A vision for population health: Towards a healthier future
Authors: David Buck, Alex Baylis, Durka Dougall and Ruth Robertson
• Substantial improvements in health over the past 100 years mean that people are living longer and healthier lives than ever before.
• Despite these improvements, England lags behind other countries on many key health outcomes, increases in life expectancy have stalled and health inequalities are widening.
• The NHS has a critical part to play but these challenges cannot be met by the health and care system alone; a much broader approach that pays more attention to the wider determinants of health and the role of people and communities is required.
• Our vision for population health is to reduce inequalities and achieve health outcomes on a par with the best in the world. We have developed a framework for population health based on four pillars:
- the wider determinants of health
- our health behaviours and lifestyles
- the places and communities in which we live
- an integrated health and care system.
• Achieving our vision will require action at national, regional and local levels, drawing on the assets of people and communities. Improving population health is a shared responsibility and progress also depends on supporting people to live healthier lives.
• Political leadership is essential to ensure that population health is a key priority for the health and care system and across government. This should include setting ambitious and binding national goals to improve health outcomes and developing a new cross-government strategy to reduce health inequalities.
• Local system leaders and politicians should champion population health. Local authorities have a key role to play working with the NHS and other partners including through health and wellbeing boards, sustainability and transformation partnerships (STPs) and integrated care systems (ICSs).
• National and local accountability for improving health is fragmented and unclear. The roles of NHS England and Public Health England in particular should be clarified. As part of this, the role of Public Health England should be reviewed to ensure it has the authority to provide effective leadership and challenge to government.
• Funding for public health should be restored in the Spending Review as the first step towards re-balancing spending across the four pillars.
• Building on the success of the Soft Drinks Industry Levy, the government should be bold in using taxation and regulation to support health improvement.
• In recent years, The King’s Fund has played a key role in promoting integrated care and supporting place-based systems of care. This report marks the next stage in our journey and signals that population health will be a key focus of our work in future.