Learning, work and health: six big challenges for the next 70 years of the NHS26 October 2018
This year the National Health Service celebrated its 70th birthday. There is no question that the overall health of the population in England has improved greatly over the last 7 decades, but we must also recognise that the health challenges of 2018 are very different to those of 1948: we live longer, we smoke less but other ‘lifestyle diseases’ are still prevalent and cost millions to address. The focus of our health spending is largely on cure and rehabilitation rather than prevention. And yet learning and work both have a clear role to play in working alongside the NHS to ensure a healthier nation.
There are clear links between learning and health: many international surveys show that people with higher qualifications tend to enjoy better health, and levels of qualification are also linked to how we make use of health services, how we manage our own health and that of those we care for.
Similarly, workplaces are critical to our health. Many people spend a large part of their lives at work and increasingly have longer working lives. Generally speaking, work is good for us – but it has to be ‘good’ work – precarious and insecure employment can be harmful to our health.
Our report ‘Learning, work and health: the next 70 years’ proposed six big challenges which, if achieved, would support a greater coordination of health, learning and work, as we move into the third decade of the 21st century.
- Future funding of healthcare needs to better address the social determinants of poor health. Prevention is better than cure. Social solutions, such as access to learning and support to work, can also be part of supporting people with health conditions. The new NHS Forward View is a golden opportunity to do this, as would increased investment in public health initiatives that link more closely with other devolved funding such as the adult education budget. Similarly, the joint Work and Health Unit set up to look at how to better join up employment and health programmes and policy could have its remit widened to include learning and its £70 million budget expanded to £100 million with joint investment from DHSC, DWP and DfE.
- A coordinated approach to health and associated services, including adult learning and employment services, should be adopted locally with multidisciplinary teams to avoid unnecessary duplication.
- Social prescribing to support learning linked to health, work and communities should be extended across the UK. We argue that linking social prescribing with entitlement to a personal learning account would help give people greater choice and ownership over their learning, as well as more flexible help with the cost.
- Person-centred curricula, using an asset-based approach, to enhance capabilities and existing knowledge, should be adopted, again making using of multidisciplinary teams.
- Government should accelerate plans to transform how we support disabled people into work, to stay in employment and to progress.
- Devolution Deal areas should work with government to set out how they will halve the disability employment gap together and then to develop ‘local labour market agreements’ to deliver it.
To investigate this further, Learning and Work Institute polled 3,000 adults across England. We asked them how they thought about their health in general, how well they knew how to keep healthy or improve their health, and which three changes they thought would help them to keep healthy or improve their health.
The poll showed that many of us have very different views on how healthcare spending should be allocated. For example, older people are more likely to favour investment in hospitals, while younger adults favour a more balanced approach including social prescribing and preventative models. Those in poorer health are least likely to say they know how to improve their health. Generally speaking, the public seems to think a more balanced range of approaches are appropriate.
This is a critical finding at a time when government has pledged more funding for the NHS. How that plays out is important.
The NHS is not an organisation but a set of interrelated services which need to work more closely in partnership with social care, local learning and employment services, and employers themselves to give everyone, regardless of background, a fairer chance in life. Interconnected issues deserve interconnected solutions.
Joyce Black, deputy director for research and development, Learning and Work Institute