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* What's happened to our economy and what does it mean for our health? Many developed economies have been growing more slowly since around 2008, but the UK economy has been struggling more than most. Wages haven't risen since 2008 leaving the average worker £14,000 worse off. Productivity growth – vital to rising living standards – has stalled. Regional inequalities are unusually large, and economic hardship is widespread with 2.8 million people reporting not working because of long-term sickness. So what’s driving this economic stagnation, how is it connected to our health, and what can politicians do to address the challenges? To discuss, our Chief Executive Jennifer Dixon is joined by: __ DIANE COYLE, Bennett Professor of Public Policy at the University of Cambridge and Co-Director of the Bennett Institute. TORSTEN BELL, Chief Executive of the Resolution Foundation. __ * SHOW NOTES The Health Foundation (2023). The unsustainable is not sustained: why productivity is fundamental to the future of the NHS https://www.health.org.uk/publications/reports/the-unsustainable-is-not-sustained-productivity-future-NHS. The Resolution Foundation (2023). Ending stagnation: a new economic strategy for Britain https://economy2030.resolutionfoundation.org/reports/ending-stagnation/. The Health Foundation (2023). What we know about the UK’s working-age health challenge https://www.health.org.uk/publications/long-reads/what-we-know-about-the-uk-s-working-age-health-challenge. Coyle D and Muhtar A (2022). . Levelling up policies and the failure to learn https://www.tandfonline.com/doi/full/10.1080/21582041.2023.2197877. Bennett Institute for Public Policy (2023). A Universal Basic Infrastructure for the UK https://www.bennettinstitute.cam.ac.uk/blog/ubi-for-uk/. The Resolution Foundation (2024) (funded by the Health Foundation). We’ve only just begun: action to improve young people’s mental health, education and employment https://www.resolutionfoundation.org/publications/weve-only-just-begun/.
* Given the huge pressures on the NHS it's perhaps inevitable people ask, what's the future of it? The NHS and social care are struggling to deliver care and support to people who need it. With services so stretched, waiting times at record highs, public satisfaction falling and a demoralised workforce, is now the time to ask some fundamental questions about the NHS? In the past month, two independent commissions on the future of the NHS have reported – the Times Commission in early February, and the first of several papers from the BMJ Commission at the end of January. We speak to the commission chairs about what they found out and what they’d like to see future governments prioritise on health. And given the tight squeeze on public funds, what will it take to truly put the NHS on a sustainable footing? To discuss, our Chief Executive Jennifer Dixon is joined by: __ __
* About a fifth of us of working age – just under 9 million people in the UK – are not looking for or are not able to work. Recently the biggest growth has been among those reporting long-term illness, now at a record high of around 2.7 million. This decline in working-age health is causing concern among employers, politicians and policymakers. Earlier this month the Health Foundation launched an independent Commission for Healthier Working Lives https://www.health.org.uk/commission-for-healthier-working-lives to build consensus around the kind of action needed. So what’s going on, and what do the solutions look like both at a local and national level? To discuss, our Chief Executive Jennifer Dixon is joined by: __ SACHA ROMANOVITCH, Chief Executive of Fair4All Finance. Sacha is a member of the government’s levelling up Advisory Council, and Chair of the Commission for Healthier Working Lives, which is supported by the Health Foundation. OLIVER COPPARD, Mayor of South Yorkshire. Oliver was elected as the Labour Co-op mayoral candidate in May 2022. Oliver sits on a commission led by Alan Milburn, former Secretary of State for Health, investigating economic activity in Barnsley. __
* Join us as we look back at the pick of the pod in 2023. It's been a turbulent year: the NHS under pressure, the health of the population not improving as fast as we’d like and economic inactivity remaining stubbornly high, especially among working-age people. But it's not all gloom. To some surprise, we saw government ditch its nanny state objections and take bold action on tobacco. And there have been breath-taking advances in technology, not least in artificial intelligence. A reminder that innovation and politics can open up new possibilities and hope for the future. Join our Chief Executive Dr Jennifer Dixon as we reflect with guests who appeared on the podcast in 2023. SHOW NOTES __ Alice Wiseman and Clare Bambra, Low life expectancy in the north east, and what to do about it https://www.health.org.uk/news-and-comment/podcast/low-life-expectancy-in-the-north-east-and-what-to-do-about-it Rachel Wolf and Stephen Bush, What do the main political parties really have in store for health? https://www.health.org.uk/news-and-comment/podcast/what-do-the-main-political-parties-really-have-in-store-for-health-with-rachel-wolf-and-stephen-bush Jagjit Chadha and Anita Charlesworth, NHS at 75: What are we up against? https://www.health.org.uk/news-and-comment/podcast/nhs-at-75-what-are-we-up-against-with-professor-jagjit-chadha-and-anita-charlesworth John Bell and Axel Heitmueller, AI in health care: hope or hype? https://www.health.org.uk/news-and-comment/podcast/ai-in-health-care-hope-or-hype-with-professor-sir-john-bell-and-dr-axel-heitmueller Ashish Jha, Keeping up with AI in health care: what we need to do next https://www.health.org.uk/news-and-comment/podcast/keeping-up-with-ai-in-health-care-what-we-need-to-do-next Navina Evans and Penny Pereira, NHS at 75: The huge promise of technology https://www.health.org.uk/news-and-comment/podcast/nhs-at-75-the-huge-promise-of-technology-with-navina-evans-and-penny-pereira Jane Dacre, Nikita Kanani and Gabrielle Mathews, International Women’s Day: Voices in health care https://www.health.org.uk/news-and-comment/podcast/international-womens-day-voices-in-health-care Alan Milburn and Stephen Dorrell, NHS at 75: Is political leadership up to the challenge? https://www.health.org.uk/news-and-comment/podcast/nhs-at-75-is-political-leadership-up-to-the-challenge-with-alan-milburn-and-stephen-dorrell __
