Helping people in the UK to be healthier

The Health Foundation is expanding its scope, looking beyond just health care to how the organisation’s activities can support population health across the UK. Jo Bibby, Director of Strategy and Innovation, is developing plans for 2016 and beyond. We spoke to her about what programmes of work and grant opportunities the Health Foundation is considering and how that might help people in the UK to live healthier lives.

Can you tell us about the Health Foundation’s new strategic aim to improve the health of the UK population?

At the Health Foundation we want people to have good health. We’ve contributed to that over the last 10-15 years by doing work to improve the health care that people receive across the UK, in particular making sure that it is safe and that it meets their needs.

But we recognise that health care is just one small aspect of what helps keep people healthy. In reality, how healthy people are is determined by wider factors such as where they live and work, what they eat, how much they exercise, and the social support networks they have...

So if we want people to have healthy lives we need to look not only at improving health care but also more widely at how we can address all these determinants of health.

Can you share any of your plans for work in this area yet?

We’re scoping work in three main areas at the moment before we lay down more concrete plans over the next 12 months.
 

1. Encouraging everyone to think differently about health

When the government talks about ‘investing in infrastructure’, they talk about energy, transport networks, etc. And in those areas they’re willing to make decisions based on planning over 30, 50, or even 100 years. Health is also a fundamental part of the infrastructure of any country. But when we talk about health we just talk about the NHS, and limit ourselves to one or two year funding decisions.

We’re still scoping how to do it, but we really want to encourage the government to make health a priority and to think about it more long term. This might include essays, thought papers, short films... anything that gets people thinking about how health is a lifetime challenge for our country.
 

2. Developing the evidence about what works

It’s difficult for the government to know where to invest when it’s not always clear what works. Should we have a sugar tax? Should we stop advertising junk food? Should we be offering cookery classes in primary school? Should we be investing in setting up walking groups, or prescribing free gym memberships? There are hundreds of ideas out there aimed at encouraging people to improve their health, but we don’t actually know which ones work best.

It’s difficult because these sorts of interventions don’t give you instant results at a population level. You might have to wait ten years, or even much longer. For example, encouraging healthy lifestyles in young people now might help to reduce vascular dementia when they’re older… but the results are a lifetime away. So how do we evaluate the benefits and make decisions now?

And whatever intervention you take, it will only be one of a myriad of different factors which influence a person’s health during their lifetime. So it makes it very, very challenging to work out what works.

We’ll be working on developing methods for evaluating health interventions in order to help the decision makers take action in the right way.
 

3. Building skills and funding work on the ground

This is familiar ground for the Health Foundation and after some careful scoping work we will be launching a substantial programme of funding over several years, similar to the support we’ve given in the past to patient safety and quality improvement.

It is too early to say what this might look like and exactly where we will focus but we will want to make a contribution to testing and evaluating approaches that improve population health. We’ll also be asking who are the ‘health’ leaders and what support do they need to mobilise the resources necessary to address this agenda.

But we’re just one player in this huge field. We need to take the next ten months or so to scope it out properly so that we know what others are doing, and rather than duplicating work, work out where we think we could add most value.
 

What can we learn from work to improve population health in other countries?

There’s lots of great work to learn from. But the context is different in each country. It’s not as simple as just going somewhere and saying ‘right, that’s what they’ve done and we’ll do the same’.

Finland has done some good stuff, tackling some of the underlying health issues they’ve had there. There’s also a project we’ve been following in Greater Massachusetts, led by the Boston Foundation. They’re using a balanced scorecard approach to assess how much their local environment supports healthy living. This is looking at a whole range of factors; education, community, as well as health care and workplaces. It would be very interesting to try and do something similar in the UK.

The Robert Wood Johnson Foundation in the US, like us, has done a lot of work to improve health care. They’re also moving now into looking at how they can improve health and are doing a lot of community-based initiatives. So we can learn a lot from them.

I’m really looking forward to a global seminar we’re holding with Salzburg Global Seminars and the Robert Wood Johnson Foundation in January called Hooked on Health Care. We’ve got representatives coming from around ten different countries to talk about developing strategies to improve health.
 

Find out more

If you want to hear more about our plans around supporting population health across the UK, please email website@health.org.uk