Half of UK adults struggling to access trusted health information, report finds

By Integrated Care Journal

Research by PIF and Ipsos reveals inequalities in access to health information and the impact of misinformation, calling for greater signposting towards credible health information.

The Patient Information Forum (PIF) and Ipsos have today published new research into health information access across the UK. The Knowledge is Power report offers new insights on information access, trusted sources, communication with healthcare professionals and the impact of misinformation on patient awareness of health.

The report is based on a cross-sectional, nationally representative survey of 2,003 adults in the UK from May to June 2024 using the Ipsos KnowledgePanel.

It reveals the demand for the NHS to signpost trusted information and wide support for the verification of health information.

Key findings include:

Half of adults in the UK are struggling to access trusted health information, with 55 per cent feeling they cannot trust health information they find online
1 in 10 adults in the UK have been affected by misinformation, rising to 1 in 5 for ethnic minorities
8 in 10 adults in the UK agree access to trusted health information would help them manage their health
1 in 6 say adults in the UK say their views are not taken seriously by their health professional. This rises to 1 in 4 for ethnic minorities
Only 1 in 10 adults with long term conditions in the UK are signposted to patient organisations, yet these are highly trusted by their users
2 in 3 adults in the UK state independent verification of health information would increase trust
There is already recognition of the PIF TICK – the UK’s only independently-assessed certification for both print and digital health information – among the UK population

Melissa Moodley, UK Head of Healthcare Research, Ipsos, said: “This timely research reveals a critical gap in access to trustworthy health information, with half of UK adults struggling to find reliable sources. This challenge is particularly acute for those with long-term conditions and minority groups.

“The impact is clear: 8 in 10 adults believe better access to credible health information would improve their health management. These findings underscore the urgent need to improve the provision of verified, accessible health information. Doing so is not just beneficial, but essential for enhancing overall health outcomes across the UK.”

Knowledge is Power makes five recommendations on the right to health information, aligned with the three shifts proposed in the NHS 10-year plan. In summary they are:

A right to health information – Health information is provided as a core part of patient care
Tackle misinformation – Through robust content standards and effective signposting of credible health information via health professionals and the NHS Apps
Tackle inequality – Health information must be accessible and appropriate for all
Lived experience as a metric – Embedding patient experience as a measure of NHS performance using the NHS Apps and single patient record
Dedicated leadership – A mandate for the effective delivery of health information with a named lead in all NHS organisations

Sue Farrington, chair of PIF, said: “Credible information supports people’s health decisions, from childhood vaccinations to joint replacement surgery. For people with long term conditions, it is a core element of care.

“Our 2024 survey gives a clear view of how people want to access health information and the challenges they face. Resolving these issues will ensure everyone gets the information they need, supporting the prevention agenda and contributing to the delivery of positive health outcomes for all.”

View the full Knowledge is Power report here.

Public Policy Projects’ Patient Safety Programme

In partnership with the UK-based charity, Patient Safety Learning, Public Policy Projects (PPP) is developing a new programme, Harnessing technology to enable a system wide approach to patient safety, to position patient safety as a core purpose of integrated care systems. The programme is taking a collaborative approach, bringing together health system leaders, industry experts and patient/end-user representatives to discuss patient safety through the lens of technology, digital innovation and data-driven transformation.

To find out more about the programme and to register for the next roundtable, Safety design and user engagement: the power of digitally enabled people, please visit the website here or contact Samantha Semmeling on samantha.semmeling@publicpolicyprojects.com.

RPS calls for government action to tackle medicines shortages

By Integrated Care Journal

Endemic medicines shortages need urgent action, says RPS, as supply chain woes and manufacturing consolidation drive worsening outcomes for patients and extreme pressures on pharmacy sector.

A new report from the Royal Pharmaceutical Society (RPS) has called on the Government to create a national strategy to manage medicine shortages and to change legislation to allow community pharmacists to amend prescriptions when medicines are in short supply.

Backed by charities and patient groups, the Medicines Shortages: solutions for empty shelves report explains how medicine supply chains are global and complex, with shortages caused by manufacturing problems and disrupted, less resilient supply chains. The report finds that supply chain issues are in part due to the consolidation of manufacturing outlets and cost-driven pressures.

The report calls on the UK Government to create a national strategy to both prevent and manage medicine shortages that would streamline efforts across the NHS, reduce inefficiencies caused by duplication of effort and ensure information and guidance for professionals and patients is available as soon as shortages occur.

The findings also highlight that supply chain vulnerabilities have combined with unplanned spikes in demand, such as shifts in prescribing practice or increased diagnosis of some conditions, to create a perfect storm of unstable supply.

This has made it harder for patients to access treatment, causing frustration, anxiety and in some cases, harm to patient health. The report cites high profile examples of patients being unable to access hormone replacement therapy, antibiotics, diabetes drugs, and medicines used to treat epilepsy and attention deficit hyperactivity disorder, among many others.

“Taking a new approach to medicine shortages is essential. A properly resourced UK-wide medicines shortages strategy that helps prevent and manage shortages would greatly improve the resilience of the supply chain. This would relieve stress and anxiety for patients and free up time for pharmacists to focus on patient care rather than constantly chasing down supplies.

James Davies, RPS Director for England and co-author of the report

The report also urges the Government to legislate to allow community pharmacists to make minor amends to prescriptions when medicines are in short supply. This simple change would enable a different quantity, strength or form of the medicine to be provided. For example, changing tablets to a liquid version of a medicine, or substituting a pack of 20 mg tablets with 2 x 10 mg packs when necessary.

At present, patients have to return to their GP to get their prescription amended, delaying access to medication, increasing bureaucracy and intensifying pressure on an already overburdened system. This move already has support from medical organisations, patient groups and other pharmacy bodies.

Frontline pharmacy teams are also under added pressure due to medicines shortages; A 2024 Community Pharmacy England survey found that almost three-quarters of community pharmacy staff report spending one-two hours or more daily trying to obtain medicine stock or source alternatives. One acute hospital trust also reported that the number of staff required to manage medicines shortages has increased from one person to five in the last five years – a situation “likely to be reflected in trusts across the country”.

Ohter recommendations in the report include:

Improve reporting by manufacturers: prompt alert of the risk of shortages would transform the impact on patients, and those consistently failing to report should be fined.
Build supply chain resilience: strengthen NHS procurement contracts to ensure manufacturers can meet supply demands and respond to shortages quickly.
Improve data connectivity: Use better demand forecasting and share information across the supply chain to prevent stock issues before they happen.
Enhance systems for life critical medicines: improve collaboration across the health service to coordinate access to specific medicines.

James Davies, RPS Director for England and co-author of the report, added: “Community pharmacists must be allowed to make minor changes to prescriptions during shortages. The current outdated system inconveniences patients, wastes time and causes frustration. The Secretary of State for Health should give pharmacists the authority to act in the best interests of their patients, rather than remain subject to ‘empty shelf syndrome’.”

