Through a survey of experts from across the health and science fields, researchers captured diverse perspectives on what health challenges in England will be like in 20–30 years’ time, to inform NIHR’s future strategy and priorities with a rational view of the future.
Some key findings include the fact that ageing populations are living longer but not necessarily in better health, health inequalities are rising, and there is an increasing influence of unhealthy lifestyle choices.
Background
The rapid advancement of science, and demographic and societal changes, mean the health challenges that we will face in 20 years’ time may look significantly different to the landscape of health as it is in 2017 — just as the health challenges in 1997 differ to those today. With this in mind, many pieces of research are currently being launched to look into what the future of health looks like.
In January 2017, the National Institute for Health Research (NIHR) commissioned RAND Europe to conduct a survey of experts from across the health and science fields. The outcome of these surveys will be used to inform NIHR’s future strategy and priorities with a rational view of the future.
Goals
The objective of the study was to capture diverse perspectives on what health challenges in England will be like in 20–30 years’ time, and how they will differ from 2017. The study aimed to reflect both pervasive views and unique insights on key trends, shifts and drivers which will affect health and healthcare in the future, whether these are economic, social, technological, environmental or otherwise.
Methodology
To capture a rational and comprehensive view of the future, a survey questionnaire was developed and distributed to a diverse range of experts working in health and social care across the UK.
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.
Findings
The key trends, shifts and drivers that will affect future healthcare in England
Ageing populations are living longer but not necessarily in better health.
Health inequalities are rising.
There is an increasing influence of unhealthy lifestyle choices.
The prevalence of mental health issues is increasing, especially among children and older people.
There is a future threat of changing patterns of infectious and respiratory disease, in part due to antimicrobial resistance and air pollution.
The interaction of healthcare and advances in technology, medicine and data access
Technological advancements (e.g. artificial intelligence and digital apps) are expected to facilitate the roll-out of self-management approaches for patients. However, there are concerns that such approaches could exacerbate inequalities in health, due to accessibility.
Advances in genomics and personalised medicine hold transformative potential for prevention, diagnostics and treatment. While this was a consensus among respondents, the suggested degrees to which personalised approaches could be widely implemented in the NHS in the near future were varied.
Access to and the availability of data is another key area of predicted change. Researcher and clinician access to vast population level datasets (‘big data’) and linked service datasets could inform approaches to prevention, diagnostics and treatment.
Expected future changes to the delivery and organisation of healthcare services
Changes in models of care will be needed to tackle the health challenges associated with an ageing population and increasingly complex physical and mental illness. These will involve shifts towards more holistic, integrated models of care and prevention, supported by more multi-disciplinary working among health and social care professionals.
Areas for further research to help inform the future of health
Manage and understand multi-morbidity.
Address social determinants of health inequalities.
Understand the causes and effects of mental illness.
Respond to the threat of infectious disease pandemics.
Priority areas for health research funders
Ensure the responsiveness of research governance and ethics reviews to a changing research landscape.
Build and facilitate proven approaches to research translation.
Facilitate the use of appropriate methodologies and the latest technologies in designing and conducting health research.
Continue to strengthen patient and public engagement in health research.
