latest health care news


STPs a ‘step on the road’ to fixing public overreliance on the NHS

Sustainability and transformation partnerships (STPs), accountable care systems (ACSs), accountable care organisations (ACOs) and other service-related acronyms are merely a step on the journey to recognising that inspiring good health is about focusing on people and place, rather than treatment, diagnosis, illness and conditions, the boss of Public Health England (PHE) has argued.

Speaking exclusively to NHE, Duncan Selbie, who first joined the NHS when he was 17 and worked his way up to chief executive at a handful of health providers, said these system transformation plans are “about the NHS getting out a bit more and recognising that in order for it to thrive, it needs to be more engaged in the community.

“It needs to be more engaged in what we call, in today’s jargon, ‘population health’ – which is what’s driving ill health and what’s driving poor health,” he explained.

“It goes back to the [Derek] Wanless Report in 2004: if we want a sustainable NHS, then we need to invest in the public’s health and be concerned with these wider issues: housing, economic growth, jobs, how to help the education system to support young people getting into work. And the NHS depends on that.

“STPs are, if you’d like, an advanced form of planning for the NHS, but it’s only a step on the journey to recognising that it’s people and place, rather than treatment and diagnosis of illness and conditions, that matter.”

A crucial component of focusing on ‘people and place,’ and ultimately on inspiring health creation, lies in realising that wellbeing stretches far beyond the ability to access a hospital or see a GP.

“The whole thing is about how to help people in their home and in their community. And the best way to help the NHS is to use it smartly and not to be using it where there are genuine alternatives,” added Selbie. “That is at the heart of a health-creating community.

“Prevention, in the sense of the days gone by, would’ve meant how to help people quit smoking or drinking, focus on what they’re eating, that sort of thing – or it might’ve been thought of as how to help people get out of hospital faster or avoid admissions. But it’s much more than that.

“It’s about how to help people stay well for longer. The way I frame it is, it’s not so much about what the matter is with people, but what matters to them.”

This could be anything from staying in work and having money in your pocket to simply having a meaningful reason to get out of bed every day or a friend to turn to.

“We know that there’s as much or more science underpinning people remaining well by having a job or a friend than there is anything we do in healthcare,” continued Selbie.

“That isn’t to say healthcare doesn’t matter; it’s just not all that matters. For years, politicians, the media and the public have conflated good health with what the NHS can do. The NHS can do a lot, but it can’t help people to stay well. That’s not what its function is.

“If we’re going to improve the health of the people, we need to improve the housing, we need to improve the education, we need to get more jobs. You can’t have an overreliance on the NHS.”

Our full interview with Selbie will be available in the upcoming edition of NHE (Jan/Feb). To receive your free copy, subscribe here.

(Top image c. Joe Giddens/PA Images)


Hermit Singh   20/01/2018 at 21:35

"Oooh Betty! " Selbie sounds just like JC, but without any socialist rationale whatsover. Instead, his ilk, ( "partisan experts" ) have watched the systematic attack on public health in the uk. Indeed, SOCIETY, not the nhs helps people to stay well. But a society broken by Tory values, NEEDS a functional nhs to minimise the collateral damage by the "greedy party"

Add your comment


national health executive tv

more videos >

featured articles

View all News

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us throu more > more last word articles >

health service focus

View all News


NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental ... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Bei... more >


Mike Farrar, Swim England - Last Word

07/12/2019Mike Farrar, Swim England - Last Word

Mike Farrar Chairperson of Swim England Would you talk us through... more >

the scalpel's daily blog

Unappreciated Qualities of Leadership: Hope

17/02/2020Unappreciated Qualities of Leadership: Hope

Independent consultant and strategic advisor Dean Royles continues his series on The Unappreciated Qualities of Leadership. You can find links to his previous pieces here. ... more >
read more blog posts from 'the scalpel' >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital exemplars who were revealed at the same show 12 months earlier.  Jeremy Hunt also stated that by the end of 2018 – the 70th birthday... read more >