The Health Foundation podcast

8.2 million working-age people report having a long-term health condition that limits their ability to work. 1.7 million say that work itself is making them ill or creating challenges. In addition to causing personal hardships, this decline in working-age health is causing concern among employers, politicians and policymakers.  With the benefits bill rising, government has set its sights on wide-ranging welfare reforms, including significant changes to health and disability benefits. Are these reforms likely to incentivise and support people back into work? And how can the system intervene earlier and support employers to provide people with the flexibility they need to stay in work in the first place?  To discuss, our Chief Executive Jennifer Dixon is joined by: Jon Ashworth, Chief Executive of Labour Together and former shadow Secretary of State for Health and Social Care and for Work and Pensions. Sacha Romanovitch, Chair of the Commission for Healthier Working Lives, which is supported by the Health Foundation. Show notes Commission for Healthier Working Lives (2025). Action for healthier working lives.  UK government (2025). Pathways to Work: Reforming Benefits and Support to Get Britain Working Green Paper.  Barnsley Metropolitan Borough Council (2024). Pathways to Work Commission.  Health Foundation (2025). Will short-term fixes undermine building a healthier workforce in the long run? Financial Times (2025). How to keep sick people in employment.  Health Foundation (2025). Mental health trends among working-age people. 

‘Today we are abolishing the biggest quango in the world,’ – Wes Streeting, 13 March 2025  Many people were surprised by the government’s decision to abolish NHS England and fold its functions into the Department of Health and Social Care. Not least Richard Meddings, Chair of NHS England since 2022. Having formally completed his term in March, Richard joins our Chief Executive Jennifer Dixon to discuss.  In a wide-ranging conversation, Richard reflects on his time at NHS England and how the organisation has changed. With the NHS facing growing demand for care, and continuing to top the public’s list of priorities, where does the forthcoming 10-year health plan need to focus? How should ministers lead the service in the future? And what needs to happen to ensure the NHS reaches its 100th year? Show notes The Health Foundation (2020). Glaziers and window breakers. Former health secretaries in their own words. OECD (2025). How do health system features influence health system performance? Department of Health and Social Care (2023). The Hewitt Review: an independent review of integrated care systems. The Health Foundation (2025). Taking a chainsaw to NHS England is not the sign of a healthy state.  The Health Foundation (2025). Labour’s 10-year plan for the NHS in England: what should it look like? NHS England (2025). Review of NHS performance and delivery (27 March 2025). NHS England board meeting.

It’s 2 years since Keir Starmer first set out his five missions for government, including a health mission to build ‘an NHS fit for the future’ and ‘a fairer Britain, where everyone lives well for longer’. Missions were supposed to mean a new way of doing government – focused on ambitious, long-term objectives that provide a driving sense of purpose for the country. So, with Labour now in office for 9 months, what have we learned about how mission-driven government works in practice? Are clues emerging about how government plans to improve the nation’s health beyond the confines of the NHS? And do missions show signs of bringing about durable changes in policy and how the state works?  To discuss, our Chief Executive Jennifer Dixon is joined by: Hannah White, Director at the Institute for Government.  Jo Bibby, Director of Health at the Health Foundation.  Show notes Institute for Government (2025). Inside Briefing. Keir Starmer rewires the state.  Institute for Government (2024). What does a mission-driven approach to government mean and how can it be delivered? Health Foundation (2024). Health at the heart of government.  UK Government (2024). Plan for change: Milestones for mission-led government.  Future Governance Forum (2024). Mission-critical: statecraft for the 21st century. 