* AI technologies are advancing rapidly. Yet when it comes to AI in health care we're still in the early stages. The prize could be big – the question is what will it take to realise the benefits? The applications of AI in health care will be far-reaching and profound, from high-quality personalised treatment advice made instantly available to automated systems that can cut bureaucracy, free up staff time and reduce costs. All this is exciting and could help with some of the big challenges ahead. But what of the risks? The current emphasis among policymakers is on AI safety – but a range of other considerations will need attention like serving the public interest, inclusion, cost, accountability, autonomy, privacy and more. And how can the NHS and social care rapidly get up to speed with all these developments? Join our Chief Executive Jennifer Dixon on location with expert guests including: Effy Vayena (Professor of Bioethics at the Swiss Institute of Technology); Alastair Denniston (Consultant Ophthalmologist and Honorary Professor at the University of Birmingham); Ashish Jha (Dean of Public Health at Brown University) and David Cutler (Professor of Applied Economics at Harvard University). SHOW NOTES The Health Foundation (2023). What do technology and AI mean for the future of work in health care? House of Commons Science, Innovation and Technology Select Committee (2023). The governance of artificial intelligence: interim report https://committees.parliament.uk/committee/135/science-innovation-and-technology-committee/news/197236/ai-offers-significant-opportunities-but-twelve-governance-challenges-must-be-addressed-says-science-innovation-and-technology-committee/. UK government (2023). UK's AI Safety Summit 2023 https://www.gov.uk/government/topical-events/ai-safety-summit-2023. Institute for Government (2023). How is the UK government approaching regulation of AI? Financial Times (2023). How will AI be regulated? Air Street Capital (2023). State of AI report https://www.stateof.ai/. OECD. OECD Artificial Intelligence Papers https://www.oecd-ilibrary.org/science-and-technology/initial-policy-considerations-for-generative-artificial-intelligence_fae2d1e6-en. The White House (2023). Fact Sheet: President Biden Issues Executive Order on Safe, Secure, and Trustworthy Artificial Intelligence //www.whitehouse.gov/briefing-room/statements-releases/2023/10/30/fact-sheet-president-biden-issues-executive-order-on-safe-secure-and-trustworthy-artificial-intelligence/#.
* A GENERAL ELECTION IS EXPECTED IN 2024 AND NO PARTY CAN IGNORE THE NHS − BUT WHAT DO THEY PLAN TO DO ON HEALTH? The health service regularly tops voter concerns, consumes a growing share of public spending and features daily in the media. The health of the nation is also moving up the agenda, with ill health the main reason why 2.6 million working-age people are economically inactive. So what are the main parties planning as we move towards an election and have the party conferences revealed anything new? To discuss, our Chief Executive Jennifer Dixon is joined by: __ RACHEL WOLF, Partner at Public First, a consultancy specialising in public policy, public opinion and campaign strategy. STEPHEN BUSH, Associate Editor and Columnist at the Financial Times. __ * SHOW NOTES The Health Foundation (2023). Health in 2040: projected patterns of illness in England https://www.health.org.uk/publications/health-in-2040. The Health Foundation (2023). Public perceptions of health and social care: what are the priorities ahead of a general election? https://www.health.org.uk/publications/long-reads/public-perceptions-health-and-social-care-priorities-general-election The Health Foundation (2023). What should be at the top of the political agenda for health and care? https://www.health.org.uk/news-and-comment/blogs/what-should-be-at-the-top-of-the-political-agenda-for-health-and-care The Health Foundation (2023). Health Foundation responds to the Prime Minister’s announcement of smoke-free measures https://www.health.org.uk/news-and-comment/news/health-foundation-responds-to-the-prime-minister-s-announcement-of-smoke-free-measures. The Health Foundation (2023). Social health insurance: be careful what you wish for https://www.health.org.uk/news-and-comment/blogs/social-health-insurance-be-careful-what-you-wish-for. Institute for Government (2023). The NHS productivity puzzle: why has hospital activity not increased in line with funding and staffing? https://www.instituteforgovernment.org.uk/publication/nhs-productivity The Times. Tories as the party of change: that’s a hard sell https://www.thetimes.co.uk/article/tories-as-the-party-of-change-thats-hard-to-sell-3qmxkkr7v (2023). Ipsos. Ipsos issues tracker: July 2023 https://www.ipsos.com/sites/default/files/ct/news/documents/2023-07/Ipsos_Issues_Index_July23_charts.pdf (2023).
