Developing Labour Health Policy: what does the evidence tell us?

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Socialist Health Association

Ruth Thorlby, Nuffield Trust May 2012

Health & Medicine Education

Developing Labour Health
Policy: what does the evidence
tell us?
• Ruth Thorlby, Nuffield Trust

© Nuffield Trust

Total inpatient waiting list, England 1996-2009

© Nuffield Trust

Source: Thorlby and Maybin eds., A High Performing NHS? King’s Fund

Deaths per 100,000 from circulatory diseases, selected
OECD countries, 1990-2007

© Nuffield Trust
Source: Thorlby and Maybin eds., A High Performing NHS? King’s Fund

Changes in average real earnings, selected NHS staff
groups, England

© Nuffield Trust

The Scale of the Challenge
Estimating the Nicholson Challenge for Health and Social
Care in England 2011-12 to 2021-22

© Nuffield Trust

Social Care Funding Social Care Pressures Health Funding Health Pressures

Average Number of Admissions Per Person Per Year
by Condition (Renal & Cancer Omitted)
2

1.9

1.8

Diab
1.7
CHD
Admissions Per Person

Epilepsy
COPD
1.6
Arthritis
HeartFailure
MH
1.5
Asthma
Dementia
Stroke
1.4

1.3

1.2
2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10
Year

© Nuffield Trust

Average Number of Admissions Per Person From 2004/05
to 2009/10
0.18

0.16

0.14
Admissions Per Person

0.12
Elective
Admission

Non-Elective
Admissions
0.1

0.08

0.06
2004-05 2005-06 2006-07 2007-08 2008-09 2009-10
Year

© Nuffield Trust

In 2009 an estimated 61% of adults (aged 16 and over) were overweight or
obese (National Obesity Observatory)

Trends in adult prevalence of obesity (BMI ≥30kg/m2) – percentage of the adult
population assessed as obese in a selection of countries
(NOO based on OECD data)

NHS Expenditure

Maternity
3% Other
Secondary
7% GPs
9%

Community Prescribing
10% 9%
Other Primary
Mental 6%
Illness
10%

Acute and A&E
47%

© Nuffield Trust

Changes in satisfaction with the way the NHS is run,
1993-1997

Source: Thorlby and Maybin eds., A High Performing NHS? King’s Fund © Nuffield Trust

Changes in number of NHS Staff, England 1998-2008

© Nuffield Trust

Patients aware of choice 2006-2009

© Nuffield Trust

Changes in inputs, outputs and quality adjusted
productivity, UK NHS

© Nuffield Trust

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Developing Labour Health Policy: what does the evidence tell us?

2. Total inpatient waiting list, England 1996-2009 © Nuffield Trust Source: Thorlby and Maybin eds., A High Performing NHS? King’s Fund

3. Deaths per 100,000 from circulatory diseases, selected OECD countries, 1990-2007 © Nuffield Trust Source: Thorlby and Maybin eds., A High Performing NHS? King’s Fund

5. The Scale of the Challenge Estimating the Nicholson Challenge for Health and Social Care in England 2011-12 to 2021-22 © Nuffield Trust Social Care Funding Social Care Pressures Health Funding Health Pressures

6. Average Number of Admissions Per Person Per Year by Condition (Renal & Cancer Omitted) 2 1.9 1.8 Diab 1.7 CHD Admissions Per Person Epilepsy COPD 1.6 Arthritis HeartFailure MH 1.5 Asthma Dementia Stroke 1.4 1.3 1.2 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 Year © Nuffield Trust

7. Average Number of Admissions Per Person From 2004/05 to 2009/10 0.18 0.16 0.14 Admissions Per Person 0.12 Elective Admission Non-Elective Admissions 0.1 0.08 0.06 2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 Year © Nuffield Trust

8. In 2009 an estimated 61% of adults (aged 16 and over) were overweight or obese (National Obesity Observatory) Trends in adult prevalence of obesity (BMI ≥30kg/m2) – percentage of the adult population assessed as obese in a selection of countries (NOO based on OECD data)

9. NHS Expenditure Maternity 3% Other Secondary 7% GPs 9% Community Prescribing 10% 9% Other Primary Mental 6% Illness 10% Acute and A&E 47% © Nuffield Trust

10. Changes in satisfaction with the way the NHS is run, 1993-1997 Source: Thorlby and Maybin eds., A High Performing NHS? King’s Fund © Nuffield Trust

Editor's Notes

Targets and terror?Central control or local flexibility?Contribution from ISTCs?
Consultants and GPs were the big winners: not clear that more productivity increased..GPs: era of financial incentives=QOF, DES, LES. What is the vision for changing public sector motivation?
Satisfaction at an all time highMore surveys of patient experience than ever before, but not clear they are sensitive enough to reflect quality failure or pick up views of the most vulnerable
Huge investment : alot went on staff, all types, including managers

Developing Labour Health Policy: what does the evidence tell us?

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Editor's Notes