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One of the most frequent questions I’m asked is ‘how do you decide what the Foundation should work on?’ Stalling life expectancy? The health of under-fives? Productivity in the NHS? The likely future of AI and health care? And do we help areas with greatest need, or fund already go-ahead areas which may be showing the way for the rest? With a broad mission to improve health and care for people in the UK, and no shortage of need out there, deciding our priorities in theory could be challenging.

In practice it isn’t. We combine intelligence from a wide range of sources, look at what others do that we shouldn’t duplicate (or subsidise), and add in a whole lot of intuition as to not just what might be today’s priorities but tomorrow’s as well. While strategies to some extent focus on long-term challenges, ours also emerge and flex during the year as opportunities come our way. 

So, what’s up at the Foundation in 2020? Some headlines are as follows.

First, health. It’s difficult to ignore the widening differences in health across socioeconomic groups, and stalling life expectancy particularly in women in the most deprived communities. So, we’re focusing upstream on the wider determinants of health, and trying to mobilise more action to address them. We are continuing to fund the £50m grant programme – the UK Prevention Research Partnership – with the Wellcome Trust, ESRC and NIHR among others. In February, Michael Marmot and team at the Institute of Health Equity publish an update on progress made ten years after his ground-breaking report Fair Society, Healthy Lives. Why has health improvement been so disappointing over the decade and what needs to be done next if the new government really has an agenda to ‘level up’ all regions of the country?

To help, we are launching a new £1.5m grant fund to fund more action with local government. Our Shaping Economies for Healthier Lives programme will support local government to work with others to make sure health is at the centre of the new local industrial strategies. And following our inquiry reporting last year on the future prospects for the health and wellbeing of young people, we are funding policy posts in national organisations to develop actionable recommendations in five areas including good work, transport and inequalities among young people. To mobilise even further action we are developing plans with ten other organisations to launch a £15m national Collaboration for Wellbeing and Health later in the year.

Second, improving care on the ground. We’re well known for our contributions to quality improvement – research and frontline practice – over the last decade. On research we’ll work with The Health Improvement Studies (THIS) Institute to develop the evidence supporting scalable improvement in care. And we are commissioning, jointly with ESRC, a new Social Care Evidence Centre. In 2020 we’ll be doing more to develop the infrastructure to support faster frontline improvement in the UK. This includes investing in the national set of Flow Coaching Academies, introducing two new grant programmes – on implementing technology and supporting patients and professionals to generate innovations for change – and growing the Q community to 5,000 members by the end of 2022. We are also funding, with NHS England and NHS Improvement, a programme across England to accelerate learning on developing anchor institutions in the NHS.

Third, AI and data science. Through our new Data Analytics for Better Health strategy, we are broadening our scope to help create a future where everyone can benefit from the huge possibilities. We’ll be using data to tackle the most pressing challenges facing health and health care, and supporting and conducting research into the risks as well as the opportunities that analytics and data-driven technologies pose. We’ll be bringing organisations together and looking to establish partnerships to address key issues. This new strategy builds on the track record we have already established as innovators in analytics, and our ability to establish significant initiatives like the Networked Data Lab and Improvement Analytics Unit. 

Fourth, resourcing health and care. We are establishing a new specialist centre within the Health Foundation – the REAL Centre (Research and Economic Analysis for the Long term), to be launched formally in the summer, to carry out long-term analysis of demand, supply and resources needed for health and social care in England. This follows calls to set up an independent ‘OBR’ (Office for Budget Responsibility) for health, for example made by the Lords Select Committee on the long-term sustainability of the NHS and adult social care in 2017. Watch out for the launch and linked inaugural lecture to get us off to a good start.

Fifth, improving national policy. With the breadth and ambition of work we are undertaking, it’s important to see the wood for the trees as to the direction of policy and what it means. We will be doing in-house analysis and commissioning work on a range of topics, from the path of reforms and initiatives, the evidence on them to date, how our health and care systems perform relative to those seen in other countries, and how best the NHS can get the right intelligence to anticipate and be more prepared for future challenges. Look out for evidence of the impact of devolution in Greater Manchester, deeper dive analysis on international comparisons, lectures on some big ‘futures issues’ such as the impact of social media on teen health, and how the NHS might respond even better to the challenge of climate change. Oh yes and an update to our popular book ‘Glaziers and Window Breakers’ on the insights from former Secretaries of State for Health, the newest chapter being on Jeremy Hunt.

That’s a rapid canter through the headlines. I am writing this on blue Monday – 20 January 2020 – but no blues here. If you are as gripped as we are, don’t forget to sign up for more regular updates.

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.

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