* A record 7.7 million people are now waiting for elective care in England. With so many waiting for NHS care, polls show deep public concern over access to health services and many considering going private. Meantime policymakers are exploring how the independent sector can help get waiting lists down, and private equity investors are making moves in the independent health care provider market. So does this mean we’re slowly sliding towards a mixed model of health care in this country? And if so, is it a good thing or should we be worried? To discuss, our Chief Executive Jennifer Dixon https://www.health.org.uk/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ SARAH NEVILLE, Global Health Editor at the Financial Times. HETTIE O'BRIEN, Assistant Editor at the Guardian and currently researching a book investigating the role of private equity in the contemporary economy and public services. __
__ __ * Other reading __ The Health Foundation (2022). Is poor health driving a rise in economic inactivity? https://www.health.org.uk/news-and-comment/charts-and-infographics/is-poor-health-driving-a-rise-in-economic-inactivity __
* As we approach the NHS’s 75th birthday in July, we’re releasing a series of three podcast episodes setting out the big questions facing the health service. This second episode explores the role of political leadership in addressing the big challenges in health care, whether political leadership is up to the task of getting the NHS to its 100th anniversary – and if not, how could it improve? * To discuss, our chief executive Dr Jennifer Dixon is joined by: __ ALAN MILBURN, Labour MP for nearly 20 years to 2010. During the Blair government, Alan held a number of ministerial roles including Secretary of State for Health from 1999 to 2003. Alan currently serves as chair of the Social Mobility Foundation and Chancellor of Lancaster University. STEPHEN DORRELL, Conservative MP for over three decades to 2015. Stephen served as Secretary of State for Health from 1995 until the 1997 general election, and as chair of the House of Commons Health Select Committee from 2010 to 2014. Since leaving parliament, Stephen spent time as chair of NHS Confederation, and joined the Liberal Democrats. __ SHOW NOTES __ The Health Foundation (2021) The most expensive breakfast in history https://www.health.org.uk/publications/reports/revisiting-the-Wanless-review __
* – so said former health secretary, Kenneth Clarke. Well, can that miracle continue? As we approach the NHS’s 75th birthday in July, we’re launching a series of three podcast episodes setting out the big questions facing the health service. This first episode explores current pressures on the NHS, economy and wider society and what the future might hold. What are the questions that policymakers may face as the population’s health and care needs change over the coming decade? How can the UK economy power the investment needed for health services to survive and thrive? And how can more long-term thinking help to foster good health and economic productivity? To discuss, our chief executive Dr Jennifer Dixon is joined by: __ PROFESSOR JAGJIT CHADHA, Director of the National Institute of Economic and Social Research and chair of the UK Productivity Commission ANITA CHARLESWORTH, Director of Research and the REAL Centre at the Health Foundation. __ SHOW NOTES * NIESR (2023). UK economic outlook – Spring 2023 https://www.niesr.ac.uk/publications/uk-economy-sluggish-growth-high-inflation?type=uk-economic-outlook Chadha (2023). ‘Commentary: fixing the mix’ https://www.niesr.ac.uk/publications/fixing-mix?type=national-institute-economic-review. National Institute Economic Review. Office for National Statistics (2022) National population projections https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationprojections/bulletins/nationalpopulationprojections/2020basedinterim Health Foundation (2022). How many hospital beds will the NHS need over the coming decade? https://www.health.org.uk/publications/reports/how-many-beds-will-the-nhs-need-over-the-coming-decade Health Foundation (2022). How does UK health spending compare across Europe over the past decade? https://www.health.org.uk/news-and-comment/charts-and-infographics/how-does-uk-health-spending-compare-across-europe-over-the-past-decade Health Foundation (2022). NHS workforce projections 2022 https://www.health.org.uk/publications/nhs-workforce-projections-2022 Health Foundation (2022). Health is wealth? Strengthening the UK’s immune system https://www.health.org.uk/publications/reports/health-is-wealth
* How healthy we are in part depends on the many different exposures we've had over our life – including to physical, psychological and social factors. Chronic exposure to psychosocial stress – for example, poverty or other disadvantage – leads to prolonged strain on the body. This weathering can make us physically ill before our time and prematurely age us. So what is psychosocial stress, how does it harm our health and what can be done about it? To discuss, our chief executive Dr Jennifer Dixon https://www.health.org.uk/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ DR MICHELLE KELLY-IRVING, a life course epidemiologist working on health inequalities and the social determinants of health. Michelle is a director at Inserm in Toulouse, part of France's National Institute of Health and Medical Research. PROFESSOR NISH CHATURVEDI, Professor of Clinical Epidemiology at University College London and Director of the Medical Research Council Unit for Lifelong Health and Ageing. __ SHOW NOTES __ __
* News of artificial intelligence (AI) is everywhere. We seem to be on the cusp of a revolution in how the latest AI models will change our lives – and health and care could be at the centre of those changes. AI will transform medicine, AI will allow doctorless screening and personalised prevention, AI will boost productivity, AI will make thousands of jobs redundant – so go all the claims. But is this hype or real hope? How will AI transform health and care services and the experiences of staff and patients? What’s been the progress so far? And how best to move forward safely? And with growing demand, staff shortages and a public spending squeeze, could AI be a key answer to sustaining the NHS itself? To discuss, our chief executive Dr Jennifer Dixon is joined by: __ PROFESSOR SIR JOHN BELL, Regius Professor of Medicine at the University of Oxford and an adviser to the government on life sciences strategy, and to Sir Patrick Vallance’s current review of how to regulate emerging technologies. DR AXEL HEITMUELLER, Managing Director of Imperial College Health Partners. Axel has also worked as a senior analyst in the Cabinet Officer and Number 10 Downing Street. __ SHOW NOTES * European Parliamentary Research Services (2022) AI in healthcare: applications, risks and ethical and societal impacts https://www.europarl.europa.eu/stoa/en/document/EPRS_STU(2022)729512 Health Education England (2022) AI Roadmap: methodology and findings report Health Education England (2019) The Topol Review: Preparing the healthcare workforce to deliver the digital future https://topol.hee.nhs.uk/the-topol-review/ The Health Foundation (2021) Switched on: how do we get the best out of automation and AI in health care? https://www.health.org.uk/publications/reports/switched-on HM Government (2021) National AI Strategy https://www.gov.uk/government/publications/national-ai-strategy HM Government (2018) Artificial intelligence sector deal https://www.gov.uk/government/publications/artificial-intelligence-sector-deal HM Government (2017) Industrial Strategy: Building a Britain fit for the future https://www.gov.uk/government/publications/industrial-strategy-building-a-britain-fit-for-the-future
