ANNUAL CONFERENCE REPORT
Professor Sir Michael Marmot calls on government to ‘ put a fair distribution of health and wellbeing ’ at the heart of its policies
In the opening plenary session Professor Sir Michael Marmot , director of the Institute of Health Equity and UCL Department of Epidemiology and Public Health , called on the government to put a fair distribution of health and wellbeing at the heart of its policy .
Comparing the statistics on life expectancy going back to 1980 up to 2010 , he told delegates that poorer people do have worse health than everyone else , but the real message is that the less the deprivation , the longer the life expectancy .
In stark figures , he demonstrated that for over 100 years life expectancy had been consistently improving ‘ for about one year for every four years for women and for men ’, but between 2010 and 2011 there was a break in the curve and the rate in increases slowed dramatically – ‘ just about ground to a halt ,’ he said .
So what happened in 2010 ? Looking at other countries ’ annual life expectancy in weeks , between 2011 and 2017 , Professor Sir Michael concluded that the UK had the slowest life expectancy improvement of any rich country , apart from Iceland and the US .
Asserting that ‘ we had not reached peak life expectancy ’, he suggested that ‘ something went on ’ here ‘ that didn ’ t happen in this time in all of these other countries ’.
So , what happened after 2010 ? ‘ The government ’ s ambition was to roll back the state ,’ he said , ‘ and by golly they did it .’ Before the pandemic , public sector expenditure went down year on year , in a regressive way ; life expectancy was stalling , inequalities increasing and life expectancy for the poorest people was falling , he noted .
‘ And in the UK , that slowdown in life expectancy was nearly the slowest of all rich countries … I think of health as a measure of society ’ s success . If health is improving , society is improving … and then during the pandemic , where we had the highest excess mortality , what ’ s the link between these two ?’
Professor Sir Michael pointed to four culprits : poor governance and political culture ; an increase in social and economic inequalities ; reduction in spending on public services – meaning we were ill-prepared ; and the fact that we were unhealthy coming into the pandemic .
Reflecting on his diagnosis of why , as a country , we have done so badly pre-pandemic and in our handling of the pandemic , he said all four of these areas need addressing . ‘ My overall recommendation is to put a fair distribution of health and wellbeing at the heart of government policy ,’ he urged .
How close are occupational therapists to using data intelligently ?
Suzy England , RCOT professional adviser in health informatics , has urged people to identify data champions ‘ at every level ’ and connect with RCOT if you want to help lead on this work – as we need people willing to understand , lead and negotiate .
In a session looking at how close occupational therapists are to using data intelligently , Suzy set out to explore two critical questions : has the profession ’ s use of data evolved in line with the wider health and care community ? And what measures need to be in place to support the profession to measure its impact and cost effectiveness ?
But what does ‘ intelligent use of data ’ mean ? Suzy explained that this is about information that we can use to extract insights and make better decisions about how we can structure services .
She added that data comes from a wide variety of different sources – such as clinical data , workforce data , population health data – before asking : ‘ How confident and skilled are occupational therapists to be able to use this knowledge , to answer the question : does my service meet the needs of the local population and how do I know everyone can access it in the way they need to ?’
She pointed to four common barriers : multiple stakeholders , multiple systems , a changing landscape , and information and systems organised for other users .
Using RCOT ’ s published , but now archived , vision for information by 2024 as a benchmark , Suzy said that ‘ it ’ s fair to say that the pandemic has brought us on in leaps and bounds in terms of the digital tools available ’.
While we are working and thinking very differently today in terms of our use of digital tools , we are lagging behind when it comes to our use of data , she suggested .
‘ The best way to describe the state of data in the AHP world is that we have this deep , dark , murky , unclean lake of information – with pockets of excellence – that we really need to start to clean if we are going to be able to gain meaningful insights from it ,’ she said .
But it ’ s not all bleak . She suggested that there are five things that everyone can do locally : ring fence time to prioritise data ; understand the different stakeholder perspectives on information ; start with the end in mind – identify what you want to know about your service and work backwards to configure the right systems ; focus on information sharing – ‘ how do we record our data in a way it ’ s easily shared ?’; and identify who can help you outside of the sector .
Advocating a tiered approach , she ended by stressing that all occupational therapists have a role in this agenda and that every organisation needs to have an AHP / occupational therapist specialist – somebody who is driving the innovation forward and driving the exciting links outside of the sector .
She urged delegates to think about what they can do , to identify champions and most importantly , connect with RCOT .
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