Hospital worker says leaving EU had negative impact on NHS

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Health levels remained stable in England in the years leading up to the pandemic, yet the broader picture disguised growing regional disparities. The contrast is most stark within the county of Lancashire – home to the least and most healthy local authorities in England. A year after the foundation of the Office for Health Improvement and Disparities (OHID), research conducted by the ONS shows some areas in 2019 remained far below 2015’s National Health Index. 

The health and care system across the UK is under intense pressure as an ageing population, rising patient expectations and critical workforce shortages have led to unprecedented waiting times. Patient and public satisfaction with the NHS has consequently dropped significantly.

However, the broader picture of health in the country varies widely by region. According to the King’s Fund, men in England’s most deprived areas live almost 10 years fewer than those in the least deprived, with women living seven years fewer. An international study attributed half the difference in life expectancy to a higher prevalence of smoking in more deprived areas – with a similar conclusion drawn for obesity rates.

In a bid to address these disparities, in October 2021 the Government launched the OHID. Then-Health and Social Care Secretary, Sajid Javid said: “The pandemic has laid bare the health disparities we face not only as a country but as communities and individuals. This must change and this body marks a new era of preventative healthcare to help people live healthier, happier and longer lives.

“The Office for Health Improvement and Disparities will be the driving force across government, supported by communities, academics, industry and employers, to level up the health of our nation, which will reduce the pressure on our NHS and care services.”

Although the move was prompted by the pandemic, recent data released by the ONS show sharp geographic contrasts in general health levels have existed for many years.

The ONS compiles a variety of indicators to produce its overall Health Index score for each local authority in England. These include measures of physical health, mental health, living conditions, crime and access to services, among others.

The most recent data release tracks each area’s Health Index between 2015 – with a score of 100 representing the national average for that year – and 2019. The data show health in England remained relatively stable in the years leading up to the pandemic.

Indeed, over that time, improvements in areas such as risks to young people were offset by declines in others, such as mental health. However, disparities also emerged between different regions. 

Health declined in the North East – in part due to its crime score falling significantly from 96.5 to 89 – but improved in the North West, where behavioural risk factors improved from 94.3 to 95.5. 

In 2019, the South East has the highest regional Health Index score (102.9), but at a local level, the healthiest places to live are in fact dispersed all over the country.

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Ribble Valley in Lancashire was found to be the healthiest area in England in 2019, reporting a Health Index of 112.9 – representing a 12.9 percent improvement from the 2015 national average. 

Across all component health indicators, Ribble Valley scored highest in the “Children and young people” category, which looks at early years development, teenage pregnancy, and young people in education, employment and apprenticeships – scoring 122.7.

Indeed, many among the top 10 healthiest local authorities in England score particularly high in this domain, as shown by second-placed Hart in Hampshire – with an overall Health Index of 111 – recording a 128. Third-placed Rushcliffe in Nottinghamshire (110.2) scored highest in the country in “Children and young people” with 129.4.

Then came Wokingham in Berkshire (110.1), Waverley in Surrey (110.1) and Eden in Devon (110).

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On the tail end of the spectrum, the data also reveal the most unhealthy areas in the country – Blackpool chief among them.

The Lancashire seaside resort’s 2019 Health Index came in at 90.6 – almost 10 percent lower than the national average of four years earlier. Blackpool scores particularly low on life expectancy (73.1) and avoidable mortality (70.9) – both categories in which it is the worst in the country – and alcohol misuse (76.3).

Manchester came second with an overall index of 90.8, brought down by a mental health conditions index of 74.6 – the fourth-lowest in the country – and the second-worst avoidable mortality score, also at 74.6.

In third place is Middlesbrough, North Yorkshire, with an overall score of 91, followed by Lincoln, Lincolnshire (91.6) and Hull in the East Riding of Yorkshire (91.8).

For comparison, internationally the UK’s standing as a whole varies depending on the metric considered.

According to a 2021 analysis of 11 comparably developed nations by the Commonwealth Fund, the NHS ranked fourth in terms of overall quality, behind Norway, the Netherlands and Australia. 

In terms of life expectancy at birth, according to the latest estimates by the World Health Organisation (WHO), the UK ranks 25th in the world at 81.4 years – behind the likes of first-placed Japan (84.3 years), France (82.5) and Germany (81.7).

According to Our World in Data, in 2019 Wales reported the highest proportion of inhabitants with an alcohol disorder in the world, at 4.5 percent. Scotland was third-placed on 4.19 percent and England came tenth at 3.33 percent.

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