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Health of the Public in 2040


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05 May 2015

The Royal College of Surgeons of Edinburgh have today responded to the Academy of Medical Sciences’ consultation on the Health of the Public in 2040.

This exercise is attempting to set out an idealistic vision for the health of the UK population in 2040, some proposed drivers of change likely to affect the population’s health over the next 25 years, and some of the health implications and uncertainties that may be associated with four possible scenarios for the future.

In response, RCSEd made the following points;

  • That the most important aspiration is that healthcare in the UK remains free at the point of need and should be included in this document.
  • Support for the inclusion of the aspiration for greater equality; fairness and social cohesion and empowerment of the population to make educated decisions about their health.
  • That a greater emphasis could be placed upon the aspirations required to deliver high quality surgical interventions in 2040.
  • Demographic change will undoubtedly be a major driver for change but with increasing obesity, alcohol and substance abuse and the move to computer games rather than physical activity it is possible that the younger generation may in fact die earlier rather than live longer than the current generation by 2040. As such, the impact of these changes will depend on the success of intervention initiatives.
  • That there is also significant potential for genomics, gene editing and regenerative medicine.
  • That in recent years there have been substantial efforts to better understand the nature of comorbidities. The ability of the health service to diagnose and treat individuals with two or more long term health issues will represent a key driver of change over the next 25 years.
  • That the increase in microbial resistance associated with the lack of antibiotic development coupled with the emergence of highly infective viral infections probably means that bacteria or viral infections are most likely to be the biggest threats to the health of the public in the future.
  • That research should be focused around personal delivery of care, preventative medicine and methods to maintain quality of life.
  • That 3D printing has the potential to produce living replacement implants for bone repair; reconstructive surgery and a variety of other implants so this technology requires an appropriate funding stream.
  • That surgical services, particularly in specialist areas, need to be relocated into larger institutions and more needs to be done to support patients in travelling further for these services.
  • That district general hospitals should be redesigned to undertake elective general surgery and to provide rehabilitation and return to work/home life services for patients transferred out of the specialist hospitals.
  • That there will need to be improved virtual links between the specialist centre and the district hospitals to monitor these transferred patients and provide support and guidance to the local generalists.
  • That in remote and rural settings investment in robotics will reduce the need to transfer patients or enable appropriate stabilisation prior to transfer.
  • That computer driven diagnostics will also be important both in general practice and remote settings.

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