* Today, women make up around half of all doctors and two-thirds of all medical students. So, has equality in health care finally been achieved? When International Women’s Day began in 1909, women were still barred from entering medical school. Today women make up a growing share of the medical workforce and students in the UK. Despite this considerable progress, research indicates that today women in health care are under-represented in leadership roles, are paid less than male colleagues on average, and still all too often encounter sexism and discrimination. To mark International Women’s Day 2023, we invited three female leaders at different stages of their careers in health care to reflect on the expectations, experiences and challenges that have shaped their professional journeys and what needs to happen to continue building a truly inclusive workforce. To discuss, our chief executive Dr Jennifer Dixon https://www.health.org.uk/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ DAME JANE DACRE, emeritus professor at UCL Medical School, chair of the Health and Social Care Select Committee’s expert panel and former president of the Royal College of Physicians DR NIKITA KANANI, director of clinical integration at NHS England and deputy senior responsible officer for the NHS COVID-19 vaccination programme and a GP in south east London DR GABRIELLE MATHEWS, NHS Assembly Member (NHS England) and a doctor at North Middlesex University Hospital NHS Trust. __ SHOW NOTES * World Health Organisation (2019) Gender equity in the health workforce World Health Organisation (2019) Delivered by women, led by men: A gender equity analysis of the global health and social workforce British Medical Association (2021) Sexism in medicine General Medical Council (2022) The state of medical education and practice in the UK: the workforce report Royal College of Physicians (2009) Women and medicine: the future https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4952492/ The Nuffield Trust (2018) The gender pay gap in the English NHS Institute for Fiscal Studies (2023) Progress of parents in NHS medical and nursing careers Dacre et al (2020) Independent review into gender pay gaps in medicine https://www.gov.uk/government/publications/independent-review-into-gender-pay-gaps-in-medicine-in-england
* Improvements to life expectancy slowed in the last decade, and in some communities even went into reverse. In England, the north east region has the lowest life expectancy. The last decade and a half has seen a worrying increase in mortality among younger people, and in particular men who are dying before their time. A big chunk of this excess mortality seems to be down to so called ‘deaths of despair https://www.health.org.uk/news-and-comment/podcast/episode-04-deaths-of-despair’ – that’s deaths by suicide, violent injury and substance misuse. So what's going on? And what can be done about it? To discuss, our chief executive Dr Jennifer Dixon https://www.health.org.uk/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ DR ALICE WISEMAN, Director of Public Health at Gateshead Council. PROFESSOR CLARE BAMBRA, professor of public health at Newcastle University. __ SHOW NOTES __ __
* WHAT A ROLLERCOASTER YEAR IT'S BEEN. IN THIS CHRISTMAS ROUND-UP, WE'RE LOOKING BACK OVER OUR 2022 PODCAST EPISODES AND PULLING OUT SOME TOP INSIGHTS FOR YOU TO REFLECT ON. Our chief executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon shares clips from: __ __
* We're all familiar with some of the challenges ahead in the UK: a fiscal squeeze, limp productivity, a labour shortage and an ageing population with increasing needs. As Andy Haldane put it in our recent REAL Challenge lecture, two routes to prosperity for the UK include increasing the number of workers and their productivity. But both of these routes now appear to be hampered by increasing ill health. * Since the pandemic, 600,000 working people have become economically inactive – that’s the size of the city of Manchester taken out of the economy. Two-thirds are the over 50s who've left and aren't looking for work. And at the other end of life, younger people entering work are reporting markedly more ill health due to depression and anxiety, and more young men in particular are economically inactive. Can we carry on like this if our economy is to recover? Or is it now time for us to get serious about these trends, and how? To discuss, our chief executive Dr Jennifer Dixon is joined by: __ SARAH O’CONNOR, employment columnist at the Financial Times. JAMES BANKS, Professor of Economics at the University of Manchester and Senior Research Fellow at the Institute for Fiscal Studies. __ SHOW NOTES __ Health is wealth? REAL Challenge annual lecture (2022) The Health Foundation https://www.health.org.uk/about-the-health-foundation/get-involved/events/health-is-wealth Is poor health driving a rise in economic inactivity? (2022) The Health Foundation https://www.health.org.uk/news-and-comment/charts-and-infographics/is-poor-health-driving-a-rise-in-economic-inactivity Proportion of UK workers on low pay at lowest level since 1997 (2022) Financial Times https://www.ft.com/content/ad3f6134-cf38-4a7e-b624-304b680ab9b7 There is a deepening mental health recession (2022) Financial Times https://www.ft.com/content/d5dc1d64-1f7b-4776-89fa-cad55e4f87d2 Is worsening health leading to more older workers quitting work, driving up rates of economic inactivity? (2022) IFS https://ifs.org.uk/articles/worsening-health-leading-more-older-workers-quitting-work-driving-rates-economic The rise in economic inactivity among people in their 50s and 60s (2022) IFS https://ifs.org.uk/publications/rise-economic-inactivity-among-people-their-50s-and-60s Half a million more people are out of the labour force because of long-term sickness (2022) ONS https://www.ons.gov.uk/employmentandlabourmarket/peoplenotinwork/economicinactivity/articles/halfamillionmorepeopleareoutofthelabourforcebecauseoflongtermsickness/2022-11-10#:~:text=The%20number%20of%20working%2Dage,2.5%20million%20in%20summer%202022. Reasons for workers aged over 50 years leaving employment since the start of the coronavirus pandemic: wave 2 https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/articles/reasonsforworkersagedover50yearsleavingemploymentsincethestartofthecoronaviruspandemic/wave2 New Polling for Phoenix Insights (2022) Public First https://www.publicfirst.co.uk/new-polling-for-phoenix-insights-2.html Mental health conditions, work and the workplace (2022) Health and Safety Executive https://www.hse.gov.uk/stress/mental-health.htm Labour Market Statistics, October 2022 (2022) Institute for employment studies https://www.employment-studies.co.uk/resource/labour-market-statistics-october-2022 Economic inactivity and the labour market experience of the long-term sick (2022) Jonathan Haskel and Josh Martin https://t.co/B06wJvPUJJ __
