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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?

  • 1. Developing Labour Health Policy: what does the evidence tell us? • Ruth Thorlby, Nuffield Trust © Nuffield Trust
  • 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
  • 4. Changes in average real earnings, selected NHS staff groups, England © Nuffield Trust
  • 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
  • 11. Changes in number of NHS Staff, England 1998-2008 © Nuffield Trust
  • 12. Patients aware of choice 2006-2009 © Nuffield Trust
  • 13. Changes in inputs, outputs and quality adjusted productivity, UK NHS © Nuffield Trust

Editor's Notes

  1. Targets and terror?Central control or local flexibility?Contribution from ISTCs?
  2. 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?
  3. 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
  4. Huge investment : alot went on staff, all types, including managers