Bruce Warner, Chair of the advisory group for the report, said: “This report provides a comprehensive assessment of what is causing medicines shortages, their impact on patients, pharmacists and healthcare professionals, and what more can be done to mitigate and manage shortages.”

Sharon Brennan, Director of Policy and External Affairs at National Voices, a coalition of 200 health and social care charities in England, said: “We urge the Department of Health and Social Care to recognise the serious and worsening impact medication shortages are having on patients, and to commit the same level of urgency to improving the situation as it has to other NHS access-to-care issues such as diagnosis and waiting lists.”

Data-driven, proactive prevention. Are we finally ready for population health management?

By Simon Swift

As we navigate the complexity of modern healthcare, it is clear that preventative, data-led approaches can help solve some of the NHS’ major challenges. But ‘are we finally ready for population health management?’ asks Health Navigator CEO, Simon Swift.

I am sure every generation of health and care leaders think they face unprecedented challenges. I don’t think it is an error to say the current NHS leadership feels this, and with some justification. Urgent and emergency care services are under immense pressure, planned care waiting lists remain very close to the 2023 high of 7.7 million, while persistent health inequalities threaten the foundations of the UK’s universal healthcare model.

We must ask ourselves a crucial question: what, if any, proven approaches are there to deliver better outcomes for patients while ensuring the long-term sustainability of our health systems?

I firmly believe that the answer lies in harnessing the power of data. This data-driven approach takes different shapes at different points across the system. For example, optimising system design and service scale and location at the macro level, while at the micro level, there are cumulative marginal gains to be made through ‘command centre’ type solutions to operational management, optimising efficiency and safety for people in A&E or waiting for planned care. These are impactful uses, but not sufficient.

Another use of data is to enable a shift from reactive to proactive care models. Logically it is attractive; we stop people becoming acutely unwell, which is good for them. If they don’t become acutely unwell, they don’t need urgent and emergency care, reducing demand at the front door. This (in the UK system) means we can allocate resources to focus on other things, and there is plenty to do. If we are going to be responsible custodians of health services, this transition is not just desirable; it’s imperative.

The case for change: A closer look at the crisis

Waiting times for emergency care have reached historic highs, which is a miserable experience for patients, an awful work environment for staff facing intolerable moral hazard and probably dangerous.¹ Bed occupancy rates in many hospitals mean managers are in constant firefighting mode, with waits backing up into A&E and elective cancellations routine, without a bed to admit a cold patient into.

Though this pressure on hospitals is universal, emergency department attendance rates are more than twice as high for those living in the most deprived areas compared to the least deprived, demonstrating the deep-rooted inequalities in our health system and society. The inverse care law is alive and well.

The COVID-19 pandemic has exacerbated these issues, creating a backlog of need that will take years to address. Moreover, an ageing population and the rising prevalence of chronic conditions are adding to the complexity of healthcare delivery. These challenges are not just statistics; they represent real people experiencing pain, anxiety, and diminished quality of life for many.

A data-driven approach to prevention

I believe we must use preventative, data-led, approaches to address these challenges, finally taking a step away from sole focus on the traditional reactive model. The evidence base is growing that the logically attractive proactive, preventative approach, leveraging the data at our disposal, actually works.

By harnessing this data (how this works is a sexy thing to some – advanced analytics and machine learning algorithms), we can identify patients at high-risk of unplanned care needs months in advance. This foresight allows us to intervene early, providing personalised support that empowers patients: precision population health management (PHM). The potential of this approach is enormous, offering a way to improve people’s health and so reduce pressure on acute services in the short-term and planned care in the longer term.

At HN, we’ve seen first-hand the transformative impact of this precision PHM approach. Our Proactive solution has demonstrated significant reductions in emergency admissions and A&E attendances.

Empowering patients and supporting healthcare systems

With advice from the Nuffield Trust and with the support of several NHS trusts, HN conducted a randomised controlled trial.² It meticulously tracked up to 2,000 patient outcomes across multiple trial sites. We demonstrated a 36 per cent reduction in A&E attendances for patients supported by health coaching, which is in line with other studies. This isn’t just about numbers; it’s about people avoiding traumatic emergency visits and receiving care in more appropriate, less stressful settings.

The benefits of proactive, data-driven care extend far beyond reducing hospital admissions. We saw improvements in mortality rates, Patient Reported Outcome Measures (PROM’s), patient activation, and quality of life.

These outcomes are transformative on multiple levels. For patients, it means taking control of their health, understanding their conditions better, and enjoying an improved quality of life. For healthcare systems, it translates into reduced pressure on acute services, better resource allocation, and improved overall efficiency.

This approach helps to address health inequalities. By identifying at-risk individuals early, regardless of their socioeconomic background, we can provide targeted interventions that prevent health issues from escalating. This is particularly crucial in areas of high deprivation, where health outcomes have traditionally lagged. For those close to this type of risk modelling it will be no surprise that deprivation (income and health) is a significant risk factor.

The role of technology

As we navigate the complexity of modern healthcare, it’s clear that innovation and technology will play a crucial role. However, it’s essential to understand that technology is not a panacea. The true power lies in how we apply these tools to reimagine healthcare delivery. Those who have worked in this arena for any length of time know that implementing a technology rarely delivers benefit alone, and is often problematic and unhelpful. Carefully designing the change in process, behaviour, decision making etc. that the technology enables is the key to delivering value.

While the potential of data-driven, proactive healthcare is material, we must acknowledge the challenges in implementing the approaches. Data privacy and security are serious concerns that need to be addressed rigorously. We must ensure that as we leverage patient data for better care, we do so in a way that respects individual privacy and complies with all relevant regulations. However, the current red tape-bound and bluntly obstructive approach to information governance in the NHS needs improving if we are to derive value at a meaningful scale and pace.

Looking to the future

The opportunities are tantalising. By embracing data-driven insights and personalised interventions, we can create a more proactive, efficient, and equitable healthcare system that actively helps people live healthier for longer. This approach not only addresses immediate pressures but also lays the foundation for a more sustainable future.

The change from sickness to health care will require collaboration across all sectors of health and care – from policymakers and healthcare providers to technology companies and, most importantly, patients themselves. We need to encourage innovation, where new ideas can be tested and scaled rapidly.

At HN, we’re committed to being at the forefront of this transformation. Our work in AI-guided clinical coaching is just the beginning. We envision a future where patients receive personalised, proactive care that keeps them healthy and out of the hospital.

References

¹ Jones S, Moulton C, Swift S, et al. Association between delays to patient admission from the emergency department and all-cause 30-day mortality. Emergency Medicine Journal 2022;39:168-173.

² Bull LM, Arendarczyk B, Reis S, et al. Impact on all-cause mortality of a case prediction and prevention intervention designed to reduce secondary care utilisation: findings from a randomised controlled trial
Emergency Medicine Journal 2024;41:51-59.

