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Behavioural risk factors such as tobacco use, physical inactivity, unhealthy diet and the harmful use of alcohol increase the risk of non-communicable diseases such as cardiovascular disease, cancer, respiratory disease and diabetes. While it is difficult to put an exact figure on the amount that the NHS spends on treating health conditions attributable to lifestyle risk factors, studies suggest it is in the billions.

The NHS published its Five Year Forward View in October 2014, setting out a new vision for the future of the NHS based around new models of care.  In this document, the NHS argued that “the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health”.  The NHS therefore committed to backing “hard-hitting national action on obesity, smoking and other major health risks”; to helping “develop and support new workplace incentives to promote employee health and cut sickness-related unemployment”; and to advocating “for stronger public health-related powers for local government and elected mayors”.  The Five Year Forward View also promised that “when people do need health services, patients will gain far greater control of their own care”. A third strand of the vision was for the NHS to “take decisive steps to break down the barriers in how care is provided between family doctors and hospitals, between physical and mental health, between health and social care”.  The document proposed that local health communities would be able to choose between “a small number of radical new care delivery options”. Since March 2015, 50 vanguard sites have been selected to take the lead on developing new care models which will, according to NHS England, “act as the blueprint for the NHS moving forward”. 

The King’s Fund and the Health Foundation have argued for a dedicated ‘transformation fund’ to support change in the NHS, warning that “without resources specifically earmarked for transformation, there is a risk that the NHS will be unable to become more productive and that the bill for additional running costs will only get larger”. The two organisations have suggested that a transformation fund of £1.5–2.1bn a year (in 2015–16 prices) should be established over and above the core resource funding of the NHS to support NHS staff and organisations to achieve higher rates of efficiency growth and to invest in developing a range of new care models.


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