About this report

In this briefing, we:

  • examine what the government’s strategy to ‘level up’ should contain if it is to improve health in line with government commitments
  • assess the approach taken by the government so far, and whether better health is likely to be supported
  • outline some key elements that should feature in the forthcoming white paper.

Key points

  • The government has set out an aim to ‘level up’ the country, promising to increase prosperity, widen opportunity and ensure that no region is left behind. Action to ‘level up the nation’s health’ has also been described as a core part of this agenda. Yet levelling up is an opaque term, and the government’s plans are still under construction.
  • Despite encouraging signs, levelling up funding and policies laid out so far are partial and fragmented. Measures of health are not yet influencing the initial allocation criteria for levelling up funds, and initiatives are firmly tilted towards boosting financial and physical infrastructure capital. The role of local government and the NHS in helping to level up is also underplayed.
  • A more balanced view of the factors that shape people’s health and impact on the prosperity of a local place is needed in the forthcoming levelling up white paper. Attention should be paid to investing in all four capitals: financial/physical, human, social, and natural.
  • Good health is interconnected with all of these assets and vital to creating prosperity. Action to improve health and reduce inequalities therefore needs to be a core component of the government’s levelling up approach.
  • A broader set of metrics should be used to target funding and assess progress, with short and longer term measures of health and wellbeing taken into account.
  • Any plan to level up health should be underpinned by three interlinked elements:
    1. a strategy to improve health and reduce inequalities that genuinely aligns priorities across different government departments
    2. a real partnership between national and local government
    3. a greater role for the NHS in improving population health.

The government’s strategy for ‘levelling up’ is still being worked out, with a white paper promised later this year.

The government has committed to level up the country by boosting prosperity and widening opportunity, particularly for people living outside of London and the south east. Policies outlined so far have focused heavily on increasing prosperity by developing physical and financial infrastructure. Yet to the public, prosperity means the overall quality of their lives and local communities, not just their economic livelihood and local GDP or productivity growth.

We also know that health is a key part of prosperity. Good health is not just personal, but a collective national asset that improves wellbeing, productivity and the ability of individuals to contribute to their families, communities and wider society. A person’s life expectancy and healthy life expectancy are closely correlated with their income and wealth, with poorer health limiting the opportunity for good-quality, stable employment, and poverty in turn associated with worse health outcomes. Measures to improve the nation’s health and narrow the health gap across different areas of the country, and between different groups, are a logical focus of government efforts to level up.

There are signs the government recognises that improving health is key to increasing prosperity, as referenced in the 2021 Queen’s Speech. But will the government’s plan really include health at its core? And what might be the most impactful approach to level up health?

Cite this publication

Dixon J, Everest G. The government’s levelling up agenda: an opportunity to improve health in England. The Health Foundation; 2021 (https://doi.org/10.37829/HF-2021-C07).

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