10-Year Health Plan must address cancer care failings identified by Darzi

By Gabriel Blaazer

From improving access to care and diagnosis to addressing treatment delays, Lord Darzi’s recent independent investigation highlights the complex web of challenges facing the NHS. In doing so, it also offers a series of starting points for the upcoming 10-Year Health Plan to address.

Cancer remains one of the leading causes of avoidable death in the UK, and despite improvements in survival rates over the past decades, the country still lags behind others in cancer care. Lord Darzi’s recent independent investigation into the NHS in England offers a comprehensive review of the current state of cancer treatment within the NHS and points to several factors that have contributed to its struggles. These include funding constraints, the aftermath of the Covid-19 pandemic, and systemic issues within healthcare management.

Using the failings identified by Lord Darzi as a basis, the upcoming 10-Year Health Plan for the NHS has the chance to radically transform cancer care provision in the NHS.

Rising cancer waits and slowing survival rate improvements

Cancer cases in England have steadily risen, increasing by approximately 1.7 per cent per year from 2001 to 2021. When adjusted for age, the rise is still significant at 0.6 per cent annually. This translates to around 96,000 more cases in 2019 than in 2001. Although survival rates for one-year, five-year, and ten-year intervals have improved, the rate of improvement slowed considerably in the 2010s.

The UK also continues to record substantially higher cancer mortality rates than its peers. International comparisons show the country falling behind not only European neighbours but also the Nordic countries and other English-speaking nations. While survival rates have inched upwards, “no progress whatsoever” was made in early-stage (stage I and II) cancer detection from 2013 to 2021. However, this has recently changed, with detection rates improving from 54 per cent in 2021 to 58 per cent by 2023, partly driven by the success of the targeted lung health check programme. This initiative has helped identify more than 4,000 cases of lung cancer, with over 76 per cent caught at stage I or II, significantly boosting early intervention efforts.

Nonetheless, challenges remain in treatment selection, particularly for brain cancer patients. While genomic testing, critical for tailoring treatments, is now more widespread, only five per cent of eligible brain cancer patients can access whole-genome sequencing. A recent Public Policy Projects (PPP) report has highlighted the inequalities in access to genomic sequencing. Moreover, turnaround times for genomic tests – only 60 per cent of which are processed on time – further hinder timely treatment for many patients.

Access delays and missed treatment targets

One of the key areas within the Darzi investigation is the NHS’ ongoing struggle to meet its cancer treatment targets. The 62-day target from referral to the first treatment has not been met since 2015, and as of May 2024, only 65.8 per cent of patients received treatment within this window. Similarly, over 30 per cent of patients now wait more than 31 days for radical radiotherapy, reflecting growing delays in critical care pathways. Given the importance of timely cancer treatment, the upcoming Plan must consider how to reduce delays in access to treatment.

While the number of cancers diagnosed through emergency presentations has decreased, with the percentage falling from nearly 25 per cent in 2006 to under 20 per cent in 2019, access to primary care services continues to be “uneven”. This affects the timeliness of cancer referrals, especially as the proportion of patients waiting more than a week for a GP appointment rose from 16 per cent in 2021 to 33 per cent per cent by 2024. Darzi notes that declining access to general healthcare services directly reduces the likelihood of timely cancer detection and treatment.

The drivers behind performance issues

Several factors have compounded the challenges facing the NHS’s cancer care system, as identified by Lord Darzi, which the 10-Year Health Plan must seek to address:

Austerity and capital starvation: Funding restrictions and limited capital investments over the past decade have led to under-resourced healthcare infrastructure, making it difficult to accommodate growing patient demand. The underinvestment in estates and facilities is also preventing the NHS from making full use of diagnostic advancements; in many cases, hospitals may be able to purchase new state-of-the-art diagnostic and imaging equipment, but not have a suitable site in which to use it. PPP has explored this topic in detail in a previous report.
Covid-19 pandemic: The pandemic severely disrupted healthcare services, creating a backlog of cases and delaying non-Covid-related care, including cancer treatments. Although efforts have been made to prioritise long-waiting patients, the effects of the pandemic still ripple through the healthcare system, contributing to worsened performance.
Lack of patient voice and staff engagement: The investigation highlights that the perspectives of both patients and healthcare staff have often been overlooked in decision-making processes, resulting in management structures that are out of touch with the realities on the ground. A more engaged and responsive system would likely yield better outcomes. The need for coproduction was reiterated at PPP’s recent Cancer Care Conference, and is increasingly being recognised in Cancer Alliances’ health inequalities strategies.
Management structures and systems: The report also points to inefficiencies within the NHS’ management structures. These systems are often seen as bureaucratic, which slows down decision-making and the rollout of new treatments. Disparities in the adoption of new systemic anti-cancer therapies highlight these inefficiencies, as some regions wait over a year for access to drugs approved by NICE, while others see the same drugs introduced within a month. This inequality in access to drugs is a key driver of the postcode lottery that is seen in cancer care.

The importance of early diagnosis and screening

A clear priority identified by Lord Darzi is the need for more effective early diagnosis strategies. Cancers detected at stages I and II are much more treatable, and early intervention is strongly associated with better survival outcomes, as well as substantially lower treatment costs. Darzi notes, however, that progress in this area had been stagnant until recent years, with no gains between 2013 and 2021. The improvements seen in early-stage detection from 2021 to 2023 offer hope, but Darzi cautions that further efforts are needed.

The 10-Year Health Plan must also seek to address the UK’s lack of CT and MRI scanners relative to other comparative companies – a major inhibitor of greater diagnostic capacity in the NHS.

Screening participation rates have also declined, with breast and cervical cancer screening coverage falling since 2010. Yet there are signs of promise. For example, the bowel cancer screening programme has been highly successful and provides a model that could be replicated for other types of cancer.

However, hopes for improved early diagnosis cannot rely solely on the establishment of national screening programmes. Poor levels of health literacy, particularly among underserved communities, must also be addressed to ensure that people know which signs and symptoms to be aware of, and to seek treatment if necessary.

More sophisticated treatments but growing delays

The development of more sophisticated treatments is a key area of progress, but the availability of these treatments is often constrained by capacity issues. While the NHS is a world leader in incorporating genomic testing as part of routine cancer care, delays in processing these tests and long waiting times for treatments like radiotherapy undermine their potential impact and can lead to poorer outcomes.

As Darzi points out, “turnaround times are poor… [which] can delay the start of treatment,” especially when coupled with the system’s failure to meet its 62-day target for referral to treatment. In a healthcare system already stretched by rising demand and workforce shortages, delays in treatment can make the difference between life and death for many cancer patients.

Addressing the challenges ahead

Lord Darzi’s investigation underscores the critical need for systemic reforms within the NHS to address the growing cancer burden. From improving access to care and speeding up diagnosis to addressing treatment delays, the report highlights the complex web of challenges facing the NHS. In doing so, it also offers a series of starting points for the upcoming 10-Year Health Plan to address.

