Working to improve health and well-being

Our assessments show a mixed picture on the progress being made by healthcare services in preventing illness and improving public health, and a particularly mixed picture for both the purchasing and delivery of services by primary care trusts.

Healthcare services have contributed to some dramatic improvements in the health of people in England and Wales over the last 20 years.

Since 1986:

• life-expectancy has increased by nearly five years for men and by more than three years for women
• infant deaths have fallen from around nine per 1,000 live births  to around five per 1,000 live births in 2003-2005

However there is a difference of ten years between the life expectancy of men living in the most deprived local authority areas in England and the population as a whole.

Premature death
Alcohol related illness and obesity
The role of primary care trusts
Recommendations

Premature death

Leading causes of premature death are:

• cancer
• circulatory diseases (e.g. coronary heart disease and stroke)
• respiratory diseases (e.g. chronic obstructive pulmonary disease and emphysema)

Premature deaths from circulatory disease have fallen by over 40% since 1995. Early deaths from cancer have been cut by nearly 20%. Respiratory disease deaths fell by 29%.

Alcohol related illness and obesity

In England in 2005, 22% of men and 24% of women were obese.

Alcohol-related deaths in the UK almost doubled between 1991 and 2005 (from 6.9 to 12.9 per 100,000) and there has been a rise of more than 80% in the number of admissions to hospital for alcohol-related reasons in the last 10 years.

The role of primary care trusts

Most patient contacts take place in primary care, and primary care trusts (PCTs) are also responsible for ensuring that all NHS healthcare services are planned and purchased appropriately for their local populations. Our work over the last year, including the annual health check, shows a particularly mixed picture for both the commissioning and delivery of services by PCTs. 

Recommendations

Primary care trusts need to work with their partners to gain a better understanding of the health needs of the populations they serve, in order to target preventative measures more effectively and purchase the healthcare services their populations need.

Download the chapter Working to improve health and well-being (PDF 287kb) (Opens new window)
Download the State of Healthcare 2007 report (PDF 1610kb) (Opens new window)