Press release: England’s 32 cash-strapped ‘risk zones’

Researchers find higher rates of preventable deaths in areas where there is both poor health outcomes and hospitals are in financial trouble.

Health economists publish new analysis which names 32 areas in England where you are 29% more likely to die of preventable causes.

The Centre for Progressive Policy (CPP) has released a paper today, Diagnosis Critical, which identifies these 32 ‘risk zones’, each of which have below average health outcomes and NHS trusts in deficit.

CPP’s economists have found age-standardised mortality rates for causes considered avoidable, amenable and preventative are 29% higher in these risk zones than in other local authority areas.

The data also identifies 13 ‘crunch zones’ which may not be prepared for ageing populations and where social care is currently underfunded. This is compounding pressure on the NHS and making trusts more likely to run deficits. Without urgent intervention these areas have the potential to become risk zones.

To respond to these challenges CPP has launched a 12-month programme of data-led research and deliberative public and professional engagement supported by an advisory group of senior international leaders from across health, technology and social care, including Sir Mike Richards, Professor Sir Cyril Chantler, Dame Julie Moore, Margaret Willcox and Stephen Klasko MD. The programme will result in recommendations for a truly sustainable, high quality system of health and social care for the future.

Dr Sarah Wollaston MP, chair of the Health and Social Care Select Committee, said:

Welcoming the report, Sir Cyril Chantler, Emeritus Chairman UCLPartners Academic Health Science Partnership, said:

“This new analysis has shown an alarming trend between hospital pressure and financial deficits and below average health outcomes resulting in the 32 risk zones. We must act now to protect those residing in the risk zones and prevent any more from occurring. I look forward to continuing to work with CPP on their research and anticipate their suggestions in how we can truly make the health service both high quality and sustainable.”

Charlotte Alldritt, Director of the Centre for Progressive Policy, who emphasises the importance of a long-term strategy and funding settlement for health and social care, said:

“The government is under increasing pressure to respond to a health and social care funding crisis. But the chronic challenges facing the NHS demand more than a short-term cash injection or another five – or even ten – year strategy. A new approach to health and care is needed that can cope with our ageing population, improve joint working between local government, community services and the NHS and take up the opportunities of technology for diagnostics and delivery, and embed health outcomes within a wider, place-based economic and social policy interventions. This could imply a radical shift in our expectations of the state – and ourselves as patients and citizens – with huge implications for how we fund and deliver these essential public services.”

The paper presents other new analysis, including the statistics that should a typical NHS trust increase its funding by 10%, it would improve its:

  • Average A&E performance (i.e. seeing A&E attendees within four hours), from 94.4% to 95.8%, just over the 95% national standard
  • Elective care waiting times, from 83.1% of all patients referred within 18 weeks to 88.4%, closing the gap by 59%, but still short of the 92% national standard
  • The cancer treatment performance would improve by 29%, thus increasing the amount of patients seen within the national guideline times from 88% to 91%, above the 85% national standard.

Notes to Editor

1. The report is available to download here.

2. The Centre for Progressive Policy is a new think tank committed to making inclusive economic growth a reality, led by Charlotte Alldritt, former Senior Policy Advisor to Nick Clegg. By working with national and local partners, CPP aims to devise effective, pragmatic policy solutions to drive productivity and shared prosperity in the UK. The relationship between health indicators and social and economic outcomes means that health must be a central component of national and local inclusive growth strategies.

3. CPP is supported by ZPB Associates, a healthcare consultancy throughout the inquiry.

4. CPP’s authoritative advisory group of clinical and non-clinical professionals includes:

  • Professor Mike Bewick, former Deputy Medical Director, NHS England and Independent Chair Mid and South Essex STP Joint Committee
  • Sir Cyril Chantler, Honorary fellow and emeritus chairman UCL Partners academic health science partnership
  • Dr Maureen Dalziel, former Chair, Barking, Havering and Redbridge University Hospitals NHS Trust
  • Pam Garside, Fellow, Judge Business School, Cambridge University
  • Sir Ian Gilmore, Professor, University of Liverpool and former President, Royal College of Physicians
  • Peter Kopelman, Emeritus Professor of Medicine, Former Principal, St George’s, University of London
  • Alex Kafetz, Managing Director, ZPB Associates and Independent Member of the National Information Board
  • Tim Kelsey, CEO, Australian Digital Health Agency
  • Stephen K. Klasko, M.D., M.B.A., President and CEO, Thomas Jefferson University and Jefferson Health
  • Dame Julie Moore, Chief Executive, University Hospitals Birmingham
  • Margaret Willcox, Past President, ADASS
  • Professor Sir Mike Richards, former Chief of Inspector Hospitals, Care Quality Commission
  • Professor Sir Terence Stephenson, Chair, General Medical Council and Nuffield Professor of Child Health, Institute of Child Health, UCL
  • Charlotte Alldritt, Director, Centre for Progressive Policy

5. The project will run for 12 months, between May 2018 and May 2019, reporting as we head into the first legislative window following the UK’s departure from the European Union. Key outputs will include:

  • Deliberative public engagement events (July – October 2018) to devise and test innovative, practicable solutions.
  • Deep sector engagement (June 2018 – November 2018) with clinicians and policymakers (including via sector events, such as NHS Expo, PHE Annual Conference, as well as CPP’s inaugural summit).
  • Political engagement and influencing (September 2018 – May 2019) including 1:1 meetings and party conference fringe events.
  • Edited collection of future scenarios (May 2019) written by leading international thinkers and health professionals setting out more radical policy proposals, costed by CPP.
  • Final report (May 2019) including primary recommended policy option, costed with outline transition plan and accompanied by video footage/vox pops of engagement activity.

6. CPP seeks to engage with other initiatives to ensure we add value and feed into emerging political debate. But our focus will also extend to considering a range of more ambitious financial, structural and operational policy options for the longer term.

For more information or to interview Charlotte Alldritt please contact Charlie Smoothy at ZPB Associates: