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Future of Health

Findings from a survey of stakeholders on the future of health and healthcare in England

by Jennie Corbett, Camilla d'Angelo, Lorenzo Gangitano, Jon Freeman

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Research Question

  1. What are the key trends, shifts and drivers (economic, social, technological, environmental or others) that will affect health and healthcare in England in the future?

The report presents findings from a survey conducted by RAND Europe at the request of the National Institute for Health Research (NIHR) to gather and synthesise stakeholder views on the future of health and healthcare in England in 20 to 30 years' time. The aim of the research was to generate an evidenced-based picture of the future health and healthcare needs, and how it might differ from today, in order to inform strategic discussions about the future priorities of the NIHR and the health and social care research communities more broadly.

The survey provided a rich and varied dataset based on responses from 300 stakeholders in total. A wide range of fields were represented, including public health, social care, primary care, cancer, genomics, mental health, geriatrics, child health, patient advocacy and health policy. The respondent group also included a number of professional and private stakeholder categories, such as clinicians, policy experts, academics and patient and public representatives.

The study findings validate a number of prominent health research priorities currently visible in England, such as antimicrobial resistance, the burden of dementia and age-related multi-morbidity, digital health and genomics. Interest in these areas and other themes, such as mental health, health inequalities and transforming health service models, cut across multiple disciplinary boundaries. However, it is clear that there are a variety of views among stakeholders on the relative importance of these areas of focus, and the best approach to manage their emergence in the coming decades.

The full dataset of survey responses, for which permission to share was given, has been published alongside the report and is a useful resource for those seeking to engage with a particular issue in more depth.

Download the dataset from nihr.ac.uk

Key Findings

  • Key trends and changes which emerged from the survey included: an ageing population that lives longer but not necessarily in better health; rising health inequalities; the increasing influence of unhealthy lifestyle choices; increases in the burden of mental health, especially for children and older people and; the future threat of changing patterns of infectious and respiratory disease, in part due to antimicrobial resistance (AMR) and air pollution.
  • Changes in models of care to tackle the health challenges associated with an ageing population and increasingly complex physical and mental illness included shifts towards more holistic, integrated models of care and prevention, which were supported by more multidisciplinary working among health and social care professionals.
  • Advances and expansion in the use of technology (e.g. artificial intelligence (AI) and digital apps) were expected to facilitate the roll-out of self-management approaches for patients, but concerns were expressed that due to differential access across groups such approaches could exacerbate inequalities in health.
  • Advances in genomics and personalised medicine were seen as holding transformative potential to prevention, diagnostics and treatment. However, respondent views varied on the degree to which personalised approaches could be widely implemented in the NHS in the near future.
  • Access to and the availability of data was another key area of predicted change, as researcher and clinician access to vast population level datasets ('big data') and linked service datasets could inform approaches to prevention, diagnostics and treatment.
  • Key areas deemed to warrant further research included: managing and understanding multi-morbidity; addressing social determinants of health inequalities; understanding the causes and effects of mental illness; and; responding to the threat of infectious disease pandemics.
  • Key priorities for health research funders: ensuring the responsiveness of research governance and ethics reviews to a changing research landscape; building and facilitating proven approaches to research translation; facilitating the use of appropriate methodologies and the latest technologies in designing and conducting health research, and; continuing to strengthen patient and public engagement in health research.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Methods

  • Chapter Three

    Views on the future health and healthcare landscape

  • Chapter Four

    Perceived priority areas for health research

  • Chapter Five

    Perceived priorities for supporting future health research and impact

  • Chapter Six

    Discussion

Research conducted by

The research described in this report was commissioned by the National Institute for Health Research (NIHR) and conducted by RAND Europe.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.