Securing Good Health for the Whole Population index

25 February 2004

Securing Good Health for the Whole Population: Final Report, 25 February 2004
In April 2003, the Prime Minister, the Chancellor and the Secretary of State for Health asked Derek Wanless, ex-Group Chief Executive of NatWest, to provide an update of the challenges in implementing the fully engaged scenario set out in his report on long-term health trends. Derek Wanless' final report "Securing Good Health for the Whole Population" was published on 25th February 2004.

Securing good health for the whole population: Population Health Trends, 9 December 2003

Launched on 9th December 2003, this document Securing Good Health for the Whole Population: Population Health Trends describes recent health trends in England and sets the context of Derek Wanless' current Review.

The document is available below in Adobe Acrobat Portable Document Format (PDF). If you do not have Adobe Acrobat installed on your computer you can download the software free of charge from the Adobe website. For alternative ways to read PDF documents and further information on website accessibility visit the HM Treasury accessibility page.

Securing Good Health for the Whole Population: Population Health Trends (PDF 446KB)

Background

Securing our future health: Taking a long-term view, Final Report
Derek Wanless, biography

Prior to the 2002 Spending Review Derek Wanless was asked to assess “the financial and other resources required to ensure that the NHS can provide a publicly funded, comprehensive, high quality service on the basis of clinical need and not ability to pay”.

The review concluded that the UK must devote a significantly larger share of its national income to health care over the next 20 years to catch up with the best developed countries in 10 years and keep up for the following 10, and that success or failure would depend largely on how effectively the health service uses its resources.

The Review looked at three different scenarios, including a “fully engaged” scenario in which the level of public engagement in relation to health is high, life expectancy goes beyond current forecasts, health status improves dramatically, use of resources is more efficient and the health service is responsive with high rates of technology uptake. The fully engaged scenario was the least expensive scenario modelled and delivered better health outcomes. In absolute expenditure terms the gap between the best and worst scenarios is large – around £30 billion by 2022/23, or half of current NHS expenditure.

Securing good health for the whole population, overview

In April 2003 Derek Wanless was asked by the Government to provide an update of the challenges in implementing the fully engaged scenario with a particular focus on cross-departmental work on preventative health measures and health inequalities.

The review will look at how public health spending decisions are taken and how to ensure that they can be taken, by whoever takes them, as cost-effectively and consistently as possible, in order to improve health outcomes for any given level of resources. This will include an assessment of the evidence about what interventions work and at what stage they work and will examine the adequacy of the evidence base on which they are made.

Terms of Reference for the review

The terms of reference for the review are as follows;

The review will be led by Derek Wanless and will report by early 2004 to the Secretary of State for Health, the Prime Minister and the Chancellor. It will focus on prevention and the wider determinants of health in England and in doing so will:

make recommendations to the Government on implementing cost-effective approaches to improving population health, prevention, and reducing health inequalities consistent with the public health aspects of the "fully engaged" scenario outlined in the first Wanless report;
help enlist support from across government and other agencies in addressing these issues; and
advise on whether the delivery plan to implement the Government's cross-cutting review on tackling health inequalities, and other follow-up action including public health delivery plans at the national and local level, is consistent with delivering the public health aspects of the "fully engaged" scenario in the Wanless review.

The review will not, other than in respect of public health, cover the financing or organisation of the National Health Service.

The review will consider some of the following questions:

What is best practice, in the UK and internationally, in public health policy?
How can we compare and prioritise between different public health interventions?
What is the best way to develop a cost-effective way of managing diseases (this can be with reference to one specific disease area)?
Is there a measure of cost-effectiveness that can be applied consistently across different interventions to improve population health?
How do public health measures compare with other measures and interventions in terms of cost-effectiveness?
What are the priorities in public health over the next 20 years that will help us to meet the fully engaged scenario?
And what does this mean for the health status of the population in 2022?
How does analysis about the cost-effectiveness of different interventions currently feed into spending on health promotion and prevention activities?
Is implementation of public health policy to date, and particularly over the last year, consistent with the fully engaged scenario?
What are the difficulties and barriers to implementing a cost-effectiveness approach?
How should the research programme to provide developing knowledge be funded and directed?

Enquiries regarding the report should be addressed to the Correspondence & Enquiry Unit

Wanless 2002 index

Independent Reviews index