As this House is aware, the health and social care system faces long-term challenges to ensure the public enjoy longer and healthier lives. Currently in England, 5.4 million people live with cardiovascular disease, around 8.6 million live with chronic respiratory disease and 8.2 million people live with mental health issues.
An increasing number of us live with one or more major conditions. People with diabetes are twice as likely to have depression. Nine in ten dementia patients have another long-term condition. Half of people with a heart or lung condition have musculoskeletal disorders.
Tackling the major conditions that lead to people spending more years in ill health is a significant opportunity to improve the lives of millions of people. That is why today, I am announcing that, in consultation with NHS England and colleagues across government, my Department will develop and publish a Major Conditions Strategy.
The Strategy will set out a strong and coherent policy agenda that sets out a shift to integrated, whole-person care, building on measures that we have already taken forward through the NHS Long Term Plan. Interventions set out in the Strategy will aim to alleviate pressure on the health system, as well as support the government’s objective to increase healthy life expectancy and reduce ill-health related labour market inactivity.
Our approach will be rooted in the best understanding of the evidence to tackle the major conditions which contribute to the burden of disease in England, namely:
- Cardiovascular diseases, including stroke and diabetes
- Chronic respiratory diseases
- Mental ill health
- Musculoskeletal disorders
These areas account for around 60% of total Disability Adjusted Life Years in England. Tackling them is critical to achieving our manifesto commitment of gaining five extra years of Healthy Life Expectancy by 2035, and our levelling up mission to narrow the gap in Healthy Life Expectancy by 2030.
Our approach will harness the potential of whole person care, addressing the fact that our health and care system has been built in silos, often focused around specific diseases or organs in the body. Our workforce model needs to adapt, reflecting that the NHS is caring for patients with increasingly complex needs and with multiple long-term conditions. We need greater emphasis on generalist medical skills to complement existing deep specialist expertise in the NHS, supporting clinical professionals to heal with whole person care. The Major Conditions Strategy and the upcoming NHS Long Term Workforce Plan work together to set out the standards patient should expect in the short term and over a five year timeframe.
This is about shifting our model towards preserving good health, and the early detection and treatment of diseases. We have a proud record of opening new treatment possibilities in the NHS. Diseases that were once a death sentence have become conditions that can be managed over the long term. By harnessing innovation and technology we are increasingly capable of detecting diseases at an early stage, in some cases before symptoms emerge. Intervening at this point will reduce demand downstream on health and care services.
Healthy, fulfilled, independent and longer lives for the people of England will require health and care services, local government, NHS bodies, and others to work ever more closely together. People living in England’s most deprived places live, on average, 19 fewer years in good health than those in the least deprived places. 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.
This work combines our key commitments in mental health, cancer, dementia and health disparities into a single, powerful strategy. It will align to the government’s ambitious Life Sciences Missions. We will take forward a separate Suicide Prevention Strategy this year.
Alongside work on common diseases the Department and the NHS also continue work on rare diseases, under the 2021 UK Rare Diseases Framework. All four nations of the UK have now published their first action plan, and England’s second Rare Diseases Action Plan is currently being finalised.
As we develop this Strategy I continue to be grateful for the thoughts and contributions from colleagues across the House, stakeholders, citizens and industry. I will set out opportunities to contribute further in due course. We also intend to publish an interim report on the Strategy in the summer.
Strategies alone will not change outcomes. Delivery will require concerted effort from government and the NHS working in tandem, alongside social care, patient representatives, industry and partners across the health and care system.
This statement has also been made in the House of Lords