* We don’t like to think about death. To many, death and dying have no value and are relegated to the margins of our lives. But about half a million of us in Britain die each year, mostly in our 80s, with half of us dying in our usual place of residence – in our own bed. With palliative care stretched and family and friends often left unsupported, what could be an enriching and meaningful phase of life can become over-medicalised, transactional and feared. There have been many attempts over recent years to normalise conversations on death, and in January this year published its commission on the value of death following a five-year inquiry. So how could we die better in the UK? Or as commission puts it, how do we bring death back into life? To discuss, our chief executive Dr Jennifer Dixon is joined by the two lead authors of the commission: __ RICHARD SMITH, currently Chair of the UK Health Alliance on Climate Change. Richard’s former roles include editor of the BMJ, chair of the board of trustees of the International Centre for Diarrhoeal Disease Research, Bangladesh and director of the UnitedHealth Chronic Disease Initiative. LIBBY SALLNOW, Palliative medicine consultant at CNWL & UCLH and honorary senior clinical lecturer in new public health approaches at St Christopher's & UCL. __ SHOW NOTES __ __
* A new Prime Minister, government and health secretary, all facing a formidable array of challenges. Prime Minister Liz Truss has said that putting the NHS ‘on a firm footing’ is one of her top three priorities (alongside the economy and energy). Meanwhile, Health Secretary Thérèse Coffey has said her priorities are ABCD (ambulances, backlog, care and doctors and dentists), and since the podcast recording she has set out the government's plans https://www.health.org.uk/news-and-comment/news/tiny-fixes-in-the-face-of-huge-challenges. So how will this translate to the NHS, social care and improving the UK’s health? Will government have the bandwidth before an election to address more than the day-to-day pressures? And if a Truss government won a general election with a mandate to do more, what form would it take? To discuss, our chief executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ RACHEL WOLF, Founding Partner at Public First. Rachel is also on the Board of the Centre for Policy Studies, co-authored the Conservative Party’s Election Manifesto in 2019 and was previously education and innovation adviser to the Prime Minister at 10 Downing Street. ISABEL HARDMAN, Assistant Editor at . Isabel has authored two books – and and is currently finishing a third on the NHS. __ SHOW NOTES __ Rachel Wolf, Public First, A few thoughts on the Downing Street policy unit https://www.publicfirst.co.uk/a-few-thoughts-on-the-downing-street-policy-unit.html Rachel Wolf, Conservative Home, Truss’s in tray 3) Rachel Wolf: Levelling Up. There is no time for another new approach. The new Prime Minister must focus on delivery https://conservativehome.com/2022/08/31/trusss-in-tray-3-rachel-wolf-there-is-no-time-for-another-new-approach-she-must-focus-on-delivery/ Isabel Hardman, The Spectator, Is Coffey good for health? Thérèse Coffey is expected to become Deputy Prime Minister and Health Secretary. What's the significance? https://www.spectator.co.uk/article/is-coffey-good-for-health- Isabel Hardman, The Spectator, Can Liz Truss deliver, deliver, deliver? https://www.spectator.co.uk/article/can-liz-truss-deliver-deliver-deliver-%20 The Health Foundation, Public perceptions of health and social care: what the new government should know https://www.health.org.uk/publications/reports/public-perceptions-of-health-and-social-care-what-government-should-know The Health Foundation, Waiting for NHS hospital care: the role of the independent sector https://www.health.org.uk/publications/long-reads/waiting-for-nhs-hospital-care-the-role-of-the-independent-sector __
* In meeting the huge challenges facing the NHS, technology is often looked to as the great hope. Yet studies suggest good management is a more active ingredient for success. Over the years numerous reports have called for more clinicians to manage the NHS, highlighting their deep knowledge of clinical care, and insight and credibility to make effective change. Now, over a third of all NHS chief executives hold a clinical qualification and about a third of jobbing clinicians have part-time management roles too. But that’s still only a third, and getting trained in management is patchy and haphazard – a finding echoed in the recent Messenger Review https://www.gov.uk/government/publications/health-and-social-care-review-leadership-for-a-collaborative-and-inclusive-future/leadership-for-a-collaborative-and-inclusive-future of health and social care leadership. How can we support more clinicians to manage the NHS, and learn from those who already do it well? To discuss, our chief executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ DR STEPHEN SWENSEN, Senior Fellow at the Institute for Healthcare Improvement. https://www.ihi.org/ Stephen worked at the world-leading Mayo Clinic in Minnesota for three decades, overseeing the development of over 4,000 physicians and 200 leaders. DR DOMINIQUE ALLWOOD, Chief Medical Officer and Academic Health Science Network Deputy at UCLPartners https://uclpartners.com/, where her focus is on clinical engagement and management. Dominique is an experienced medical leader and an expert in quality improvement. __ SHOW NOTES __ Management Lessons from Mayo Clinic Inside One of the World's Most Admired Service Organizations https://blackwells.co.uk/bookshop/product/9781260011838?gC=5a105e8b&gclid=CjwKCAjw6MKXBhA5EiwANWLODPClSerwpzQOMJRuMj4Q-UlBlk8kc3CWsoZprJWQ7XLhX0-9OFwBYhoCu8kQAvD_BwE (2017) Leonard L. Berry, Kent D. Seltman Mayo Clinic Strategies To Reduce Burnout: 12 Actions to Create the Ideal Workplace https://www.waterstones.com/book/mayo-clinic-strategies-to-reduce-burnout/stephen-swensen/tait-shanafelt/9780190848965 (2020) Stephen Swenson, Tait Shanafelt Strengthening NHS management and leadership: Priorities for reform https://www.health.org.uk/publications/long-reads/strengthening-nhs-management-and-leadership (2022) The Health Foundation Leadership for a collaborative and inclusive future https://www.gov.uk/government/publications/health-and-social-care-review-leadership-for-a-collaborative-and-inclusive-future/leadership-for-a-collaborative-and-inclusive-future (2022) Sir Gordon Messenger Five recommendations for strengthening NHS management and leadership https://www.health.org.uk/news-and-comment/blogs/five-recommendations-for-strengthening-nhs-management-and-leadership?utm_campaign=13284860_NHS%20Management%20%20June%202022%20%20Warm&utm_medium=email&utm_source=The%20Health%20Foundation&dm_t=0,0,0,0,0 (2022) The Health Foundation __
