This In Focus briefing provides some statistics relating to the impact of lifestyle risk factors on health and what this means for the NHS, as well as examining policy responses to these challenges as set out in the NHS Five Year Forward View.
Building a Health-Creating Society (79 KB , PDF)
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.
Building a Health-Creating Society (79 KB , PDF)
The government recently announced an independent review of physician and anaesthesia associates to be led by Professor Gillian Leng. This announcement followed a debate about the use of the roles in the NHS and concerns raised by some stakeholders about patient safety. The review has been widely welcomed by stakeholders as a way to move the debate forward.
Fracture liaison services proactively identify people at risk of fractures caused by osteoporosis. Patients can then be assessed and treated to prevent future fractures. The provision of fracture liaison services in England has been called a ‘postcode lottery’ by the Royal Osteoporosis Society, and evidence shows variation in quality and reach. The government has committed to 100% coverage by 2030.
The Mental Health Bill [HL] is a government bill that would amend the Mental Health Act 1983. The 1983 act is the current legislation that regulates the compulsory detention and treatment of those with a mental disorder in England and Wales. There have long been calls to update the legislation, and in 2017 there was an independent review of the Mental Health Act. In 2022 the previous Conservative government published a draft Mental Health Bill. The current bill is similar (but not identical) to the draft bill and it would implement many of the recommendations of the 2017 independent review. Changes proposed in the bill include tightening the detention criteria in the 1983 act and providing for more frequents reviews; limiting the period that people with autism or a learning disability can be detained; and removing prisons and police stations as “places of safety” in the act. This briefing provides a summary of the background to the bill, the bill’s provisions, and the differences from the 2022 draft bill.
![Mental Health Bill [HL]: HL Bill 47 of 2024–25](https://lordslibrary.parliament.uk/content/uploads/sites/2/2020/09/Health-568x426.png)