging schools to complete a statement on their school websites. It is the Government’s intention that this will become mandatory when schools can do this effectively.
Tackling diagnostic backlogs
The key points:
- £2.3bn of Government investment to improve access to vital diagnostic services and tackle the diagnostic backlog
- At least 100 Community Diagnostic Centres to be established in England by 2025
- The People at the Heart of Care White Paper published late last year outlines planned reforms to adult social care in England
A closer look:
The majority of the Community Diagnostic Centres will be based outside of London and the South East, boosting diagnostic capacity in areas that need it most and offering a range of services tailored to local needs. The centres may include imaging, cardio-respiratory, pathology, endoscopy and general consulting equipment to allow several tests in one visit, improving the accuracy of diagnosis and overall patient experience. It is said that the Community Diagnostic Centres rolled out this year will deliver nearly three million additional scans in the first full year of operations. Over the next three years, they are projected to increase scans by an additional eight million tests each year, providing the equivalent of 23,000 years of improved quality of life.
As part of the Government’s commitment to build 40 new hospitals by 2030, Two hospitals are to be delivered in the North East by the end of the decade. These include the rebuild of Northgate hospital and a new hospital to replace Shotley Bridge Hospital. It is also said that 725 more doctors and 1,552 more nurses will be working in hospitals in the North East between September 2019 and September 2021.
Wellbeing
The Government has stated that, by 2030, wellbeing will have improved in every area of the UK, with the gap between top performing and other areas closing.
This ‘mission’ is considered an overarching, outcomes-based measure of success for levelling up. The report states that wellbeing captures the extent to which people across the UK lead happy and fulfilling lives, and consider it the very essence of levelling up.
Wellbeing is affected by a multitude of things, from physical and mental health, jobs, community relationships, quality of housing, and the environment. The report found that even the most productive and prosperous of places have some of the lowest levels of life satisfaction, which persisted even after controlling for personal and economic characteristics. They considered this a powerful illustration that wellbeing goes beyond income and that other factors are just as, if not more, important.
While the North East had the most significant deteriorations in happiness and life satisfaction from April 2019 to March 2020, the most recent investigation on personal wellbeing from the ONS found that the North East was an exception to increases in anxiety and decreases in happiness the feeling that the things done in life are worthwhile.
The Government states that, over time, it will be able to expand its use of new and administrative data through the ONS and the Integrated Data Services Platform, and that this will improve estimates of factors such as wellbeing.
Freya Thompson
Knowledge and Research Executive
@NEEChamberFreya
Photo by Andrew Tanglao on Unsplash