While recent advancements in genomic testing and early detection programmes offer hope, the NHS must tackle its systemic inefficiencies, funding shortfalls, and management issues if it is to close the gap with its international counterparts and improve outcomes for cancer patients.

For more information about PPP’s Cancer Care Programme, or to request further discussions, please contact: Rachel Millar, Programme Lead for Cancer Care: rachel.millar@publicpolicyprojects.com

Dr Chris Rice, Director of Partnerships for Cancer Care and Life Sciences: chris.rice@publicpolicyprojects.com

Greater Manchester lauded for approach to population health

By Integrated Care Journal

A new report from the King’s Fund had praised Greater Manchester’s progress on improving population health, emphasising the importance of addressing the wider determinants of health.

The King’s Fund has praised Greater Manchester for its work improving key measures of health and health inequalities. The influential national charity has called Greater Manchester “the poster child for devolution” in England and has recognised the time, effort and resources put in place helping people to live good lives, improve wellbeing and prevent illness.

The new report, published this week, shows how health is influenced by wider determinants such as high‑quality and secure housing, a good job and a healthy environment. It highlights the vital link between health, and the communities we live in as well as the value in aligning strategies to ensure improvement of both the economic and health status of the population.

Since 2015, Greater Manchester has had a wide-ranging devolution deal with Government on health which has led to improvements in life expectancy and other measures (see here for information). Greater Manchester’s model was integral to the creation of statutory integrated care systems in 2022 with improving outcomes in population health and health care a key aim.

The King’s Fund report reiterates the importance of population health being a core goal of integrated care systems and the value in different government departments below the national level working more closely together, including at mayoral level. It underpins Greater Manchester’s ‘live well model’ that aims to transform the relationship between work and health.

While this new publication recognises the financial challenges that the NHS and other public sector organisations face, it makes the case for continuing with a population health approach and the strong evidence that improvements in health can have for the economy at large.

Andy Burnham, Mayor of Greater Manchester and NHS Greater Manchester Integrated Care Partnership co-chair, said: “Greater Manchester’s health devolution journey has a simple but fundamental principle at its heart: that more local decision-making can deliver better outcomes for people.

“This report from the King’s Fund sets out clearly the wider social factors that impact people’s health and wellbeing, but also the power of devolution to draw the connections between those issues and tackle them systematically.

“That is the strength of our devolved approach, and the mission of the new Live Well service that we want to pioneer here in our city-region. There are still challenges and pressures that we face. But we’ve made progress already, including on healthy life expectancy, and by bringing together partners and joining up the support offer for residents – whether that’s health and social prescribing, housing advice, or employment support – we can deliver better, more efficient public services, and improve people’s life chances.”

Jane Pilkington, Director of Population Health for NHS Greater Manchester Integrated Care said: “The King’s Fund spotlighting Greater Manchester as leading the way in population health is pivotal to re-emphasise the important role the NHS plays in improving the health and wellbeing of residents, by focusing on preventing ill-health in the first instance rather than just treating sickness, as well as relentlessly working to reduce health inequalities.

In Greater Manchester we need to continue to work together with communities and the voluntary sector, local government, and the NHS to help create a place where everyone can live a good life, growing up, getting on and growing old in a greener, fairer more prosperous city-region – focusing on improving both the health and economic circumstances of our residents.”

News, Population Health September 25, 2024

Innovating beyond digital: A comprehensive ICS approach to musculoskeletal care

By Dr Carey McClellan

Physiotherapy practitioner, Dr Carey McClellan, explores how supported self-management tools can help integrated care systems to support MSK patients across their entire care pathway.

Musculoskeletal (MSK) injuries and conditions impact approximately 20 million people in the UK, making them the leading cause of disability. They affect people’s daily lives, the NHS, the workplace and the economy.¹

In fact, MSK problems cost the NHS £5 billion ever year, account for 14-18 per cent of all GP appointments in England, and result in 24 million lost working days annually.^2,3 Despite this already substantial burden, the prevalence of MSK conditions is rising due to a combination of an ageing population and lifestyle factors.⁴

The case for self-management

The value in supporting people to self-manage MSK conditions as early as possible is well researched, and recommended within national guidelines and policy.^5-13 However, it is not delivered consistently or at scale. A recent report by The Arthritis and Musculoskeletal Alliance (ARMA) highlighted the variation in strategy, leadership and prioritisation of MSK conditions across integrated care boards (ICBs) despite it being one of six priorities in NHSE’s major conditions strategy.

NHS England’s ‘Best MSK Health Collaborative’ and Getting It Right First Time’s (GIRFT) community MSK workstream have both highlighted the absolute need to adopt evidence-based digital technology to support people with MSK injuries and conditions.¹⁴ At the same time, there is a growing emphasis on the link between health and economic inactivity and a new government focused on improving both.¹⁵

Early intervention holds the key, but people are waiting too long

GIRFT has highlighted the need for early intervention in the MSK care pathway to reduce the primary impact and longer-term consequences. Additionally, not enough is being done to support people, or minimise the time they spend, on waiting lists. The BMA estimates that 8 million patients are currently waiting for consultant-led elective care.¹⁶ However, the number does not include the ‘hidden backlog’ – those who have not yet presented for care or are waiting for other services (e.g., physiotherapy or investigations).

There are up to six waiting stages before an orthopaedic procedure, each offering a chance to reduce deconditioning, encourage self-management, support a person’s return to work, and possibly avoid costly surgical intervention. Extended waiting times for MSK treatment at any point on this journey take a toll on patients’ physical and mental health, leading to deconditioning, increased pain, lesser quality of life, difficulty to work and, in some cases, irreversible deterioration.¹⁷

Enabling people to self-manage their recovery

Digitally supported self-management tools help integrated care systems (ICSs) to support MSK patients across their entire care pathway. They help people to trust their recovery, utilise less healthcare resource and return to work more quickly and safely.

For maximum impact, digital self-management pathways should be made available to people at the earliest possible opportunity wherever they connect with the health system or seek help – in the community (pharmacies, libraries, leisure centres), primary care (GP, first contact practitioner), urgent care or secondary care (elective care). Self-management support is suitable for 80 per cent of all new, recurrent, or long-term MSK conditions, including people on waiting lists.¹⁸

Tools like getUBetter enable people to self-manage their recovery by following a recovery and prevention pathway defined by their local healthcare system. And, because it’s digitally enabled, it supports people to manage their condition 24 hours a day, 365 days a year, taking them through their recovery day-by-day, and providing them with the knowledge, skills, and confidence to help themselves. Support is provided through triage, advice and guidance, exercises, outcome measures, dynamic safety netting and referral when necessary.

getUBetter also supports people by connecting them to treatment, local support and public health services (e.g., smoking cessation, weight reduction and return to work).

