There may be trouble ahead... and here’s a plan

‘There may be trouble ahead’. Cross out the maybe. I don’t need to rehearse here the economic outlook and its likely impact, nor the pressure the NHS and social care system and wider local government services are under. Nor the trends in population health, including inequalities, which are likely to point in the wrong direction given the prevailing environment. And that’s not to mention the need for recovery in the wake of the pandemic’s first waves.  

In 40 years of working in the health sector, I’m hard pressed to think of a more challenging time. 

Rather than ‘let’s face the music and dance’, how is the Health Foundation responding? 

Charitable foundations like the Health Foundation can take a number of paths. We can fund immediate relief, for example the Foundation’s £4.7m donation to charities including the National Emergencies Trust and BBC Children in Need during the pandemic. We can influence through analysis to try to ameliorate damaging policies or suggest new ones. We can fund programmes on the ground to plug gaps in provision, or demonstrate new solutions for the future. We can fund fellowships and networks to try to develop others to tackle today’s and tomorrow’s issues better. We can campaign, fund institutes, or use our investment heft to influence. We can do all this alone, or better still, with others. The Foundation is often inaccurately referred to as a ‘think tank’ – in reality, it is much, much more. 

Reviewing our focus for the next 3 years 

The balance of our wide-ranging activities comes down to judgement and opportunity, as well as our capacity. We’ve been mulling on all this, while developing our strategy for the next 3 years. Given these exceptional times, we will be active on all the paths outlined above. But what we focus on boils down to three areas. 

1. Population health 

The first is population health. You’ll have seen current trends, for example in healthy life expectancy, inequalities, and the increasing prevalence of mental health issues in young people. Also, in the prevalence of risk factors, for example obesity, poor air quality, and drug and alcohol abuse, particularly in some parts of the country. And the evidence of the impact of wider determinants of health such as poverty and debt, poor housing, unemployment and poor quality work.  

As you’d expect, we will continue to quantify these trends in detail, and campaign with others for change through our new initiative ‘Health Equals’. But we will also be active with central and local government, and with investors and businesses to influence policy and support practical improvement.  

What do we want to happen as a result? Far more attention to ‘health capital’ in policy, much firmer action by national and local government, investors and business, and ultimately health trends picking up. 

2. NHS and social care policy 

The second is national policy on the NHS and social care. Better policymaking starts with good analysis of the issues at hand and what may be ahead. We will continue our analyses, rooted in rigorous research. This will include developing our modelling of long-term supply and demand projections for the NHS and social care, international comparisons, public polling, and evaluation of seminal initiatives. But more than that, we will be turning more to suggesting solutions for some of the biggest enduring issues.  

The next 3 years will see a general election, and we’ll be active in promoting informed debate and influencing political policy. What do we want to happen as a result? Better solutions tried and evaluated, and importantly a bigger consensus among policymakers and NHS and social care leaders, informed by evidence, as to the main challenges now and ahead, and routes to addressing them.   

3. Faster improvements in care 

The third area is what we are calling ‘faster improvement in care’. Improvements happen continuously, with new treatments, technologies and service models introduced all the time. But given pressures on care, not least labour shortages, it is obvious that accelerating improvements is going to be even more critical in the future.  

Testing, scaling and spreading new innovations – in particular those that are quality improving, labour saving, and productivity enhancing – will need to be done on a much vaster scale, and far more systematically than now. Using assets such as the Q community and THIS Institute, alongside our long quality improvement heritage and data analytics expertise, we aim to make a significant contribution.  

What do we want to see? A much stronger approach to testing innovation using new methods of iterative intelligent research, with successful spread of innovations and new models of care addressing the most crucial challenges. 

Details on the above all to come in the new year, watch this space. 

Maximising our impact 

Finally, as an endowed charitable foundation, we have … an endowment. This fund is invested and releases funds for us to spend on charitable activities as above. But increasingly we want our investment fund to work more towards our mission to improve health and care for people in the UK. Like other foundations we are taking steps towards this, through a ‘responsible investing’ strategy. This means working with our investment managers on green and health issues, setting expectations for change, and scrutinising performance. It also means joining ‘investor action’ campaigns on relevant issues with other investors which we regularly do. My colleagues Aidan and Jo explain more.  

So, a lot to do. It will be crucial to do this with others, so your talents and energy are important to us. Keep in touch, check our website for funding and other opportunities, join our events, read our analyses, ask questions and make suggestions. We look forward to collaborating with you as we navigate the turbulence ahead. 

Jennifer Dixon (@JenniferTHF) is Chief Executive of the Health Foundation.

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.