Improving the health of the public by 2040 June 2017 Anne Johnson DBE FMedSci Professor of Infectious Disease Epidemiology, University College London

Aims of the project To explore the health challenges the UK population will face by 2040, and the opportunities to address them. To develop a vision for the health of the UK population by 2040. To ensure that by 2040: Transdisciplinary research underpins interventions to improve the health of the public. There is a highly skilled research workforce. Strong links exist between evidence, policy development, and service delivery. What’s out Recommendations about specific interventions Assessment of the strengths and weaknesses of the current UK public health system Thanks to our funders:

Our vision Primary aspiration for 2040 Substantial and ongoing reductions in health inequality, and improvements in mental health, physical health and health-related quality of life across the UK population Five supporting ambitions Environments All elements of the UK environment support healthy living for everybody. Empowerment People are empowered to actively contribute to their own and other people’s health. Values All sectors of society value health and health equity, and they are indicators of societal success. Sustainability Improvements to UK health are gained in ways that are economically, environmentally and socially sustainable.   Resilience The UK has developed resilience to potential health crises and is a major contributor to global health security. One underpinning requirement The UK has the transdisciplinary research capacity, capability and infrastructure to generate evidence to improve the health of the public

‘Health of the public’ research: a new paradigm There is still much we do not know. Interlinking factors that influence health. Confluence of social determinants, behaviour, and biology. How to solve the many challenges at a population level. Delivering on the promise of a comprehensive prevention agenda. Realising our vision depends on a shift from ‘public health’ to ‘health of the public’.

Implementation workshop Workshop in January 2017 Brought together key stakeholders for implementation of recommendations. Explored three priority areas Optimising research Linking research and delivery Training and capacity building

Optimising research UK Strategic Co-ordinating Body for Health of the Public Research (SCHOPR) Bring together a broad range of research funders and stakeholders – beyond the traditional biomedical sphere Provide strategic direction. Enhance co-ordination. Identify key priorities (‘Big questions’ and infrastructure). To be established as a sub-board of OSCHR Ensure co-ordination with UK Prevention Research Partnership (UKPRP) Working with NIHR on emerging strategy Office for Strategic Coordination of Health Research Board has agreed to establish a sub-Board to bring relevant funders together in order to start to identify and address issues in funding for public health research. The arrangements for the sub-Board are currently being finalised and its likely the Board will meet for the first time in the Autumn.

UK prevention Research Programme (PRP) Announced May 2017 Multi funder partnership of Research Councils, Health Departments and Charities Addresses many of concerns and principles in AMS HoTP 2040 report £40-50 million over 6-7 years Aim to produce robust new knowledge about implementable, cost effective, scalable, ways to improve population health and reduce inequalities in health By providing substantial long term investment to bring together a wide range of disciplines and stakeholders to build multidisciplinary teams addressing and answering big questions Capitalising on, and developing, opportunities from new digital technologies, ‘big data’, and basic sciences across a range of disciplines The partnership consists of three research councils (engineering and physical sciences research Council, economic and social research Council, the medical research Council); health departments from across the UK; and charities including the Wellcome trust and the British Heart Foundation. Funding to date is £40 million, but the existing funders would welcome new funders coming on board. Their vision is the generation of well evidenced new knowledge about interventions, policies, strategies, products, or designs that can be implemented by the relevant providers or authorities, are good value for money, and can be scaled up to a national level, which improve population health and reduce inequalities in health by preventing NCDs The partnership will do this by bringing together a number of different disciplines, not all of whom may have worked with each other before, and potential users and providers of research findings (users of research including both those who might implement research findings and the ultimate beneficiaries of any new policies, services or designs). Multidisciplinary teams will be created, funded and supported to undertake ambitious programmes of research. The funders have a particular interest in using capitalising on new opportunities provided by large-scale data capture and data linkage; new digital technologies, means of communication and social media; and recent developments in basic science whether that be in psychology, engineering, or biological science.

Harnessing the digital revolution Medical Informatics Physical data People Populations Systems Agents Personal Organisational EBI Sanger Administrative Data RC Farr Institute NHS Machine learning Speech processing Data architectures Natural language Linked data Security Social computation Sensors Robotics New therapeutic interventions Real Time HTA Integration in real time Discovery Science Precision Medicine Public Health Source: Andrew Morris

Understandingpatientdata.org ‘Understanding Patient Data has been set up to support better conversations about uses of health information.  We think that responsible use of patient data has the potential to improve everyone’s health and deliver better care. It is important that everyone …… can…understand more about the safeguards that are in place to protect patient confidentiality.’   

Linking research and delivery Regional hubs of engagement Strong support for these hubs at the implementation workshop Build on existing networks and bring in a wide range of sectors Co-ordination by a national oversight body with sufficient freedom for hubs to innovate Pilot year to allow hubs to gain experience and establish best practice Commitment by PHE to support implementation in its annual business plan “We recommend that Public Health England, Health Education England and their equivalents in Scotland, Wales and Northern Ireland work with the research community to develop regional hubs of engagement between practitioners and researchers to integrate health of the public research and health and social care delivery, building on existing national and regional public health structures, which together can form a UK-wide network”

Training and capacity building Fostering transdisciplinarity Launch of AMS Springboard – Health of the Public 2040. Joint AMS-Health Foundation taskforce to explore transdisciplinary fellowship scheme. Practitioner training Joint workshop on 3 July with MSC, HEE and GMC - ‘Starting the transformation in educating the health professionals of the future’ FPH Education Committee task and finish group to consider areas to be included in the proposed health of the public credential. Working with RCP. Springboard – Health of the Public 2040 offers funding of up to £50,000 over two years and a bespoke package of career support to researchers at the start of their first independent post working in the health social sciences and medical humanities. (https://acmedsci.ac.uk/grants-and-schemes/grant-schemes/springboard-health-of-the-public) 3 July workshop – aims to inspire educational leaders and practitioners by sharing good practice on how to ensure future health and social care practitioners have a good understanding of drivers and interventions that affect the health of the public and its relevance to practice. Attendees will together create solutions to embed this across health education.

The report Download the report at acmedsci.ac.uk/2040 Join the discussion on social media using #health2040 View our summary animation at youtube.com/acmedsci