Behaviour change model

For a digital platform to have a positive impact on people and the NHS, it must be trusted, and help people change their behaviour. That’s why getUBetter was designed with an underpinning COM-B behaviour change model as its foundation.¹⁹ The COM-B model is a theoretical framework that incorporates key components (capability, opportunity, and motivation) considered to affect behaviour.

For example, all content has been created with behaviour change at its core and tailored depending on the individual’s stage of their recovery and how they are feeling. Content includes support to mitigate against negative behaviours and promote positive behaviour; it is personalised, targeted, and localised to clinical pathways, health services and community support. getUBetter includes support for safety netting as well as other factors such as psychological elements of MSK recovery, the relationship between work, home, and health and system obstacles to work. All can influence someone’s ability to recover, live and work well.

Digitising isn’t enough to drive clinical transformation and positive impact

The NHS is littered with examples of poorly designed patient-facing applications that have not been co-designed with their users. This leads to a frustrating experience and short-lived engagement.

An iterative design process ensures content is accessible, intuitive, inclusive, and easy to follow, while barriers to adoption such as digital exclusion are minimised.²⁰ Working in partnership with ICB clinicians, champions and transformation stakeholders is essential. Their local expertise is crucial for ensuring that any digital tool integrates seamlessly into routine care. This ensures the best approach for deployment and adoption, and creates a blueprint for NHSE scale and adoption.²¹

The impact of digital self-management

Lord Ara Darzi’s Independent Investigation of the NHS in England confirms that it must move care into the community, enable patients to take active involvement in their own care, digitise, and help tackle economic inactivity. MSK digital self-management tools are ideally placed to play a central role in realising this.²²

Earlier this year, NICE published an Early Value Assessment approving the use of five digital tools for use in the NHS for non-specific low back pain – the biggest cause of days taken off work.

An economic evaluation conducted by Health Innovation Network (HIN) South London highlighted the scale of the burden of back pain, and the possible return on investment that can be achieved by deploying digital self-management tools. The independent report demonstrated that a cost saving of more than £1.9 million for back pain alone could be achieved per area (place) of an ICS with a population of 330,000 through deploying digital self-management.²³

Further research conducted by the HIN demonstrated that when using getUBetter, an ICS can expect a 13 per cent reduction in GP follow-up appointments, a 50 per cent reduction in MSK-related prescribed medication, a 20 per cent reduction in physiotherapy referrals, and 24-66 per cent fewer urgent care attendances. A Somerset NHS Foundation Trust evaluation revealed that 50 per cent of patients awaiting MSK physiotherapy appointments felt their needs were met after using getUBetter, prompting them to remove themselves from the waiting list. Those in NHS South East London ICS who utilised getUBetter before their physiotherapy appointments required 40 per cent fewer sessions compared to patients who did not use the app.²⁴ NHS Frimley ICS reported 11 per cent fewer sick notes, helping people back to work.

The MSK problem in the UK is a complex one to solve and requires close collaboration with patients, clinicians, ICB leads, transformation experts, health systems, and the government to ensure the solution reflects local needs. While technology has a role as an enabler in digitising ICS-wide MSK pathways, it is not achievable without clearly defined methodologies of co-design, behaviour change and clinical transformation.

If you’d like to hear more about this approach and blueprint, please sign-up for the forthcoming webinar, Transforming MSK care across complex health systems with digital self-management support: Technology vs methodology on 26 September 2024.

List of references

^1. Versus Arthritis. The State of Musculoskeletal Health 2023. 2023;1–65. Available from: https://www.versusarthritis.org/media/duybjusg/versus-arthritis-state-msk-musculoskeletal-health-2023pdf.pdf

^2. Public Health England. Musculoskeletal Health: A 5-year strategic framework for prevention across the lifecourse [Internet]. PHE publications gateway. 2019. Available from: https://www.gov.uk/government/publications/musculoskeletal-health-5-year-prevention-strategic-framework

^3. NHSE. Musculoskeletal health: What are musculoskeletal conditions? [Internet]. 2024. Available from: https://www.england.nhs.uk/elective-care-transformation/best-practice-solutions/musculoskeletal/#:~:text=In%20fact%2C

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^7. Hunter R, Beattie M, O’Malley C, Gorely T. Mobile apps to self-manage chronic low back pain: A realist synthesis exploring what works, for whom and in what circumstances. PEC Innov [Internet]. 2023;3(September 2022):100175. Available from: https://doi.org/10.1016/j.pecinn.2023.100175

^8. Hewitt S, Sephton R, Yeowell G. The effectiveness of digital health interventions in the management of musculoskeletal conditions: Systematic literature review. J Med Internet Res. 2020;22(6). Available from:https://pubmed.ncbi.nlm.nih.gov/32501277/

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^11. Kelly M, Fullen B, Martin D, McMahon S, McVeigh JG. EHealth interventions to support self-management in people with musculoskeletal disorders: A scoping review protocol. JBI Evid Synth. 2021;19(3):709–20. 10. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994513/

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How ICSs can benefit from a strategic, system-wide approach to social value

By Becky Jones

By Becky Jones, Social Value and Sustainability Lead, NHS Arden & GEM CSU

Creating healthier, more resilient communities and reducing our environmental impact are essential elements in delivering a more sustainable NHS. These ambitions are reflected in the four core aims assigned to integrated care systems (ICSs), which are: to improve outcomes in population health and healthcare; tackle inequalities; enhance productivity and value for money; and, support broader social and economic development.

The NHS has set an ambitious target to become net zero by 2040, while public bodies have had a legal responsibility to commit to the social, environmental and economic sustainability of their communities for many years. As a result, social value and environmental commitments are increasingly embedded in procurement and other legislative requirements. But how we translate these often-fragmented commitments into quantifiable achievements is less clear. Social value could have a major role to play in tackling our most pressing health and social care challenges, but this will require ICSs to adopt a more cohesive and proactive approach.

Seizing opportunities

Social value advocates for looking much more broadly at the wider determinants of health and considering how system partners can work together to achieve more for their communities. This holistic approach encompasses social, economic and environmental areas such as education, housing, work, crime and community services, and how these connect and contribute to the overall wellbeing of an area and its population.

Using population health data to inform priorities, system-wide collaboration gives health, public and voluntary sector organisations an important opportunity to develop a coordinated, strategic approach to delivering social value. This requires bringing the right mix of skills and disciplines together to identify programmes that will have the greatest impact, and mapping out the connections that need to be made for this to work. We know, for example, that poor quality housing can affect health. The health service could invest resources in treating a patient’s pneumonia only to discharge them back to their draughty or damp home, which is likely to cause a return to ill health.

Similarly, if a voluntary organisation runs activities to help tackle social isolation but people cannot afford the transport to get there, the initiative won’t achieve its aims, despite appearing on paper to meet population needs. Sharing information and planning interventions across system partners creates opportunities to break these vicious cycles and move towards disease prevention and wellness.

