1/7. 🧵 With national govt seemingly binning a serious focus on health inequalities, there is lots that can be done at regional and local level; a national govt focus & framework would obviously help that.. but we are where we are. Some positivity follows...
2/7. There's lots to learn from past health inequalities policy and it worked, much of which can be implemented regionally and with integrated care systems kingsfund.org.uk/blog/2017/08/r…
3/7. The lesson is this requires three things: partnership, disruption and endurance. National govt seems to have given up on the latter, regional and local partners must not. kingsfund.org.uk/publications/h…
5/7. Take it further, building on public health expertise. We see lots of great work in this space now and will share what we're seeing, keep going. kingsfund.org.uk/publications/p…
7/7. Finally, great signs that sustained & coordinated action can make a real difference, e.g. @MattXSutton and colleagues on Greater Manchester's experience of population health and life expectancy improvement following devolution #doitandstickthecoursesciencedirect.com/science/articl…
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1/6. Today we launched our @thekingsfund report on #publichealth and #populationhealth #leading together. A summary of key points follow. We make a limited no of recs for national leaders, and share examples of how things are working well in practice kingsfund.org.uk/insight-and-an…
2/6. There is a strength & a huge opportunity in public health & population health leaders working together in the context of a mission-driven govt. We show this is happening in various systems, at regional, ICS & place level inc bridging between NHS-LA capability & capacity e.g
3/6. And being explicit about roles and functions locally. This needs work and time put aside, it needs to be valued e.g.
1/7. The new govt @10DowningStreet has a #nhealthmission, underpinned by "Improve healthy life expectancy for all and halve the gap in healthy life expectancy between different regions of England" If they mean it, THIS IS HUGE and has massive implications. Quick thoughts follow.
2/7. Between regions is new geography for 'health', and means mayors, CAs & connecting to regional economies & actors; & the NHS playing it's part as an economic partner, as much as a deliverer of healthcare. See @HealthFdn @CLESthinkdo & us cles.org.uk/blog/combined-…
3/7. HLE also means emphasis on areas beyond healthcare, & better lives as much as longer lives. Gearing on 'H' means > work on mental health/MSK, as well as smoking/CVD. This can only be delivered by cross-govt coordination. See @ohid on what drives HLE gov.uk/government/pub…
1/7. Quick thoughts on Health Bill - it's a monster, so quick thoughts won't be sufficient. NB. These are restricted to specifics on public health and inequalties, not the overall impact likely on them. But here goes.
2/7. Transposes inequality duties from 2012 Act to new bodies plus i) ineq needs to be in ICB annual plans, ii) NHSE will performance assess on ineq. Good, but as last time provision is 'due regard', this is weak and depends on implementation, lesson of 2012 was not sufficient.
3/7. Transposes SoS ability from previous acts to delegate their powers over provision of public health to new bodies, now inc general 'anyone else'. Key thing is what intent lies behind this, welcome flexibility (e.g. in a pandemic) or setting up for change. But not new per se.
1/6. Four recent pieces on #publichealth#funding and #spending of interest and worth thinking about - it's all a bit of a mess. See thread 👇
2/6. Today, from @IPPR, looking at cuts to the public health grant > fallen most on poorest areas (ironically, this is most probably a result of cuts being split 'equally' as opposed to according to needs - but unclear since report not yet on website) theguardian.com/society/2019/n…
3/6. But, it is still not clear what has happened to the promised (1%) real-terms increase in the public health grant in 2020-21, with concerns it will be swallowed by staffing costs and additional burdens (£paywall) hsj.co.uk/public-health/…