* The pandemic challenged every health care system in the world. But what can we learn from one another aboutin the way we responded, and how we might improve for future threats? * In this episode we look up close at the experience of two large academic teaching hospitals embedded in two different health care systems – the Charité in Berlin, Germany’s largest teaching hospital, and Imperial College Healthcare NHS Trust in London, one of the UK’s largest. * How do these two health care systems compare when dealing with the pandemic and its aftermath? And what can we learn? * Our Chief Executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ PROFESSOR HEYO KROEMER, chief executive of Charité – Universitätsmedizin Berlin https://www.charite.de/en/, one of the largest hospitals in Europe. A pharmacologist by trade, Heyo joined Charité in 2019 from the University of Göttingen’s Medical Center, where he held the positions of Dean and Chairman of the Managing Board. PROFESSOR TIM ORCHARD, chief executive of Imperial College Healthcare https://www.imperial.nhs.uk/. NHS Trust. A consultant physician and gastroenterologist, Tim was appointed chief executive in June 2018 after having been the director of clinical studies at St Mary’s Hospital. __ SHOW NOTES __ How does the NHS compare internationally? big election questions https://www.kingsfund.org.uk/publications/articles/big-election-questions-nhs-international-comparisons (2017) The King’s Fund NHS hospital beds data analysis https://www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/nhs-hospital-beds-data-analysis (2022) BMA How does the UK compare internationally for health funding, staffing and hospital beds? https://www.health.org.uk/chart/chart-how-does-the-uk-compare-internationally-for-health-funding-staffing-and-hospital-beds (2017) The Health Foundation Performance of UK National Health Service compared with other high income countries: observational study http://chrome-extension//efaidnbmnnnibpcajpcglclefindmkaj/https://www.bmj.com/content/bmj/367/bmj.l6326.full.pdf (2019) BMJ What can England learn from the long-term care system in Germany? https://www.nuffieldtrust.org.uk/research/what-can-england-learn-from-the-long-term-care-system-in-germany (2019) Nuffield Trust Taxes and health care funding: how does the UK compare? https://www.health.org.uk/news-and-comment/charts-and-infographics/taxes-and-health-care-funding-how-does-the-uk-compare (2021) The Health Foundation __
* Ask the public about health, and they often put the responsibility on the individual and the NHS. * And yet we know the context in which we live and make choices really matters. The context that governments, businesses, employers and investors have a big hand in shaping. * Polling shows the public is increasingly seeing the government as having an important role to play in improving people's health, and there's public appetite to reduce the health inequalities highlighted by the pandemic. * So how does the public think about health? And what can be done to engage local communities in improving health? * Our Chief Executive Dr Jennifer Dixon https://www.health.org.uk/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ DR JACQUI DYER MBE, co-founder and CEO of Black Thrive Global https://blackthrive.org/, a community interest company established in 2016 to address the inequalities affecting the mental health and wellbeing of black people in Lambeth. Jacqui is also a local councillor. JOHN HUME, Chief Executive of the People's Health Trust https://www.peopleshealthtrust.org.uk/, a charity focused on reducing health inequalities through community development. __ SHOW NOTES __ A matter of life and death: explaining the wider determinants of health in the UK https://www.health.org.uk/publications/a-matter-of-life-or-death(2022) FrameWorks Institute Addressing the leading risk factors for ill health https://www.health.org.uk/publications/reports/addressing-the-leading-risk-factors-for-ill-health (2022) The Health Foundation The NHS as an anchor institution https://www.health.org.uk/news-and-comment/charts-and-infographics/the-nhs-as-an-anchor-institution#:~:text=First%20developed%20in%20the%20US,of%20the%20populations%20they%20serve. (2020) The Health Foundation __
* The NHS is experiencing an unusual set of pressures at the moment, with waiting lists of 6.5 million, staff shortages, ambulance delays, long waits and much more. Meanwhile, public satisfaction with the NHS has nosedived, according to the recent British Social Attitudes survey. While politicians acknowledge the challenges and repeat their support for the NHS, outriders on the political right are flexing muscles and calling for more fundamental reform – despite the ink only just drying on the last set of NHS reforms with the Health and Care Bill receiving royal assent. LORD NORMAN WARNER has been top civil servant, health minister from 2003 to 2007 and in the House of Lords for over 20 years, and has written about it all in his new book https://www.bookdepository.com/Pursuit-Competence-Norman-Warner/9781839758416. He joins our Chief Executive Dr Jennifer Dixon to share his insights and reflect on what might be ahead. SHOW NOTES * Norman Warner (2022) In Pursuit of Competence: A Life as a Westminster Nomad NHS (2019) The NHS Long Term Plan NatCen Social Research (2021) British Social Attitudes Survey 38 The Health Foundation (2021) Health and social care funding projections 2021 https://audioboom.com/node/16171 Department of Health and Social Care (2006) Our health, our care, our say: a new direction for community services Duncan Campbell-Smith (2009) Follow the money: the Audit Commission, Public Money and the Management of Public Services, 1983-2008 https://research.aston.ac.uk/en/publications/follow-the-money-the-audit-commission-public-money-and-the-manage
