Targets ‘too constrictive’ as health expectancy gap widens

System leaders have warned that too many nationally set targets focusing on acute trusts are “constricting” efforts to tackle widening gaps in healthy life expectancy.

An NHS Confederation and Institute for Public Policy Research report published today  shows the gap in health life expectancy – the number of years a person can expect to live in full health – has now grown to more than 20 years between local authorities across the UK.

System leaders told the report, which has been shared with HSJ, that national targets for ICSs too focused on acute rather than preventive outcomes are “constricting change” around improving health expectancy.

The report adds that a “smaller set of targets may be beneficial” to tackle the widening health expectancy gap between local areas. 

It says: “Despite rhetoric on subsidiarity, local systems are still subject to a proliferation of targets. In turn, those targets tend to be focused on acute rather than preventative outcomes, constricting change.”

The report engaged with four integrated care systems – West Yorkshire, North East London, Sussex and Coventry and Warwickshire – and the Hywel Dda University Health Board in Wales. It found that health inequalities are “highly localised” meaning that systems are key to progress. 

However, it argued that ICS long-term working can be “blown off course by what politicians see as burning priorities”. This is usually waiting lists and emergency department performance “rather than population health outcomes that take time to change and deliver prosperity. High turnover of health secretaries, short-termism in Treasury and the politicisation of the NHS are all challenges here. Providing long-term funding, space to experiment and political acknowledgement that real change takes time would be useful,” the report continued.

Read full story (paywalled)

Source: HSJ, 16 August 2024