Agreeing priorities

Organisations will typically have specific activity, savings or outcome targets to meet, or be used to working in certain ways. This is where data can help identify common challenges and demonstrate the value of becoming more aligned. What are your staff surveys telling you about workforce priorities? What recruitment and retention pressures does your system face? Where are the gaps in your health provision? Which patients are driving demand, and which communities are you not reaching? Engaging effectively across your ICS, and with your patients and communities, will help determine priorities at system, place and organisational levels.

Some initiatives may be unique to individual organisations or communities but aligning them to a broader set of strategic priorities will make it easier to evaluate overall impact and share learning. In Coventry and Warwickshire ICS, for example, the ICB is taking a system-wide approach to tackling health inequalities, drawing on partners’ roles as anchor institutions to deliver social value across the region. The system is establishing a charter that aims to act as a framework, enabling each partner organisation to do what it needs to do to meet its own requirements, albeit contributing to a wider strategy to deliver a more proactive and sustainable health and care service. The charter aligns to the system’s long-term planning process while giving a specific approach to delivering social value through an overarching framework.

In Cheshire and Merseyside, the ICS developed a Social Value Charter which defines what social value means to them, using a coproduction approach that enabled system partners, voluntary organisations, the private sector and citizens to contribute. The Charter sets out the principles and approach signatories sign up to, including how social value will be measured using a Social Value Outcomes Framework.

Making suppliers part of the solution

Setting social value priorities helps organisations seek meaningful contributions from suppliers. To fulfil procurement requirements, bidders are commonly required to come up with social value initiatives and carbon reduction plans which tend to be silo projects that are difficult to monitor and manage. By inviting them to show how they would contribute to your existing social value priorities, your system can start to harness a collective contribution towards priority programmes which can be measured and evaluated against agreed criteria.

This means working with procurement colleagues much earlier in the commissioning process and challenging established ways of working that prioritise savings and lower cost contracts. If your system has prioritised paying a real living wage, for example, contracts need to be assessed not just for efficiency but for the long-term, wider benefits that may come with using suppliers that pay their staff well.

Measuring impact

Social value is not about quick wins but long-term sustainability. It requires taking a step back from continuous day-to-day pressures to consider initiatives that it may take us years to fully benefit from. This makes measurement even more important – we need to be able to see steps towards achieving sustainability goals, which in turn will lead to better, broader outcomes. NHS Arden & GEM has been working with the Social Value Portal to adapt their social value themes, outcomes and measures system (TOM system) for healthcare which incorporates five key themes:

Jobs – opportunity for all
Growth – inclusive growth
Social – empowering communities
Environment – safeguarding and restoring our world
Innovation – new ideas to deliver social value.

The TOM system is endorsed by the Local Government Association and maps to both major external frameworks and the Government Social Value Model. Using robust data, proxy values are applied to each objective and outcome which helps organisations convert their progress into a quantifiable value. Using consistent standards across systems enables more reliable assessment and benchmarking, which in turn will strengthen best practice and accelerate learning across regions.

Where to start

ICSs and their individual partner organisations will be at different stages of maturity and will have varying support needs. In recognition of this, NHS Arden & GEM has established a Social Value Network to encourage information-sharing and innovation across England, and a Future NHS social value workspace where organisations can access free resources. More recently, we have partnered with the Social Value Quality Mark CIC and the Social Value Portal to create the Social Value in Health Excellence Programme, providing independent assessment, support and monitoring to help organisations move successfully through their social value journey. This is not about adding to the to-do list, but about developing best practice in social value to help ICSs deliver the four core aims they are already tasked with.

Understanding and adopting a system-wide approach to social value has the potential to deliver significant strides towards preventative care but it’s not an overnight solution. Although today’s pressures must be tackled, it is equally important to build the knowledge and confidence needed to make long-term investments in social value that will improve community health and resilience in the long-term.

*Becky Jones, Social Value and Sustainability Lead, NHS Arden & GEM CSU*

From fragmentation to integration: Lessons for the NHS from New Zealand

By Gabriel Blaazer

When David Meates became CEO of New Zealand’s Canterbury District Health Board in 2009, he took charge of a system that was “broken and fragmented”. 11 years later, the system’s fortunes were transformed. At a recent event, Meates shared his experiences and lessons from Canterbury’s transformation, offering vital insight for the NHS as it continues its own journey from fragmentation to integration.

On 14th August, Public Policy Projects (PPP) held a dinner for a group of carefully selected stakeholders to share lessons from international and devolved nations on the delivery of integrated care. Speaking to the assembled guests was David Meates, who, while current interim CEO of Rowing NZ, was CEO of New Zealand’s Canterbury District Health Board (DHB) from 2009-2020. During his tenure, Canterbury DHB undertook an ambitious series of reforms aimed at integrating the fragmented elements of the health service, which turned the ailing system into one of the most integrated health systems anywhere in the world.

Many of the issues Canterbury faced have parallels within the NHS, and as such, it provides valuable lessons for UK health and care transformation. Prior to Meates’ arrival, Christchurch Hospital (the district’s largest) was regularly ‘gridlocked’ due to a shortage of beds, while a fragmented system and growing demand for services were damaging staff morale and the system’s ability to deliver effective healthcare.

Meates took charge of Canterbury DHB in 2009, and noted that by 2007, leaders had already realised the system was unsustainable and needed change. He described it as “broken and fragmented”, siloed by profession, dominated by providers and lacking clear purpose. Exponential increases in funding over preceding years had led to little-to-no improvement in service delivery, productivity or patient outcomes.

Christchurch Hospital, Christchurch, New Zealand

Without reform, the system would have required another 600-bed hospital, a 23 per cent increase in GP practices, 2,000 more aged care beds, and 9,000 additional healthcare professionals (HCPs), simply to meet demand. Meates remarked that even with the necessary funds, the workforce to do this was simply not available. What was needed, Meates determined, was a new blueprint for delivering healthcare to Canterbury’s more than half a million residents, as well as a burning platform that would inspire substantial change.

First steps: identifying the vision

Much of Canterbury DHB’s early work – under the umbrella of Project 2020 – focused on understanding the shared challenges that affect large and complex systems in other sectors, and how these insights could be applied to a healthcare environment. One key initiative was Xceler8, an eight-week experiential leadership development programme that involved 1,500 doctors, nurses, and allied healthcare professionals from across the Canterbury system. Participants, convened in cross-disciplinary groups, spent time with leaders in other sectors to understand their challenges. At the end of the programme, these groups presented ideas for system improvements to a chief executive, with some being subsequently implemented. Beyond the positive changes this brought about, the programme also helped to embed principles of system thinking among the workforce and demonstrated that each part of the system has a role to play in broader system improvement.

Other programmes included Particip8 (a six-week night-school course focusing on change management techniques), and Collabor8 (a short course focusing on skills management).