* This year households across the UK are facing the biggest squeeze in living standards since the 1950s. Most of us will feel the impact, but poor households are being hit the hardest. We know that poverty and the stress of debt harms our health in the short and long term. * One role of the state is to provide a welfare safety net. After last month's Spring Statement, what should the government do now to support those experiencing the worst effects of rising costs? What impact on households and health are we already seeing? And what more can be done to help? Our Chief Executive Dr Jennifer Dixon discusses this with expert guests: __ DAME CLARE MORIARTY is chief executive of Citizen’s Advice. She’s a former senior civil servant and served as permanent secretary at the Department for Environment, Food and Rural Affairs and the Department for Exiting the European Union. She was also chair of our COVID-19 Impact Inquiry https://www.health.org.uk/what-we-do/a-healthier-uk-population/mobilising-action-for-healthy-lives/covid-19-impact-inquiry. BIM AFOLAMI MP has been the Conservative MP for Hitchin and Harpenden since 2017. He's on the advisory board of the Money and Mental Health Policy Institute and is chair of the All-Party Parliamentary Group for Financial Markets and Service. He's also patron of two mental health charities in his constituency. __ SHOW NOTES __ The Health Foundation (2022) Response to the Spring Statement https://health.org.uk/news-and-comment/news/a-government-that-truly-valued-the-nations-health-would-have-gone-further-today-to-protect-families Resolution Foundation (2022) Inflation Nation: Putting Spring Statement 2022 in context https://efaidnbmnnnibpcajpcglclefindmkaj/viewer.html?pdfurl=https%3A%2F%2Fwww.resolutionfoundation.org%2Fapp%2Fuploads%2F2022%2F03%2FInflation-nation.pdf&clen=508346 Institute for Fiscal Studies (2022) Analysis of the Spring Statement https://ifs.org.uk/spring-statement-2022 The Health Foundation (2022) Debt https://health.org.uk/evidence-hub/money-and-resources/debt The Health Foundation (2022) Debt and health https://health.org.uk/publications/long-reads/debt-and-health The Health Foundation (2020) Living in poverty was bad for your health long before COVID-19 https://www.health.org.uk/publications/long-reads/living-in-poverty-was-bad-for-your-health-long-before-COVID-19 Financial Times (2022) Chancellor provides minimal help to households on cost of living crisis https://www.ft.com/content/31786311-7c07-433c-9485-5e735ea3fb43 __
* For the last decade, gains in life expectancy have been stalling. We’re living more years in poor health too, with a 20 year gap in healthy life expectancy between women living in the richest and poorest areas. * The biggest risk factors driving the UK‘s high burden of ill health are smoking, poor diet, physical inactivity and harmful alcohol use. All are socioeconomically patterned and contribute significantly to widening health inequalities. * There have been many policies proposed to help over the years, and the government has already set a target to increase healthy life expectancy by five years by 2035 and reduce inequality. But at the current rate of progress this will take nearly 200 years https://www.health.org.uk/news-and-comment/charts-and-infographics/healthy-life-expectancy-target-the-scale-of-the-challenge, not 12, to reach. * Is it time to get much tougher on the risk factors? And if so, how? A recent Health Foundation report https://www.health.org.uk/publications/reports/addressing-the-leading-risk-factors-for-ill-health showed that the government could do a lot more to be effective, but will politics allow national government to do what it takes? * Our Chief Executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ PROFESSOR KEVIN FENTON is regional director for London at the Office for Health Improvement and Disparities, having previously held the same position at Public Health England. He has also been elected to be the next President of the UK Faculty of Public Health and is due to take up the position in June 2022. RICHARD SLOGGETT is the founder and director of Future Health. Between 2018 and 2019 he was Special Advisor to the then Secretary of State for Health and Social Care, working on the prevention green paper. __ SHOW NOTES __ __
* Like many other countries, the UK has a growing drug problem. * In England around 3 million people take drugs and drug deaths are the highest on record at nearly 3,000 a year. In the last decade, heroin-related deaths have more than doubled and cocaine-related deaths have grown fivefold. The situation in Scotland is even worse – now the drug death capital of Europe. * The UK government tackles drugs as a criminal justice matter focused on punishment, rather than a public health matter focused on support. But many countries are taking a different approach, most famously Portugal which in 2000 decriminalised all drugs and concentrated instead on public health and harm reduction. The result? From one of the highest drug death rates in Europe to one of the lowest. * * How did they do it and what can we learn? * Our Chief Executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ DAME CAROL BLACK, who was commissioned by the Home Office and the Department of Health and Social Care to undertake a two part independent review of drugs, to inform the government’s thinking on what more can be done to tackle the harm that drugs cause. DR JOÃO CASTEL-BRANCO GOULÃO, a Portuguese physician and the current national drug coordinator for Portugal. He is credited as being the main architect of Portugal’s drugs policy established in 2000 and since then has advised on drug policy for successive governments. __ SHOW NOTES __ Independent review of drugs https://www.gov.uk/government/collections/independent-review-of-drugs-by-professor-dame-carol-black by Professor Dame Carol Black From harm to hope: A 10-year drugs plan to cut crime and save lives https://www.gov.uk/government/publications/from-harm-to-hope-a-10-year-drugs-plan-to-cut-crime-and-save-lives/from-harm-to-hope-a-10-year-drugs-plan-to-cut-crime-and-save-lives (December 2021) Nutt, D. BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n3066 __
* THOSE OF US WORKING IN HEALTH OFTEN FOCUS ON THE GOVERNMENT AS THE MAIN AGENT TO GET THINGS DONE, ESPECIALLY WHEN IT COMES TO PUBLIC HEALTH. BUT THINK OF ALL THE OTHERS OUT THERE WITH POWER, PARTICULARLY COMMERCIAL AND INVESTMENT POWER. * There are signs that businesses and institutional investors do seem to be getting more interested in health, with some businesses starting to consider their impact on health in their environmental, social and governance (ESG) reporting. * Are we now at a turning point? Or is interest in health temporary? If businesses and investors really want to improve health, how do they best move forward? And can government do more to support them? Our Chief Executive Dr Jennifer Dixon discusses this with expert guests: __ CATHERINE HOWARTH joined ShareAction https://shareaction.org/ as Chief Executive in 2008. ShareAction coordinates civil society activism to promote responsible investment across Europe. Catherine also serves on HM Treasury's Asset Management Taskforce. JOHN GODFREY joined Legal & General https://group.legalandgeneral.com/en in 2006 and is now Director of Corporate Affairs. John has worked in the City of London for over 30 years and from 2016-17 worked at Number Ten Downing Street as Head of Policy for Prime Minister Theresa May. __ SHOW NOTES __ ShareAction, Health: An Untapped Asset – How investors can strengthen returns by improving health outcomes https://shareaction.org/reports/health-an-untapped-asset-how-investors-can-strengthen-returns-by-improving-health-outcomes (September 2021) __
