Major Conditions Strategy must tackle “root causes” of ill health

The Health Secretary, Steve Barclay, has announced that the government will publish a Major Conditions Strategy, which aims to narrow health inequalities and gain an extra five extra years of Healthy Life Expectancy (HLE) by 2035.

Some of the major conditions the Strategy aims to tackle are: cancers, cardiovascular diseases (including stroke and diabetes), chronic respiratory diseases, dementia, mental ill health and musculoskeletal disorders. These areas account for around 60% of total Disability Adjusted Life Years in England.

With an increasing number of us living with one or more major conditions, and people in England’s most deprived areas living healthy lives for 19 years less than those in the least deprived areas, the government hopes the strategy will alleviate pressure on the health system and reduce ill-health related labour market inactivity.

Mr Barclay said: “The Strategy will set out the supporting and enabling interventions the centre can make to ensure that ICSs and the organisations within them maximise the opportunities to tackle clusters of disadvantage in their local areas where they exist, informed by the Hewitt Review. This will include addressing unwarranted variation in outcomes and the care people receive in the context of the recovery from the pandemic.”

Focusing on individual behaviours “will not be enough”

The Royal College of Physicians (RCP) have welcomed the strategy, but have asked the government to clarify whether the Major Conditions Strategy will replace the Health Disparities White Paper (HDWP), which was due to be published last year.

“If the Major Conditions Strategy is a replacement for the HDWP, we hope that the Department for Health and Social Care will still work with the ‘whole of government to consider health disparities at each stage at which they arise…[including]…the wider determinants of health’, as it said it would in the Levelling Up White Paper,” said Dr Sarah Clarke, president of the RCP.

The College also warns that focusing on individual behaviours and access to services alone “will not be enough” to close the HLE between the most and least deprived areas.

“Just under a third (31%) of RCP members told us in December last year that they had seen more people with illness due to their living conditions in the previous three months. To address health inequality and reduce the gap in HLE, we must tackle the root causes of ill health such as poor housing, food quality, communities and place, employment, racism and discrimination, transport and air quality,” Dr Clarke said.

“Cross-government work on health inequalities must be a part of the Major Conditions Strategy for it to be effective. We look forward to working with government to ensure that this is put into practice,” she concluded.

NHS leaders need the right “workforce, resources and regulatory environment”

Dr Layla McCay director of policy at the NHS Confederation has also warned that “strategies alone will not change outcomes”.

She said: “NHS leaders are committed to playing their part to build a healthier population, but to do this they need the right workforce, resources and regulatory environment.”

The NHS Confederations wants to see a “genuine commitment” from the government on reducing health inequalities and moving towards a preventative healthcare model, and hopes the strategy will “incorporate both a short and long-term vision beyond the political and financial cycles and is informed by meaningful public and professional engagement.”