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2 March 2023

The Policy Ask with Tina Woods: “Digitalisation should not trump doctors’ expertise”

The preventative health expert on NHS bureaucracy, healthy ageing and what the UK could learn from Singapore.

By Spotlight

Tina Woods is founder and CEO of Business for Health, a consortium of businesses set up in 2020 that promotes and supports investment in preventative health and care. She is also the healthy longevity champion at the UK National Innovation Centre for Ageing, a government-funded organisation that promotes better health in older age; and she is a trustee of the British Society for Research on Ageing (BSRA).

How do you start your working day?

I like to start the day with a 3km jog in my local park by the Thames and when I get home I exercise for 30 minutes on an ancient rowing machine in my cellar. It’s a good time to listen to Radio 4’s Today programme, which normally sparks some ideas for the day.

What has been your career high?    

The moment I was asked to become the healthy longevity champion by the UK National Innovation Centre for Ageing, endorsing my efforts over the past five years to join up science, technology, business and policy in the pursuit for healthier, longer lives, a mission laid out by Theresa May’s government.

[See also: The NHS is “a sickness service, not a health service,” say MPs]

What has been the most challenging moment of your career?

When I left a well-paid job with security and benefits to go it alone as a social entrepreneur in my early fifties. I had spent some 30 years studying genetics and working in the conventional healthcare industry – including pharmaceuticals and biotech – until I realised that my real calling was to disrupt the healthcare model and re-gear it from disease treatment towards prevention.

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It called for considerable resilience as I had to create networks challenging the status quo without an established brand backing me or obvious funding for my work. It created considerable strain on my family and household finances. I was a complete unknown, starting from scratch with a blank sheet of paper.

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If you could give your younger self career advice, what would it be?   

If you have an idea or a calling that is nagging at you, and which you believe in, you need to put it to the test, get it out of your system and take the plunge. Too often, people don’t do this and risk years of regret. If it doesn’t work out, you can let go and revert to a conventional job.

Which political figure inspires you?

George Freeman, the science, research and innovation minister. He is curious, enterprising, committed and knows his brief well. He is one of the few people in government who can see the boundless opportunities to harness science and technology to improve people’s lives while grasping the complexity of exponential innovation. Also, Andy Burnham, the mayor of Greater Manchester (the UK’s first city to join the World Health Organisation’s network of Age Friendly Cities and Communities), who has championed greater devolution of power at a local level. This is now starting to deliver better health outcomes for people in the region.

[See also: The health disparities white paper has been cancelled. Why?]

What UK policy or fund is the government getting right? 

Too often, we’re seeing older people or those with long-term illnesses experiencing lower levels of health and well-being, and struggling to live independently. The government’s Better Care Fund is one of the major vehicles for health and social care integration and helping people stay well, safe and independent at home for longer.

It requires the NHS to work with local government to allocate spending priorities such as funding for home adaptations for disabled people, and rehabilitating people back into their communities after a stint in hospital.

Already more than 90 per cent of local areas have agreed that the Better Care Fund has improved joint working between health and social care. I’m looking forward to seeing more progress being made as more than £7bn has been committed to the fund for 2022-23.

And what policy should the UK government scrap? 

GPs used to be able to refer patients directly to a named consultant at a local hospital, but now they have to use a triage system known as “Single Point of Access”, which is intended to reduce the number of inappropriate referrals into secondary care. This entails a complicated series of multiple-choice questions with the computer dictating the specialist and GPs being asked if they agree or not. If they press “no”, the whole referral is cancelled, which puts them in a catch-22 situation of wanting care for their patients but risking inappropriate treatment. For GPs who want to refer patients to different specialities, they need to email a department to ask for guidance. Given the NHS backlog, it can take months to get a reply, let alone an appointment.

The government needs to be wary of trumping the medical experience of GPs in aid of digitalisation. GPs will have regular patients and familiarity goes a long way in building trust with the community, as well as noticing small changes in appearance or attitude, which are often early indicators of many diseases and conditions. By limiting the referral power of GPs, the current structure is contributing towards a bottleneck that drastically reduces access to secondary care.

What upcoming UK policy or law are you most looking forward to?  

The successful implementation of the government’s levelling-up agenda. Currently, people in the poorest areas of the country have, on average, more diagnosed illness over ten years earlier than those in the richest areas. While it’s vital we address these regional health inequalities, we cannot do so without tackling the wider determinants first, such as income, housing, transport, education and work.

What piece of international government policy could the UK learn from?

Singapore published its Action Plan for Successful Ageing in 2016. It was jointly developed by government agencies, non-profit organisations, academia, businesses and union members, with feedback also received from a public consultation. There are more than 70 initiatives across 12 areas, including health and wellness, employment, social inclusion, transport and public spaces.

The plan involves three core tenets: opportunities for all ages, which helps all residents to continually learn and grow, including through an academy and education programme specifically for older people; a community for all ages, which involves establishing multi-generational facilities and services in the same location, such as provision of eldercare and childcare; and a city for all ages, which is a revised transportation plan that is senior-friendly.

While there are many cultural differences, the UK could learn lessons from Singapore’s approach to financing healthcare, reducing overuse of expensive healthcare by expanding care and support services, and improving population health.

[See also: Focus on prevention to keep the NHS true to its soul]

If you could pass one law this year, what would it be?  

I’d urge a radical rethink on preventative health. Prevention is better than the best cure and ultimately cheaper too. An allocation plan for the £3.3bn promised by Jeremy Hunt, the Chancellor, for the NHS is crucial, alongside an effective preventative care strategy to reduce the need for healthcare in the first place. We need a robust approach that deals with the root causes of illness that are driving the need for care.

But the responsibility isn’t just down to the government; business has a huge role to play in population health. That’s why we launched the Work Health Index in collaboration with the Confederation of British Industry (CBI), to help employers create healthier and more supportive workplaces that reduce long-term sickness, encourage the older workforce back into the labour market and enhance productivity. These actions will deliver significant economic benefits while reducing the burden on the NHS.

Read more:

Why public health policy needs to refocus

Wes Streeting’s plan for the NHS signals a bolder Labour in 2023

I’m a public health doctor – I know austerity is why people are struggling