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The road less travelled

4 July 2018
By Professor Dame Sue Bailey

As a baby boomer, I have been a lifelong beneficiary of the NHS. With small family incomes, before the NHS arrived, both sets of my grandparents put into a “Saturday” fund to enable the health needs of my parents to be met: they “valued” their health.  

The NHS has been studied, reported on and modified continually over its lifespan, yet it remains the insatiable child, always wanting more. But more of what?

Currently across the UK, health and care services are asked to engage in an ever more frantic tarantella‎ dance of measures, metrics, surveys, dashboards, audits, incentives, penalties, regulation, inspection, access targets, waits, safety,  flow, winter pressures…to the point of exhaustion.

So where do we stand now and how do we fast forward to a sustainable health care system for my grandchildren as the voters, workers and parents of 2048? What might we need to do to bring about a sustainable approach to health? 

The keys will include a much bigger focus on disease prevention and far greater patient empowerment than we have today. We also need to take action to reduce waste and lower the NHS’s carbon footprint. We need to create a ‘new psychology of health’‎ with less of the ‘I’ and ‎‘me’, and more of the ‘we’ and ‘us’. 

Health and care services are asked to engage in an ever more frantic tarantella‎ dance of measures, metrics, surveys, dashboards, audits, incentives, penalties, regulation, inspection, access targets, waits, safety,  flow, winter pressures…to the point of exhaustion

The NHS was, after all, founded on a notion of social solidarity in the aftermath of a World War. It now needs to reconnect with a sense of shared social identity, working in partnership to build psychological and social resources to deliver place-based health, family by family in every street across the land.  

Connection, support, meaning and control are what give every citizen and every community a sense of wellbeing. Unlocking the social cure to enhance the health and wellbeing ‎of all, whatever the disease, or dis-ease, and whatever the social context, will benefit every one of us.

So how can the road less travelled of mental health help? We belatedly got parity in law for mental health in 2012. We now need to step up and out – into the wider health and social care arena because, simply, mental health is core to any future health and health creating society. Going beyond the set mantras about ageing populations and what AI and genomics may bring with them, we will always need to pay attention to our mental health, and this will always require social approaches. 

‎Mental health is defined by the World Health Organisation as a state of wellbeing in which every individual:

  • ‎Can realise their potential 
  • Can cope with the normal stress of life 
  • Can (learn) work productively and fruitfully 
  • And is able to contribute to their own community 

To make this happen, we need to equip the entire health and care workforce to make health “everybody’s business”. We need to support all ‘workers’, be they professionals, peer supporters, carers or citizens to have adaptive mindsets, to adopt critical thinking, to be lifelong students, and to connect using all of our ‘senses’. And with much talk now of ‘whole systems approaches’ we need system leaders with an ability and willingness to horizon scan, to use the practice of trend analysis, to utilise strategic foresight and to bring together details from many sources, but above all to lead with emotional intelligence through intelligent kindness ‎to move services from hospital back into communities. 

Unlocking the social cure to enhance the health and wellbeing ‎of all, whatever the disease, or dis-ease, and whatever the social context, will benefit every one of us… we will always need to pay attention to our mental health, and this will always require social approaches

These are the real challenges of the future for health education.

‎As Chair of the Children and Young People’s Mental Health Coalition I am daily reminded by young people that what they want from us is to have hope and aspiration for them, to keep the faith with them.

For my grandchildren, we have to be bold, use the skills, richness and diversity we have across the field of mental health, and speak out about the road less travelled.  


This blog is part of our NHS 70 series. Take a look at other posts in the series.

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