NHF UK health policy agenda

• NHF policy goals for prevention
• The public health agenda in England
• Tackling inequalities in coronary heart disease
• National Service Framework for coronary heart disease
• Public health policy in Scotland, Wales and Northern Ireland
• Regional prevention strategies
• Further information
• Useful links
• References

What's new in the UK health policy agenda?



	• The established risk factors of poor diet, smoking and physical inactivity should remain the focus of an effective national coronary heart disease prevention strategy. • Special efforts should be made to improve the nation’s diet and inactive lifestyle through national nutrition and physical activity strategies. • Prevention strategies must take a long-term approach which begins in childhood and builds health over the life course. • Health and local authorities should set local targets to monitor progress in closing the health gap between higher and lower socio-economic groups. • Every child born into the new millennium should be able to live until at least the age of 65 free of avoidable cardiovascular disease. • Priority must be given to the most disadvantaged, to address the widening gap in rates of coronary heart disease between higher and lower socio-economic groups. • Comprehensive strategies aimed at the whole population, which make healthy choices easy choices, should supplement health education approaches targeted at individuals. • Coronary heart disease should be a test case for national strategies to tackle social inequalities in health as it shares many determinants and risk factors with other major causes of death and disability including stroke, diabetes and many forms of cancer.



		The NHF has helped to shape the public health policy agenda since the early 1980s, and has argued consistently for a strong policy focus on coronary heart disease prevention. As part of this process, the NHF contributed to the public consultation on the government public health strategy Saving lives: Our healthier nation providing expert briefings to ministers, and advancing consensus recommendations on appropriate prevention targets and strategies. The NHF was represented on the NHS modernisation action team addressing prevention and inequalities which informed the development of the NHS Plan published in July 2000. The NHF released a major report in 1999 reviewing the evidence on trends and prevention and setting out a prevention agenda for the 21st century, called Looking to the future: Making coronary heart disease an epidemic of the past. In April 1998, the NHF submitted a response to a consultation on the government’s green paper Our healthier nation. Contact NHF for a copy of the response. A working group of the NHF produced a series of proposals for new public health structures entitled Strengthening public health (1998). Contact NHF for a copy. In November 2000, the NHF gave written evidence to the all-party health select committee’s inquiry into public health. Contact NHF for a copy.



		A threefold difference in premature death rates between unskilled and professional men has opened up since the 1970s.1 The widening social class gap shows that successes in preventing heart disease among higher socio-economic groups are not being matched among lower income groups. The NHF has recommended that coronary heart disease should be used as a test case for reducing health inequalities. Tackling the determinants and risk factors for coronary heart disease will also impact on other major diseases, such as stroke and cancer. The NHF has produced a report: Social inequalities in coronary heart disease: Opportunities for action (1998).



	The National Service Framework (NSF) for coronary heart disease launched the first ever ten-year programme to set clear standards for the services provided throughout the NHS and its partners for the prevention and treatment of coronary heart disease. The NSF’s standards on primary and secondary prevention will be fundamental to its success in helping to eliminate premature deaths and reduce disability from coronary heart disease. The NHF contributed to the development of the NSF through the external reference group whose membership included a number of NHF members. The NHF has contributed to the preparation of Coronary heart disease: Guidance for implementing the preventive aspects of the National Service Framework by the Health Development Agency. See Further information for details.



	Health and public health policy are among the legislative powers that devolved to the Assemblies and Parliaments in Scotland, Wales and Northern Ireland. Through its members and observers in the four nations, the NHF seeks to learn from and support the development of public health strategies and coronary prevention initiatives across the UK. The NHF submitted comments on the Welsh green paper, Better health, Better Wales in June 2000. Contact NHF for a copy of the comments. The NHF responded to NHS Scotland's consultation from the CHD/Stroke task force in January 2002. Download a PDF copy (41k) of the NHF response here.



			Technical note. To ensure download to disks, do this: On a PC, RIGHT click, on a Mac, OPTION (alt) click and choose to save to disc.



	Effective local action is essential to reduce rates of coronary heart disease and tackle health inequalities. An NHF policy goal is to ensure that coronary heart disease prevention is a priority for local as well as national public health strategies. Health improvement programmes should focus on a few key priority areas, including coronary heart disease prevention. An NHF working group produced a report in 1998: Public participation for public health: Proposals for action. Contact NHF for a copy. In December 1999 the NHF submitted recommendations to an inquiry into health improvement programmes by the All Party Parliamentary Group on Primary Care and Public Health. Contact NHF for a copy of the recommendations.



	NHF report: Looking to the future: Making coronary heart disease an epidemic of the past (1999). NHF report: Social inequalities in coronary heart disease: Opportunities for action (1998). Coronary heart disease: Guidance for implementing the preventive aspects of the National Service Framework. Published by the Health Development Agency (www.hda-online.org.uk).



	A short selection of websites with further information about UK health policy appears below. For more links, see Members page. The National Service Framework for coronary heart disease (www.doh.gov.uk/nsf/coronary.htm) Saving Lives: Our Healthier Nation (www.official-documents.co.uk/document/cm43/4386/4386.htm) Towards a Healthier Scotland (www.scottish.parliament.uk) Our National Health (www.scotland.gov.uk) Better Health, Better Wales (www.betterwales.com)



	1 Drever F, Whitehead M, Roden M. 1996. Current patterns and trends in male mortality by social class based on occupation. Population Trends, 86:15-20.