North East should make radical shift to preventing poor health to close health and wealth gaps with the rest of the country
National experts have challenged North East health and care leaders to be more ambitious and to close the health and wealth gap with the rest of the country by making a more radical shift towards preventing poor health.
The report, ‘Health and wealth: closing the gap in the North East’, urges North East local government and NHS services to take a fresh look at how the region’s significant health and wellbeing challenges could be tackled. It calls for better joint working across NE authorities and advises that the key way to improve health in the region is to get people back into work.
The report sets out ten recommendations for health and care leaders across County Durham, Gateshead, Newcastle, Northumberland, North Tyneside, South Tyneside and Sunderland to break the vicious circle of poor health and poverty. These include:
• Radically increasing spend on prevention by rebalancing existing local government and NHS resources, including establishing a dedicated, cross-system prevention fund to tackle inequalities
• Supporting people to get back to work after illness, including developing a training programme for primary care staff and GPs specifically focused on how they can help people with mental health conditions get back to work
• Urging health and care leaders to look beyond the interests of their own organisation’s boundaries to ensure that funding is used most effectively to support wellbeing across the region
• Bringing together local authorities, NHS organisations and the community and voluntary sector through new governance arrangements to drive forward a new push to improve the health of the area
Commission chair, Duncan Selbie, chief executive of Public Health England, said: “Health and wealth are two sides of the same coin and closing the health and wealth gap in the North East compared to the rest of the UK was the Commission’s number one priority.
“Life expectancy in the region has been improving but there is no hiding from the fact that health outcomes are poor and that health inequalities are far too great. A baby born in the NECA area can expect more than a decade fewer years in good health than one born in Richmond on Thames or Wokingham. And within the NECA region differences in economic circumstances lead to significant health inequalities between neighbouring communities.
“We are recommending that the entire system needs to shift its priority towards preventing poor health. By far the greatest risk is smoking, which is why we support intensifying the focus on programmes to reduce smoking. But the other key focus for prevention should be improving outcomes across the life cycle from school readiness, through good and fulfilling employment to healthy and independent old age.
“We propose that the North East civic and health leaders set a target for radically increasing preventive spend across the health and public service system by freeing up and redistributing existing resources. To kick start this, we have proposed the establishment of a prevention investment fund that will bring together contributions from all partners that stand to gain from the expected savings. And we also think primary care health professionals in the area should receive new training so that can support people, especially patients with mental health conditions to get back to work.”
The report says poor population health has resulted in an over focus on the treatment of ill-health at the expense of preventing it, with an over-reliance on health and care services, currently costing £5.2bn a year in the NECA area. More than 60 per cent is spent on treating ill health through hospitals and specialist care – 20 times more than the 3 per cent spent on public health.
The Commission recognises that freeing up the resources needed to radically increase preventive spending will be challenging, with a shift from treating people in hospital to helping them to stay well in the community and therefore a radical change to the way hospital services are currently configured and provided. The Commission stresses that local Sustainability and Transformation Plans (STPs) currently being developed in the area are a great opportunity to set out a new vision of a more efficient and sustainable health and care system in the North East.
The report has today (11 October 2016) been presented to leaders of health and care organisations. In the coming weeks and months, each of these organisations will be considering the detail of the report and agreeing their response to the recommendations. More information about the role of the Commission can be found here on the NECA website, and a copy of the full report is available by clicking here.
Councillor Paul Watson, chair of NECA said: “We are very grateful to everyone who has been involved in the work of the Commission and we welcome this report. It sets out some clear messages about how we can make real inroads to improve the health and wellbeing of our region.
“It’s important that we all realise how poor health is holding us back as we all try to improve our wealth and prosperity.
“The Commission’s work remains relevant for all the councils in the NECA region who have oversight on public health work. Once we have all had the chance to digest the detail of the report we will return to discuss its next steps.”
Nicola Bailey, Clinical Commissioning Group Northern Forum lead on health and social care devolution, said: “This report is very much welcomed. Within the NHS we face massive challenges to ensure safe and sustainable services in the future. Far too many people need to be treated in hospital as emergencies and we are already working with local authorities and other local partners on long term plans to reverse this trend so that we can support many more people to stay well at home and avoid coming into hospital unless it is absolutely necessary.
“We now need to consider how these recommendations can help with our long term planning to improve the health and wellbeing of local people and bring benefits to the region as a whole.”
Tim Rideout, director of commissioning operations for NHS England Cumbria and the North East, said: “A significant amount of work has been undertaken by the Commission to look at how we can work efficiently and collaboratively across health and social care.
“Today’s publication brings a wealth of information, learning and insight together, providing a sound reference point for how we can work more effectively to improve health and wellbeing across the region and in local communities.
“The contents of the report will also usefully inform improvements and developments in the planning and delivery of health services.”
Jim Mackey, chief executive of NHS Improvement, said: “The report of the Commission is very timely as health and care partners across the area are currently working on long term plans to develop a more efficient and sustainable health and care system. In doing so they will need to address some significant existing challenges and this report will be invaluable as they move forward with that work.
“I am sure that health and care organisations in other parts of the country which are facing similar challenges will find this report very helpful.”