News / Major conditions strategy offers blueprint for improved outcomes

Introducing a report trailing the future publication of a Major conditions strategy, health and social care secretary Steve Barclay (pictured) said that in most cases, poor health arose from living with at least one of these health conditions ‘That is why we have taken the decision to develop a major conditions strategy – a blueprint for improving outcomes over the next five years covering cancer, heart disease, musculoskeletal disorders, mental ill-health, dementia and respiratory diseases.

The report added that ‘improving outcomes in each of these areas would transform the lives of millions of people and fulfil the UK government’s aims to increase healthy life expectancy and reduce ill-health related labour market inactivity’.

To tackle these conditions, the strategy envisions action in three areas.

The first priority is primary prevention to ‘bear down on the principal lifestyle drivers of illness such as obesity and smoking. The next priority is secondary prevention, which covers early interventions in an effort to prevent complications and symptoms from worsening.  This problem became particularly acute during the Covid-19 pandemic, where it is thought that millions of people did not come forward as usual for check-ups, scans, tests and treatments.

Early diagnosis and treatment are the third priority, based on the principle that early detection significantly improves outcomes from treatment and reduces the impact the condition has on a person’s life. The strategy policy paper notes that the NHS has historically performed poorly in this area, including in core areas like musculoskeletal disorders, stroke and dementia.

The final priority is to provide ongoing support for people living with major conditions long term, in cases where they cannot be fully prevented or cured. Other services that can be integrated into care, like support for families and unpaid carers, are more important here.

Danny Mortimer, deputy chief executive of NHS Confederation, welcomed the direction of travel set out by the new strategy. ‘Given the previously planned health disparities white paper has been absorbed by this new strategy, [healthcare leaders] need to see the strategy translate into decisive action across government to tackle chronic comorbidities and the disparities between different communities, as well as reducing demand for NHS services for the longer term.’

He added that joint working would be vital to the delivery of the strategy, with integrated care systems ideally placed to implement it. But he added that national public policy and investment also had to play their part in creating healthier communities.

Nuffield Trust senior policy analyst, Sally Gainsbury said it was right to focus on primary prevention, early diagnosis and symptom management. ‘What is 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.’

She also questioned whether the strategy placed enough emphasis on tackling health inequalities