In England, the burden of long-term health conditions affects an estimated 25 million people. While the NHS’s recovery plan and the soon-to-be-published Major Conditions Strategy target prevalent health issues like diabetes, cancer and mental illness, there remains a gap in addressing a multitude of unattended chronic diseases.
Labour’s ten-year plan presents a comprehensive vision for overhauling the health and care services, accelerating treatments and crafting a future-ready NHS. A focus on prevention is crucial for stabilising and sustaining the NHS. Prioritising long-term health conditions and implementing transformative pathways for more responsive treatment management could alleviate capacity constraints and resource pressures and minimise waiting times.
At a New Statesman panel event in partnership with pharmaceutical company AbbVie at this year’s Labour Party Conference in October, a panel of experts delved into strategies for preventing a two-tier health service, enhancing NHS capacity, and improving outcomes for major conditions. The panel was comprised of Todd Manning, general manager and vice president at AbbVie; Baroness Gillian Merron, shadow spokesperson for health and social care; Simon Opher, a GP and Labour prospective parliamentary candidate (PPC) for Stroud; Richard Sloggett, founder and programme director of the think tank and research centre Future Health; and Georgina Carr, chief executive of the Neurological Alliance.
Manning told the audience how AbbVie is focusing its work on the “forgotten majority” – the people in the UK who are living with long-term conditions and multiple comorbidities – and ensuring this issue is at “the very highest level of political manifestos for the next government”.
The panel agreed that the government’s Major Conditions Strategy does not go far enough. So far, the government has released a policy paper on the upcoming strategy, which is expected to be published in full in 2024. Manning queried “artificial guidelines” around conditions that could potentially create “some inequality of care”. Carr and Merron also expressed disappointment that the strategy had omitted some major conditions, including neurological diseases, but Merron emphasised that Labour would not “throw out” the strategy, due to the time that had been spent on it and the expertise that had gone into it.
When asked about priorities for healthcare, many agreed that extending care out of hospitals and into the community was vital for addressing imbalances. Merron set out the actions Labour would take to improve healthcare provision in primary care, such as dentistry reform, new equipment, and the provision of two million more flexible GP appointments every year, but she also emphasised the need for community care: “We need to move away from providing such appointments in hospital. We have a national health service. If we are in government, we want it to also be a neighbourhood health service.”
Opher spoke about the need for more care and treatment to be provided outside of the NHS. He called for more “social prescribing” – connecting people to activities, groups and services in their community to improve their health and well-being – in order to reduce pressure on the NHS. “We have to de-medicalise what has become medicalised in our society, otherwise, the NHS is picking up more and more work, which could be done in the voluntary sector,” he said.
Sloggett concurred, stating that “a lot of the solutions that are needed are non-medical”, particularly around mental health. He also suggested that more power needed to be handed over to those running local services, such as integrated care services, as they know their population’s needs: “[they] will be able to say, ‘This is the model that will work for us: this is the medical bit, this is the non-medical bit.’”
The panel agreed on the need for health services to see and treat the entire patient, and for support and treatment to be tailored to each individual. “We need to be thinking about the whole person, and how they get that specialist input when they need it, as well as that wraparound support,” Carr said. She spoke of research conducted by the Neurological Alliance, which found that of the 8,500 people surveyed, more than half had not been asked about their mental health by a healthcare professional in the past three years, and more than a third had not been referred for mental health support, despite needing it.
Manning emphasised the need for a whole-patient approach as it becomes more common for people to live with two or more long-term conditions: “The time of treating patients by specialty is over,” he said. “People are living with too many comorbidities, and it’s not a patient-centric approach.”
He explained that AbbVie didn’t see this as a medical issue, but more of an “engineering problem”: “We’re challenging the government to think about this differently than it’s been thought about in the past,” he said. “To look for analogue situations, whether it be across business, or whether it be across other departments, but to fundamentally get to the point that in order to treat the patient as a whole person, it’s going to take a different approach.”
Merron seemed aligned with Manning’s calls to change the thinking of the NHS. “One wouldn’t run one’s business in a way that wasn’t flexible and did not focus on the customer,” she said. “So why is it that we tend to have to fit in with the NHS system, rather than the system providing for us? We have to change the culture.”
Finally, the panel agreed that prevention health measures must be prioritised. Opher set out how external factors impact our health: “Our health environment is poor,” he said. “That’s why we need clean air. That’s why we need more exercise. That’s why we need better taxation on unhealthy foods.”
“Prevention has to be at the heart of our national good health service into the future,” Merron concurred. “Health policies that are good go across the whole of government, because it is not a siloed matter. The departments that are going to be responsible for housing, clean air and connecting people through good transport – all of these have very direct impacts on health.”