A Trowers levelling up publication: Levelling up health and well-being


In the wake of the Covid-19 pandemic, it is perhaps unsurprising that the UK Government's White Paper: Levelling up the United Kingdom (the White Paper) has health and life expectancy at the heart of its levelling up ambitions, given the stark visibility of health inequalities during the last two years across the UK. 

It is difficult to look at levelling up in silo as all of the themes are so closely linked and health is a prominent and reoccurring issue, interwoven throughout the White Paper.

Although there is so much to say about health and health reform in the current climate, this article focuses on the Governments aspirations in respect of the heath and well-being mission of the White Paper. The aspirations (referred to as the Health Mission) are:

By 2030, the gap in Healthy Life Expectancy (HLE) between local areas where it is highest and lowest will have narrowed, and by 2035 HLE will rise by 5 years(Chapter 3.3.3 (p200)); and

By 2030, well-being will have improved in every area of the UK, with the gap between top performing and other areas closing. Chapter 3 (p159),

Improving health outcomes is broken down into three sub-missions:

  1. improving public health;
  2. supporting people to change their food and diet; and
  3. tackling diagnostic backlogs.

The proposals at a glance

To tackle these missions, the White Paper states that it will act now to deal with one of the biggest contributors of ill health, poor diet and obesity by taking forward recommendations from Henry Dimbleby's independent review towards a National Food Strategy (the Food Strategy White paper). There are also plans to introduce a new Tobacco Control Plan and set up at least 100 Community Diagnostic Centres in England by 2025 to improve access to diagnostic services.

The White Paper is not new in introducing these ambitions and refers to other recent initiatives such as the 2019 NHS Long Term Plan and the Core20PLUS5 initiative to level up healthcare. There is also reference to the launch of the Office for Health Improvement and Disparities (OHID), established to tackle preventable risk factors such as smoking and obesity. We are reminded of the ambitious programme of building 40 new hospitals by 2030, the aim to deliver 50,000 more nurses and the huge investment in health and the NHS part funded by the new Health and Social Care Levy.

We are told that the Government will set out a strategy to tackle the core drivers of inequalities in health outcomes in a new White Paper on Health Disparities in England in 2022 – this will aim to reduce the gap in health outcomes with a strong focus on prevention and disparities by ethnicity, socioeconomic background and geography.

Delivery of the proposals – the challenge ahead

There has been much anticipation as to how "levelling up" will be addressed in the health sector and expectations have been high. Whether the White Paper has satisfied expectations in this area is yet to be seen. On the surface, a cynic might say that there is nothing new on the health front, it is an amalgamation of what was already being done as part of the NHS and health reforms being rebadged with the latest Government buzz word. However even such a cynic must recognise that reforming the health sector is a huge challenge and one which can no longer be carried out in silo.

Even if some of the health initiatives are already in motion, the White Paper stresses the importance of bringing together all of the threads to ensure that health is addressed as part of a wider focus. Health will impact directly and indirectly on a number of different areas such as education, employment and regeneration and the White Paper drives a much clearer link between the health of the population and the wealth of the population.

For the health sector to address these challenges, collaboration with the rest of the public sector is going to be key going forward and the Government needs to act now to remove barriers which make this task more difficult. Health inequality needs to be addressed at a local and national level and all parts of the public sector will play a role in this not just the NHS. For now we are encouraged that there is at least a shift from Government in this direction but as always the devil will be in the detail and we look forward to more details in due course and the publication of further White Papers such as the one on Health Disparities in England in 2022.


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