Major ambitions in a new Major Conditions Strategy

A new health strategy is coming – finally! And it threatens to be a whopper.  

A Major Conditions Strategy will be consulted on – and potentially published – in 2023. After months of firefighting on day-to-day NHS operational performance the Government is looking to get back on the front foot and show the world it still has ambitions to improve the long term health of this nation. 

2022’s political turbulence put the 10-year cancer, dementia and mental health plans on ice, saw off the health disparities white paper, delayed the workforce plan, stalled the implementation of the Life Sciences Vision, and neutered the joint DHSC and NHS England Long-Term Plan refresh. Pressure on NHS services across the country and at every point in the system made long term strategising – however urgently needed – impossible. 

Steve Barclay’s ministerial statement today is an attempt to correct this perception, while streamlining the numerous strategies his predecessors committed the Department to.  

In short, the Government and NHS England will be developing a new strategy for ‘major conditions’ including cancers, cardiovascular disease – including stroke and diabetes, dementia, mental ill health and musculoskeletal disorders.  

The ambition is to develop a ‘strong and coherent policy agenda’ building on the progress of the NHS Long Term Plan to deliver the Government’s manifesto commitment of gaining five extra years of Healthy Life Expectancy by 2035.  

The statement makes for dizzying reading as it sweeps across healthcare hot topics: 

• Alleviating pressure on the health system 
• Reducing labour market inactivity due to ill-health 
• Harnessing the potential of whole person care and breaking down system silos 
• Creating a workforce with greater emphasis on generalist medical skill 
• Early detection 
• Harnessing innovation and technology  
• Reducing unwarranted variation  
• Supporting ICSs to maximise opportunities to tackle disadvantage 

Given the breadth of the scope, it will likely generate cynicism as well as hope. There is no doubt that there are many big challenges that need addressing – conditions like diabetes and dementia have a huge impact on society and individual lives, and have consistently not received the attention they need to drive meaningful improvements in care.  

However, there is also a very real risk that this new attempt at a sweeping strategy is seen primarily as a move to kick action into the long grass, while giving ministers an answer to the persistent questions about progress on long awaited strategies in cancer, dementia and mental health. As healthcare has become increasingly political, today’s announcement is primarily about providing a degree of political cover.  

The consultation will need to address how any new strategy aligns with the wider approach to delivery. A major national review across multiple disease areas doesn’t naturally lend itself to the agenda of greater delegation of powers to ICSs through Hewitt Review or the removal of centrally imposed targets. It is also unlikely that significant funding will accompany reforms when all signals point to the expectation of efficiency and restraint.  

The health community will inevitably, and rightly, want to engage again: sharing evidence, policies, and best practice examples to try and shape this latest attempt at a vision for the future of care.  

But how many times can stakeholders and patients be walked up the hill without seeing any tangible change?