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BBC Question Time audience applaud Wes Streeting's takedown of Rishi Sunak's 'sick note culture'

Rishi Sunak was accused last week of distracting from his own failures as he used a speech to warn against 'medicalising the everyday challenges and worries of life'

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NHS and the whole of society must act on social determinants of health for a healthier future

Health is going in the wrong direction in the UK, and reversing the trend requires political and societal commitment to deal with the underlying causes

The UK is facing a prolonged and serious health crisis. At a time when the future of the NHS is in jeopardy after over a decade of austerity, and with public satisfaction at an all time low,1 it must pick up the pieces of failures across government. Attaining good health requires more than healthcare, and improvements in the provision of healthcare by the NHS alone is inadequate to address the health crisis—action is needed on the social determinants of health2 (box 1).

Box 1
### Definition of social determinants of health3

The social determinants of health are defined by the World Health Organization as: “the conditions in which people are born, grow, live, work, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies, and political systems.”RETURN TO TEXT

In this paper, we propose evidence based solutions to the worsening health and widening inequalities in the UK through action on the social determinants of health. (A separate article within the commission is focused on health equity.4) We first outline the problem of deteriorating health across the UK. We then provide an overview of the evidence, showing how action on the social determinants can improve health. We confront the challenging political nature of this area, including rebuttal of criticisms of interventions as actions of a “nanny state” and the neoliberal focus on individualism. Finally, we offer action focused solutions and recommendations on what NHS workers, leaders of NHS organisations and integrated care systems, and the government can do to urgently deal with the deteriorating health of the population.

Although much of the …

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Sustainability is critical for future proofing the NHS

Interventions that consider climate change, sustainability, and nature should be integral to health system functioning. Placing sustainability at the core of the NHS’s future offers opportunities to deliver better services, support healthier populations, and save costs.

The combined threats of climate change and biodiversity loss are a global public health emergency requiring urgent attention.12 The health impacts of these crises are far reaching, spanning the direct effects of changing weather patterns, such as heat waves causing cardiovascular events or severe dehydration; damage to health infrastructure through extreme weather events; system disruptions to the upstream determinants of health, such as reduced crop viability affecting nutritional status; and the direct health effects of fossil fuel combustion, such as respiratory diseases from air pollution.3 The NHS contributes about 5% of UK fossil fuel emissions and generates substantial waste,4 which feeds into a cycle where health systems experience the impacts of climate risks while simultaneously contributing to the processes that drive them.

Sustainability must be at the heart of the NHS as we look to the future, both to improve the health system today and to make it resilient to future shocks. As an anchor institution that touches the lives of every person in the UK, the NHS must be a powerful advocate and driver for the societal changes needed to respond to the climate and biodiversity crises. The interventions required are mitigation—reducing contributions to global warming by reducing greenhouse gas emissions and other waste; and adaptation—adjusting to current or expected climate change and its effects, with the aim of minimising harm and exploiting beneficial opportunities. Beyond reducing carbon emissions, sustainable healthcare must also consider the sector’s consumption and waste practices, alongside a shift in values related to the human-nature association that reduces inequalities and promotes health and wellbeing for …

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The future of the NHS depends on its workforce

The future of the NHS depends on its workforce
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Next government must be bold to tackle worst NHS crisis ever, says BMJ commission

The NHS is facing the most severe crisis in its history, and bold leadership is needed from the next government to rebuild the service and put health at the centre of all policy, a group of experts has urged.

The first report of the BMJ Commission on the Future of the NHS (bmj.com/nhs-commission), which launched this week, identified years of constrained funding, workforce shortages, and high demand from an ageing population as some of the key pressure points on the health service.1 The next government should declare a national health and care emergency and urge all parts of society to play their part in helping improve the health, care, and wellbeing of the population, it argued.

The commission brings together leading experts from medicine and healthcare to identify key challenges and priorities and make recommendations aimed at ensuring that the vision of the NHS is realised. It is co-chaired by Victor Adebowale, Parveen …

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Experts say next UK government should declare a national health and care emergency

Experts say next UK government should declare a national health and care emergency
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Next government should declare NHS a national emergency, experts warn

Leading doctors and NHS leaders say underinvestment, staff shortages and ageing population pose ‘existential threat’ to service

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Next Govt Urged to Declare National Health, Care Emergency

Next Govt Urged to Declare National Health, Care Emergency
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BMJ calls for UK to declare "national healthcare emergency" amid NHS' "gravest crisis"

The British Medical Journal has taken the somewhat extraordinary step of calling on the next UK government to declare a “national health and care emergency".

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The BMJ's NHS commission: an emphatic recommitment to the founding principles

The first report of the BMJ Commission on the Future of the NHS calls for the declaration of a national health and care emergency and an urgent reset for the NHS

Just before the National Health Service began in the UK, Aneurin Bevan, the minister of health in 1948, wrote in The BMJ : “On July 5 there is no reason why the whole of the doctor-patient relationship should not be freed from what most of us feel should be irrelevant to it, the money factor. The picture I have always visualized is one … of a nation deciding to make healthcare easier and more effective by pooling its resources—each sharing the cost as [they] can through regular taxation and otherwise while [they are] well, and each able to use the resulting resources if and when [they are] ill.”1

Since Bevan outlined his vision, health, healthcare, and wider society have vastly changed. Life expectancy has improved from 70 years for females and 66 years for males in 1948, to 83 years and 79 years respectively in 2020.2 Healthcare is transformed through innovations in diagnostics, imaging, and therapeutics. The expectations of a growing and ageing population are spiralling, placing great strain on the NHS, with staff burnt out from working in poor environments and living with the moral distress of being unable to …

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