* In another year shaped by the COVID-19 pandemic, we explore some key health policy developments and look ahead to what 2022 might have in store. * With Omicron dominating the headlines and a public inquiry into the handling of COVID-19 on the horizon, has government learned – and acted on – the lessons from the start of the pandemic? * As the NHS faces the huge task of COVID-19 recovery, how will the debate about NHS performance and funding play out? Will the Health and Care Bill going through parliament be ready to come into effect next April, and what might it mean for the health system? * And do the social care cap and recently published white paper move us any closer to the ‘fix’ that is so desperately needed for social care? Our Chief Executive Dr Jennifer Dixon http://about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon is joined by: __ LORD VICTOR ADEBOWALE, Chair of the NHS Confederation. Victor was awarded a CBE for services to the unemployed and homeless people and became a crossbench peer in 2001. HUGH ALDERWICK, Head of Policy at the Health Foundation. Hugh leads our policy team’s work to understand and inform national policies on health and social care in England. __ * USEFUL LINKS __ Taxes and health care funding: how does the UK compare? https://www.health.org.uk/news-and-comment/charts-and-infographics/taxes-and-health-care-funding-how-does-the-uk-compare (The Health Foundation, 2021) Adult social care and COVID-19 after the first wave: assessing the policy response in England https://www.health.org.uk/publications/reports/adult-social-care-and-covid-19-after-the-first-wave (The Health Foundation, 2021) New vision for social care will feel like hollow words without the money to deliver it https://www.health.org.uk/news-and-comment/news/new-vision-for-social-care-will-feel-like-hollow-words-without-the-money-to-deliver-it (The Health Foundation, 2021) __
* For years public satisfaction with the NHS has been highest for general practice. * But even before the pandemic, rising workloads and workforce shortages had left many GPs dissatisfied and stressed. Then add a pandemic into the mix, with GPs instructed to move rapidly from face-to-face consultations to telephone or digital advice as a first step. As the pandemic eases, signs of public frustration are now spilling over to the tabloids, MPs’ in-trays and adding to demand to hospital A&E departments. * Is this a sign of general practice crumbling or are we seeing its rebirth as the old model of care enters the digital age? Do we need a fuller vision for the future of primary care? And what are the government and the NHS doing to manage the fallout from growing frustration among the public and GPs? Our Chief Executive Dr Jennifer Dixon http://www.health.org.uk/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon discusses with three expert guests: __ PROFESSOR KATHERINE CHECKLAND is Professor of Health Policy and Primary Care at the University of Manchester and until recently was a practising GP in rural Derbyshire. SHAUN LINTERN is Health Correspondent at The Independent. DR REBECCA FISHER is Senior Policy Fellow at the Health Foundation, leading policy work on primary care, and is a practising doctor, working two days a week as a GP in an area of high urban deprivation. __ * USEFUL LINKS __ Rebecca Fisher, Ruth Thorlby and Hugh Alderwick (2019) Understanding primary care networks https://www.health.org.uk/publications/reports/understanding-primary-care-networks Martin Roland, HEE Primary Care Workforce Commission (2015) The future of primary care https://napc.co.uk/wp-content/uploads/2017/09/Future_of_primary_care.pdf NHS England (2014) Five Year Forward View https://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf __
* CLIMATE CHANGE IS A GLOBAL HEALTH EMERGENCY. WHAT CAN WE LEARN FROM HOW ‘GREEN’ HAS GONE UP THE AGENDA? AND HOW MIGHT WE APPLY USEFUL LESSONS TO GETTING FURTHER IMPROVEMENTS IN ANOTHER COMPLEX AND DIFFICULT CHALLENGE – IMPROVING THE HEALTH OF THE UK POPULATION AND REDUCING INEQUALITIES? * The increasing frequency and intensity of heatwaves, floods, droughts and storms is already devastating lives and livelihoods around the world. While other countries are far more vulnerable to the health risks of climate change, the UK is not immune. * The UK government and the health and social care system must actively contribute to climate change solutions as part of our global responsibility. In the weeks ahead the UK (along with Italy as a partner) will host COP26, and countries will be showing what action they are taking towards the Paris Agreement goal to limit global warming. * Making progress on climate change will be very challenging. Like improving health, it is a complex problem needing long-term policy commitment and action. What can we learn from efforts and progress so far? And can going greener actually improve the health of people in the UK? In the latest episode of our podcast, our Chief Executive Dr Jennifer Dixon https://audioboom.com/about-the-health-foundation/our-people/directors-team/dr-jennifer-dixon discusses these issues with two expert guests: __ DR FIONA GODLEE is Editor in Chief of the British Medical Journal, a post she’s held since 2005. Fiona is on the board and executive committee of the Climate and Health Council and the UK Health Alliance on Climate Change. PROFESSOR ANDY HAINES is Professor of Environmental Change and Public Health at the London School of Hygiene and Tropical Medicine. Andy is a member of several major international and national committees, including the UN Intergovernmental Panel on Climate Change. __ * USEFUL LINKS: __ The Health Foundation (2021) What do the public think about the NHS and climate change? https://www.health.org.uk/publications/long-reads/going-green-what-do-the-public-think-about-the-nhs-and-climate-change UN Environment Programme (2021) The production gap 2021 https://www.unep.org/resources/report/2021-production-gap-report Academy of Medical Sciences and the Royal Society (2021) Climate change and health https://acmedsci.ac.uk/policy/policy-projects/climate-change-and-health HM Government (2020) The Ten Point Plan for a Green Industrial Revolution https://www.gov.uk/government/publications/the-ten-point-plan-for-a-green-industrial-revolution Council for Science and Technology (2020): Achieving net zero carbon emissions through a whole systems approach https://www.gov.uk/government/publications/achieving-net-zero-carbon-emissions-through-a-whole-systems-approach __