These programmes also sought to familiarise staff members with Lean and Six Sigma methodologies – prioritising customer value and continuous improvement – as well as chaos theory – the idea that beneath the apparent randomness of complex systems, there are underlying patterns and constant feedback loops that can be quantified, measured and understood.

Through these initiatives, system leaders began identifying commonalities and principles that extended beyond traditional approaches to healthcare system transformation, such as the concept of ‘value.’ While ‘value’ in other sectors might refer to profit or market capitalisation, it was determined that in a healthcare context, creating ‘value’ could be understood as not wasting patients’, and by extension, the system’s, time. This realisation led to the establishment of three strategic goals, forming a framework for “a connected system, centred around people, that aimed not to waste their time”.

People take greater responsibility for their own health
Prioritising the development of services that support people and families to stay well and take increased responsibility for their own health and wellbeing.
People stay well in their own homes and communities
Prioritising the development of primary care and community services to support people and families in community-based settings, close to home, and to provide a point of ongoing contact and continuity – for most, this is in general practice.
People receive timely and appropriate care
Enabling the freeing-up of hospital-based specialist resources which can be responsive to episodic events and the provision of complex care and specialist advice to primary care.

These initiatives also led to a realisation that regardless of how fragmented a system may seem, all components form part of the same ecosystem. Shuffling patients around to meet ‘activity’ targets benefits the system little, whereas prioritising the patient’s best interests—minimising their time spent while achieving the best possible outcomes—benefits both the patients and the entire system. This insight gave rise to the principle of “One system: One budget”, which became the foundation for all subsequent reforms within Canterbury DHB.

One system: One budget

These guiding principles informed the first series of practical changes that Canterbury DHB implemented to better integrate the system and create better value both for patients and the wider system.

A crucial development was the creation of the community-based HealthPathways, aimed at improving the interface between secondary and primary care. This programme was initiated by clinicians who, after reviewing a backlog of referrals, identified that many common issues could have been prevented through better communication between hospitals and primary care providers. General practitioners and hospital specialists were then brought together to agree on optimal management and referral pathways for specific conditions. These pathways were subsequently presented to larger groups of hospital doctors, GPs, nurses, and HCPs for their input. Meates reflected on the traction that HealthPathways was gaining as an approach in the Northern hemisphere, with systems in England and Wales adopting the methodology as the operating system for their integrated systems.

A key lesson from Project 2020, as Meates has argued, is that “too often, we confuse activity with progress,” a criticism frequently directed at the NHS’s Payment by Results tariff system. To better align incentives across the Canterbury system, this approach was abandoned in favour of the newly established Canterbury Health System Outcomes Framework. This change supported the principle of “One System: One Budget,” ensuring that the various components of the system would now be rewarded for achieving the best outcomes for the system or the patient, rather than merely moving patients around and being compensated for this ‘activity.’

Another change was the establishment of the Canterbury Clinical Network – a collaborative of HCPs, health system users and cross-sector partners using a principles-based framework to decide how, when and where health services are provided. These principles included taking a whole systems approach to ensure the integration and sustainability of services, ensuring that people and communities were at the centre of any changes, enabling clinically led service development, and the system operating within its financial means. Crucially, while commissioners were involved, their role was to support the process and then work out how to realise the objectives, not to prescribe the objectives themselves.

An important step towards service integration was also made by the establishment of a connected data platform – HealthOne – an electronic shared care record combining GP, hospital and community pharmacy records, along with laboratory and imaging results. Since this was not replacing existing systems, but drawing on them, its implementation was relatively non-disruptive and enabled the scope of the records to be increased over time. Citizens could opt out of all or part of the system, with the process led by the system’s Consumer Council, while regular “dynamic” automated privacy audits ensured that patient privacy was always prioritised.

Reflections

In reflecting on Canterbury DHB’s transformation journey, Meates was wary of simplistic quick fixes to complex, systemic problems, and the importance of taking a holistic and long-term approach with any proposed solutions. “You need a whole system to work for the whole system to work – focusing on part of the system will not effect the change required,” he told the assembled guests. Considering this, during its transformation Canterbury DHB paid special attention to the language it used to refer to the system and its workforce, emphasising the use of “we” in official communications, and deliberately halting the use of language which went counter to the narrative of a single system.

The principles of integration and collaboration must also be reflected in the redesign of services and pathways by actively involving relevant stakeholders and ensuring their voices are heard. Meates emphasised that “change happens at the speed of trust,” which requires meaningful engagement with frontline teams, as well as input from the clinicians who will deliver the services and the communities who will use them.

Meates also cautioned that in any large-scale system transformation, facilitating cultural change among the people involved is as crucial as any change in process or structure. With the introduction of integrated care systems and their emphasis on collaboration over competition (a significant departure from the previous way of commissioning services), this is a point the NHS could do well to acknowledge. “You can’t expect the same people that have worked in a competitive environment and who have seen their success tied to the success of their organisation to suddenly collaborate,” said Meates. This is a case of both instilling that necessary cultural change, but also of facilitating systems to be collaborative, such as by realigning incentives towards system outcomes as opposed to individual organisational sustainability.

The cultural dimension is also highly relevant to funding issues, as “too often, these involve win/lose discussions” where different parts of a system manage their activity levels to safeguard their budgets and maintain status within the broader system. While outcomes-based remuneration is undoubtedly a key solution, it is equally important to embrace the idea that the best outcome for patients is also the best outcome for the system and its individual components.

On a practical level, Meates emphasised that although reforming contracts can be the most challenging area, it is perhaps the most critical. Contracts significantly limit what healthcare providers can do and how they operate, making them essential enablers of any strategic change. “While the goal is integration,” Meates argued, this is undermined if “existing contracts and reporting requirements continue to move in the opposite direction. Contracts give you all the reasons why you can’t change what you are doing.”

Conclusions for the NHS

The transformative journey of Canterbury DHB under David Meates offers critical insights for the NHS as it continues its transitions towards integrated care. The success of Canterbury’s reforms, driven by a commitment to collaboration, system-wide integration, and a focus on patient-centred outcomes, illustrates the importance of addressing systemic fragmentation holistically. According to Meates, people in Canterbury were “30 percent less likely to be admitted medically unwell compared with the rest of New Zealand” because of these reforms.

Canterbury DHB’s experience shows that applying process and quality improvement techniques like Lean and Six Sigma to complex systems such as healthcare is no simple task; it demands a long-term vision and strong commitment from leadership to act. For too long, the NHS has been consumed by day-to-day pressures, and the introduction of ICSs has not been accompanied by the necessary cultural changes that can only clear, top-down strategic direction can bring.

Additionally, while the NHS has sought to place greater emphasis on citizen-centred care, it still often fails to adequately engage marginalised communities and provide co-designed, holistic care services that meet their needs. The establishment of community diagnostic centres is certainly a positive step in this regard, more needs to be done to ensure that these services are accessible and tailored to the unique challenges faced by marginalised and underserved groups. This includes overcoming language barriers, addressing cultural sensitivities and ensuring that services are easily reachable for those most in need. Citizen-centred care required continuous engagement with these communities, fostering trust and enabling them to have an active role in shaping their own health outcomes.

