NIHR ‘Health Future’: 20 Year Forward View

Research has to be forward-looking. There is a delay between research being conceptualised and published; and for research aiming to have an impact on practice or policy, there is a (usually much longer) delay between publication and uptake. REF impact statements suggest a median of 15 years from publication to widespread uptake is typical, so taking a 20 year forward view is a reasonable starting point for a funder of research which aims to support the NHS, public health and social care. The rapid advance of science, and demographic and societal changes, mean the health challenges in 20 years will be as different from those in 2017 as those in 1997 were from today. For example, the remarkable improvements in cardiovascular mortality over the last 40 years, driven by science from many disciplines, are continuing on a broadly stable trajectory. Some of these future changes are not predictable due to as yet unrecognised disruptive scientific discovery, but over a 20 year timescale most major shifts will be the result of trends which are visible now.

The National Institute for Health Research (NIHR) strategy has to be informed by a rational view of the future, and we would like this to be one which is broadly shared by the scientific and health community. This is most useful to a funder of translational and applied research where major future challenges are predictable and could be addressed with insights from science, but where the scientific effort does not currently match the scale of the challenge. Two examples where it is broadly accepted the historical scale of scientific effort does not match the obvious need are antimicrobial resistance and multi-morbidity in the elderly. Where science is progressing rapidly, relative to need, the role of funders is to stand back, not interfere, and fund the best by open competitive processes. Where it is falling well short of future need, funders need to acknowledge that, identify why, and try to address barriers to progress by commissioning research. The key first step is to have an evidenced-based view of what future need will be, and how it will differ from today.

We are therefore writing to you, on behalf of the NIHR, to invite your views on what health challenges in England will be like in 20-30 years’ time, and how they will differ from today. The purpose of this project is to inform our strategic thinking and ensure our view of future health and healthcare (including social care and public health) incorporates diverse perspectives, from a broad range of experts from around the country, including those of patient and public representatives. The project adds to other recent health futures work such as the report by the Academy of Medical Sciences ‘Improving the health of the public by 2040’. We would like this to include a wide range of voices, so feel free to forward this on to people or organisations you think would be interested.

We invite your views on five related issues:

  • In relation to your area of interest (discipline or geography), what differences do you foresee in the state of health and provision of healthcare in England in 20-30 years’ time? In your answer, please consider if/how these changes might affect some populations (within England) differently to others, i.e. socioeconomic, ethnic groups and/or geographic groups.
  • What do you think will be the key drivers of the changes you have described?
  • In your view, what will be the major trends in health and healthcare in England over the next 20-30 years? (Going beyond your immediate area and expertise).
  • Are there any commonly discussed issues related to the future of health and healthcare in England which you believe to be overstated? If so, why do you believe them to be overstated?
  • Are there any issues that are underrepresented in the debates around the future of health and healthcare in England? If so, please describe them and explain why you think they merit greater attention.

You do not need to give an answer to every question.

The survey may be accessed at https://smapp2.rand.org/surv4/TakeSurvey.aspx?SurveyID=84KM47m5. The survey will close at 5pm on Friday 16 June. If you have any questions about the survey, please email the following address: FoH@dh.gsi.gov.uk. Opinions backed up by data are more useful (and powerful) than ones without so we encourage you to include links to data in your responses. However, please avoid linking to long publications. For the purposes of the report, only the written responses to the survey questions will be included in the synthesis.

It would be helpful if you could indicate whether you are responding as an individual, or on behalf of a group or organisation. We have contracted RAND Europe as an objective body to analyse and synthesise the survey responses. Findings will be presented in a published report which will be shared with all participants. We would also like to publish the names and affiliations of participants and to share verbatim, attributed responses both in the report and on the NIHR website to allow others to learn from your insights. However, if you ask us not to do so we will include your contribution in an unattributed pooled analysis. You will be asked for your consent for this during the survey.

Thank you in advance for taking the time to contribute to our shared understanding of the future of heath and healthcare in England.

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