Government ‘must support health service’ to deliver Major Conditions Strategy

The Government must provide the health service with more support to fulfil its ambition of extending healthy life expectancy and reducing premature death, an expert has warned.

It comes after the Department for Health and Social Care (DHSC) published an interim report on its Major Conditions Strategy, a five-year blueprint to help manage six disease groups more effectively and tackle health inequality.

The groups are cancer, cardiovascular disease – including stroke and diabetes – musculoskeletal conditions, chronic respiratory diseases, mental health conditions and dementia.

A perennial problem in healthcare... is that those who need help the most are often the least likely to access it

The Government said the illnesses “account for over 60% of ill health and early death in England”, while patients with two or more conditions account for about 50% of hospital admissions, outpatient visits and primary care consultations.

By 2035, two-thirds of adults over 65 are expected to be living with two or more conditions, while 17% could have four or more.

Sally Gainsbury, Nuffield Trust senior policy analyst, said the Government is right to focus on the six conditions, but “will need to shift more of its focus towards primary prevention, early diagnosis and symptom management”.

She added: “What’s less clear is how Government will support health and care systems to do this in the context of severe pressures on staff and other resources, as well as a political culture that tends to place far more focus on what happens inside hospitals than what happens in community healthcare services, GP practices and pharmacies.

“This initiative is both long overdue and its emphasis has shifted over time. The Major Conditions Strategy is being developed in place of a White Paper on health inequalities originally promised over 18 months ago.

“While the strategy’s six major conditions are also those conditions which form the immediate drivers of health inequalities in England, a perennial problem in healthcare – as with other public services – is that those who need help the most are often the least likely to access it.”

The DHSC made a call for evidence for the Major Conditions Strategy in May and Health Secretary Steve Barclay said the “wide-ranging engagement has provided food for thought”.

He wrote: “We have heard how our citizens are not always empowered to live as healthily as they could, how people can find it difficult to navigate a fragmented system and that our present services are not always well placed to support people with more than one risk or condition.

“This means that support and care can be disjointed, waits are longer than they need to be, prescriptions interact unhelpfully and individuals living with long-term conditions can lack the ongoing help they need.”

The report said the Government will use its findings to develop its final strategy into 2024, adding that it recognises “that difficult choices will have to be made” about where efforts are prioritised.

David Thomas, head of policy at Alzheimer’s Research UK, said the DHSC report “is a step in the right direction”.

“Now we need to see rapid action if the strategy is to deliver, not just for people who are living with dementia, but for those who are anxiously waiting for diagnosis, and those who are at risk of developing it in the future,” he added.

Jacob Lant, chief executive of charity National Voices, also said the strategy “has the opportunity to transform the healthcare system”.

“We’ve been encouraged by how far the Government has shown willingness to listen and respond to challenge from the voluntary and community sector on the Major Conditions Strategy during its early development.

“We now need the final version to clearly lay out achievable short and long-term goals which have been designed in conjunction with the people and communities it aims to help.”