Key lessons from Canterbury DHB include prioritising cultural change, realigning incentives to emphasise system-wide benefits, ongoing community and patient engagement and leveraging technology like shared care records to enhance communication across care settings. By adopting these principles, the NHS can achieve meaningful, sustainable reforms that deliver value for both patients and the wider healthcare system.

Labour needs a preventative health strategy to transform public health

By Tina Woods

Business for Health Founder and CEO, Tina Woods, discusses the crucial role that business can play in improving the nation’s health, and calls on the Labour government to adopt a shift towards evidence-based prevention.

As the new Labour Government enters its early stages in power, it is increasingly clear that the party has inherited a sick workforce, rising levels of economic inactivity and unsustainable pressure on the NHS.

Tackling our current broken health system requires a long-term, multifaceted approach that shifts the UK’s societal attitude from reliance on the NHS to a culture of prevention. Going forward, creating a comprehensive preventative health strategy should be Labour’s focus.

Laying the foundations for a ‘prevention first’ revolution

Labour’s Health Mission in their manifesto states the aim to “deliver a ‘prevention first’ revolution”, and with the right partners and a clear strategy, this vision can become a reality.

While the ambition to halve heart attacks and strokes, create a smoke-free generation, and reduce health inequality are commendable, translating these goals into tangible policy and action will be crucial.

A preventative health strategy must go beyond individual behaviour change and address the wider determinants of health. This includes creating healthy environments, reforming the food system, and ensuring good work and housing for all. Crucially, it requires coordinated action across government departments, and wider businesses.

Easing pressures on hospitals

The UK’s poor public health is placing immense pressure on the NHS, resulting in many hospitals having far too many patients, with far too long waiting lists.

Despite over 95 per cent of the NHS budget being spent on treatment, with little ring-fenced for prevention, preventable conditions like obesity, heart disease, and lung cancer account for a significant proportion of hospital admissions and healthcare costs.

The government should set a target to allocate a specific percentage of the total health budget to evidence-based prevention programmes within 5 years, rising by 2030. Moving more pathways of care into community health will alleviate pressure on hospitals and create a more sustainable healthcare system. To support in setting and managing these targets, Business for Health has partnered with the Office for National Statistics (ONS) to deliver an enhanced ONS Health Index which will be vital in tracking against the Government’s health and wellbeing plans.

Business is essential in prevention

Alongside the NHS, businesses also have a crucial role to play in this agenda, and the Labour government must work to cultivate meaningful partnerships with the private sector.

By creating incentives and frameworks for improving health, small and medium-sized enterprises can be encouraged to do more; exploring legislation, such as making workplace health reporting mandatory for larger companies, is another driver. To support businesses in creating these strategies, the next iteration of the ONS Health Index will include additional data and tools which businesses will be able to use to understand the health of their workforce and customers better.

Looking ahead, business leaders and employees alike will be eager to see legislation and clear targets from the Labour government, accompanied by investment to support a prevention economy. Businesses are essential partners in creating healthy workplaces, promoting active lifestyles, and tackling issues like obesity and mental ill-health.

A prescription for the future

Ultimately, Labour’s health agenda must move beyond short-term fixes and invest in long-term system change. This will require bold political leadership, a willingness to tackle vested interests, and a collaborative, cross-party approach bringing together government, business, communities and individuals. Only then can we build a healthier, more prosperous future for the nation.

*Tina Woods, CEO and Founder, Business for Health*

ONS and Business for Health partner to enhance the ONS Health Index

By Integrated Care Journal

The Index will capture a wide range of health inputs, including wider societal and economic determinants, to fill the evidence gap on the interplay between health, business and work and encourage businesses to take responsibility for their impacts on health.

Business for Health and the Office for National Statistics (ONS) have announced a collaboration to develop the next iteration of the ONS Health Index – a tool to support businesses, local authorities, integrated care boards, and government on decisions to ‘invest for health and economic growth’ and inform the Treasury on the economic case for prevention.

The ONS Health Index, last published in summer 2023, measures health in its broadest terms and seeks to understand how it is changing over time. It tracks health in clinical terms (i.e. the prevalence of certain conditions), but also looks at the wider social, economic and environmental drivers of health, together with personal circumstances.

Building on these measures, the enhanced ONS Health Index will include additional data and tools relevant to businesses and their practices. These could range from capturing direct health impacts on employees and customers, to environmental impacts of a company’s products. This will increase the understanding of the interplay between health and business and work life and fill an important evidence gap. For example, it could be used at a local level to help measure corporate progress against key health and wellbeing aims.

More broadly, the additional business themed metrics will inform strategies around the link between health and wellbeing and workforce productivity, and the role of health within the Environmental Social and Governance discussion.

Business for Health, a business-led social venture, in collaboration with Lane Clark & Peacock (LCP), have identified demand from businesses and organisations for the continuation and enhancement of this tool to define their role in the economy and wider society.

They will engage with businesses to develop the next iteration of the Index that provides high-value data on the health and well-being of the nation, including the workforce. One of the key goals will be to encourage businesses to understand and take responsibility for their impacts on health. To this end, the next iteration of the ONS Health Index will seek to bring businesses into its core audiences and provide health-relevant data to the public that measures the impact of businesses on population health.

These additional data will aim to highlight key determinants influencing employee health, and in doing so, inform business decision-making and support organisational and corporate culture with health at its core.

With the UK’s general population currently facing significant health challenges, leading to long term economic inactivity and pressures on the health system, the enhancement of the ONS Health Index will enable focus on facilitating system change to improve health and wealth outcomes. This is vital for enhancing the health and economic resilience of the nation.

Tina Woods, CEO and Founder of Business for Health, said: “There is a clear need from businesses to receive better data on the role of health within wider workforce planning. The link between corporate culture and individuals’ physical and mental wellbeing is irrefutable and our role on the new ONS Health Index will act as a crucial tool in understanding how businesses can improve, report and measure their impact on health linked to economic growth.”

Lord Bethell, Former Health and Innovation Minister and Chair of Business for Health, said: “We are delighted to be working with the ONS and LCP to develop the next iteration of the ONS Health Index, which will differentiate itself by allowing companies to understand and define their social purpose alongside measuring their economic contribution.”

Jonathan Pearson Stuttard, Head of Health Analytics at LCP, said: “There is a need for employers, businesses and industry partners to work collaboratively with the government to ensure that long-term health challenges are tackled with the urgency that is required.”

Dr James Tucker, Deputy Director of Health, International and Partnerships, Office for National Statistics, said: “The importance of high-quality data to inform strategies and reporting on the health of our workforce is crucial. Working with businesses as core users of the next ONS Health Index will be key in accessing granular data from businesses to feed into the index and provide relevant health data.