NHS Providers view

We welcome the initial commitments set out in this case for change and strategic framework and can see that many of the priorities we set out in our written response to the call for evidence are reflected in the document. We look forward to more detail being published in the full version of the final strategy in early 2024 and would welcome more specific information on the role of NHS trusts in delivering the actions outlined. It is important that the final strategy document recognises the
operational pressures facing NHS trusts and aligns to other existing guidance and strategies, particularly around backlog recovery.

We welcome the focus on primary prevention, secondary prevention and managing long term conditions. We also welcome the life course approach to major conditions, as we know that the onset of many conditions is in childhood and adolescence and interventions will need to be taken during this period in order to prevent ill health. NHS trusts play a vital role in prevention and care management, as demonstrated in our report Providers Deliver: New roles in prevention. As anchor institutions, trusts positively influence the population health and wellbeing of a local area.

In the final Major Conditions Strategy, more detail should be provided on how NHS trust will be supported to overcome the barriers they face in prioritising action on prevention. This includes: improving the  accessibility and interoperability of data within systems, increasing dedicated funding for prevention and tackling operational pressures that often divert focus away from prevention. 

We support the commitments to improve early diagnosis and treatment of conditions and welcome the plans to bolster community care and invest in digital technologies. The focus on personalised patient care is particularly welcome, as we know that current care is often narrowly focused on the treatment of specific diseases or organs in the body. The interim report rightly recognises the increasing multi-morbidity of patients, whereby a holistic and integrated approach to care is most
beneficial. We also welcome the signals within the document to achieve parity of esteem between physical and mental health conditions. Delivering timely and accurate diagnosis and high-quality
treatment relies on a fully resourced NHS workforce. It is therefore crucial that the NHS Long Term Workforce Plan is fully funded and implemented to complement the Major Conditions Strategy.

We welcome the commitment to reducing health inequalities and tackling the wider determinants of health, which underpins the interim strategy. We know that disparities exist across a range of health outcomes and within the six conditions outlined in the strategy. However, actions to reduce disparities and improve prevention cannot be the sole responsibility of NHS services. The final strategy should further outline the role of cross-government departments on this agenda. Poverty drives health inequalities and economic inequalities must be tackled in order to see improvements, requiring action across governmental departments and sectors. The government must be committed to taking centralised decisions to improve health and wellbeing, such as reformulation of unhealthy food products. Cuts to the public health grant in recent years have undermined the efforts of local authorities to improve population health and reduce inequalities. There must be increased support for public services, such as public health and social care, given the crucial role these services play in providing wider care.