The NHS is essential, but good health depends on much more

The next government needs to work across parties and departments to focus on people’s health — not only support the NHS

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There is a decline in the nation’s health that governments and political parties are not addressing. The debate during the election is at risk of being too simplistic and missing the point.

Life expectancy gains have stalled[i], people perceive their health to be worsening[ii] and they’re living more years in ‘Not good’ health[iii]. These declines are not an inevitability after years of gains — we’re doing badly compared to other countries[iv].

Building on recent calls for the debate to be more realistic and less ‘weaponised’[v], we believe it needs to shift further still — beyond a fixation with services, to a broader view of health that focuses on what people need for good, healthy lives.

‘Health’ is about physical and mental health and wellbeing — across the life-course, including at the end of life. As important as hospitals are, they are rarely where good health is created. Health is made good or bad within the neighbourhoods and communities we live.

Our members rightly want to see many of the overwhelmed and under-resourced elements of the health and care system being addressed, including the reform of social care for both working age and older adults, and investment in public health. They will continue to call for evidence-based system changes that support people to live as well as possible.

However, it’s also essential that investment reaches communities, so that they can work with and support people to improve all aspects of their health. There are stark health inequality gaps across the countryand people living in the most deprived areas have seen the biggest decline in improvements[vi].

Adequately resourced communities can be equal and active partners in turning this around, refocusing the debate and avoiding a health emergency.

What needs to happen?

We stand ready to work with government to convert these actions into concrete steps, for example by setting up a cross-departmental group that could be ready to start work on 13th December.

  • Government to make health — physical health, mental health and wellbeing — an overarching goal across all ministerial departments. The Local Government Association’s ‘Health in All Policies’[vii] approach could provide a useful foundation.
  • Cross-party commitment to promote the health of current and future generations — beyond a focus on the NHS and social care as a set of statutory services.
  • Time — both parliamentary and public airtime — for domestic policy and legislation.
  • A comprehensive national physical health, mental health and wellbeing strategy — similar to the Industrial Strategy — outlining the contributions of all ministerial departments and key partners to improving population health.
  • Urgent investment that recognises and strengthens community contributions to health, especially through local authorities and the voluntary sector.
  • Resolve social care in the short-term and resource it to be both responsive and preventative to need in the longer-term — securing sustainable care and support for both working age and older adults.


Access Matters / Action Against Allergy / Age UK / Alex — The Leukodystrophy Charity / Alzheimer’s Society / Arthritis Action / Arthritis and Musculoskeletal Alliance (ARMA) / Association of Mental Health Providers / Asthma UK / Bechet’s UK / Better Living / Bright VSC — Star Wards / British Geriatrics Society / British Heart Foundation / British Liver Trust / Cavernoma Alliance UK / Centre for Mental Health / Children’s Liver Disease Foundation / Clinks / Compassion in Dying / Crohn’s and Colitis UK / Diabetes UK / Endometriosis UK / Epilepsy Action / Friends, Families and Travellers / Groundswell / Imperial Health Charity / Independent Age / Kidney Care UK / Learning Disability England / LGBT Foundation / Macmillan Cancer Support / Marie Curie / Mind / MND Association / Mobility and Support Information Service (MASIS) / MS Society / National Axial Spondyloarthritis Society / National Rheumatoid Arthritis Society / National Association for Voluntary and Community Action (NAVCA) / National Survivor User Network (NSUN) / Parkinson’s UK / Patient Information Forum / Patient Experience Library / Positively UK / Richmond Group of Charities / Scleroderma and Raynaud’s UK (SRUK) / Sense / SUDEP Action / The Neurological Alliance / The Point of Care Foundation /The Queen’s Nursing Institute / The Thyroid Trust / Thyroid UK / Together for Short Lives / Trigeminal Neuralgia Association UK / Versus Arthritis / VoiceAbility / Voluntary Organisations Disability Group (VODG) / We Hear You / Youth Access

[i] Life expectancy improvements have been slowing down since 2011, with the UK experiencing one of the largest slowdowns in comparison to similar countries. In some parts of the UK life expectancy has even decreased. The future trend of life expectancy is uncertain. [Office for National Statistics (2019). National life tables, UK: 2016 to 2018].

[ii] The UK is one of the few countries where perceived health status has worsened in the last decade, with the proportion of people rating their health as “good” or “very good” falling by nearly five percentage points. [OECD (2017). How’s life in the United Kingdom?].

[iii] The number of years lived in “Not Good” health has increased over the last decade. Women can expect to live a greater number of years and greater proportion of their lives in poor health than men — 19.3 years and 23.2% compared with 16.2 years and 20.4%. [Office for National Statistics (2018). Health state life expectancies, UK: 2015 to 2017].

[iv] The number of healthy years a person is expected to live from birth is below the EU average for both men and women [Eurostat (2019). Health life expectancy statistics]. Women in the UK are living shorter lives on average than most of their counterparts in the EU (life expectancy is ranked 17th out of 28). UK male life expectancy has started to fall down the EU rankings — from 6th to 10th. [Office for National Statistics (2019). National life tables, UK: 2016 to 2018].

[v] Hopson, C. (2019). Please don’t turn the NHS into a political weapon. The Times, November 4th 2019.

[vi] People who live in the most deprived areas of the country experience 19 fewer years in good health than people living in the least deprived areas. [Public Health England (2019). Health profile for England 2019].

[vii] Local Government Association (2016). Health in All Policies: A manual for local government.

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We are an alliance of the main voluntary, community and social enterprise groups, organisations and networks that support people to live as well as possible.

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