There are around 350,000 synthetic chemicals in use today and only a small fraction have been robustly tested for their long-term effects on our health. Many of these are used in manufacturing plastics and microplastics – the production of which has doubled since 2008 and is projected to triple by 2060.  Unknowns remain, but research is suggesting pervasive exposures to these manufactured substances is shaping human health. In particular, links are being identified with a range of non-communicable diseases, including some cancer types, metabolic disorders, neurological conditions and reproductive and developmental issues.  So, what do we know about how the chemical environment is influencing our health? Could AI and other emerging technologies shed new light on the effects of synthetic substances? And what does it all mean for regulation and wider policy protecting public health?  To discuss, our Chief Executive Jennifer Dixon is joined by: Tracey Woodruff, Professor at University of California, San Francisco, and Director of the Program on Reproductive Health and the Environment (PRHE).  Thomas Hartung, Professor at Johns Hopkins University, and Director of the Centre for Alternatives to Animal Testing (CAAT).   Show notes Woodruff et al (2025). Manufactured chemicals and children’s health – the need for new law.  Kleinstreuer & Hartung (2024). AI – it’s the end of tox as we know it (and I feel fine).  Nihart et al (2025). Bioaccumulation of microplastics in decedent human brains.  Financial Times (2023). ‘Global sperm counts are falling. This scientist believes she knows why.’  Programme on Reproductive Health and the Environment (PRHE). Scientific principles to protect public health.  Programme on Reproductive Health and the Environment (PRHE). Toxic matters. 

Nigel Edwards, former Chief Executive of the Nuffield Trust, and Hugh Alderwick, Director of Policy at the Health Foundation, dive into the pressing need for a transformative 10-year plan for the NHS. They discuss the importance of learning from previous reforms and engaging stakeholders to improve primary and community care services. The conversation explores the balance of collaboration and competition within the NHS, the role of technology in healthcare, and the public's unwavering support despite challenges like long waiting lists and access to mental health services.

We look back at our pick of the pod from 2024.  As 2024 draws to a close, what to make of the year’s developments in health and care?   As yet, a murky picture on NHS reform and on how the new Labour government’s five missions will work in practice; a pressing need to improve the health of the working-age population; and some promising ways forward for technology to improve care, quality and productivity in the NHS. In this episode, we also revisit how to drive the economic growth we need to fund high-quality public services, search for clues about what might be behind the worrying rise in cancer rates among younger adults, and explore what the latest evidence tells us about inequalities in health across ethnic groups in the UK. This episode also marks our 50th – meaning there’s a great back catalogue for you to enjoy. Join our Chief Executive Dr Jennifer Dixon as we reflect with guests who appeared on the podcast in 2024. All-time top performing episodes  Health Foundation (2020). Low life expectancy in Glasgow, and what to do about it.  Health Foundation (2021). Inside the teen mind: what’s happening to mental health? Health Foundation (2020). What should nanny do next? The government and obesity. Health Foundation (2023). AI in health care: hope or hype? Health Foundation (2021). We are what we eat: food, health and inequality. Show notes John Burn-Murdoch (2024). What if the UK isn’t actually the sick man of Europe? Financial Times.  Barnsley MBC (2024). Pathways to Work: Commission Report.  Edwards & Dayan (2024). Leagues tables for the NHS.

Health secretary Wes Streeting has set out three big shifts the NHS must deliver – including moving from analogue to digital. National strategy on health technology and digital is developing at pace, with a 10-Year Plan for the NHS expected to set out new priorities in the spring. We’ve seen no shortage of initiatives, roadmaps and plans for tech and innovation in recent years – yet delivery has often lagged behind. Today, acute pressures on health and care services, demographic headwinds and trends in disease burden mean there’s an imperative to deliver at pace. Much recent attention has focused on AI and its revolutionary potential, but leveraging this depends on a range of other digital capabilities that not all NHS trusts and services have.  So, where is the NHS on its journey to digitisation? And, given all of this, what will it take for the NHS to become a truly digital health system?    To discuss, our Chief Executive Jennifer Dixon is joined by: Holly Krelle, Assistant Director at the Center for Healthcare Innovation & Delivery Science at New York University's Langone Medical Center. Erik Mayer, Consultant Surgeon at Imperial College Healthcare and the Royal Marsden NHS trusts, and Director of Imperial's clinical analytics unit.  Show notes Darzi et al (2024). Independent investigation of the NHS in England.   The Health Foundation (2025). Briefing on digital maturity in the NHS [forthcoming].   The Health Foundation (2023). What do technology and AI mean for the future of work in health care? Horwitz & Krelle (2023). Using rapid randomised trials to improve health care systems. Annual Review of Public Health.  Honeyford et al (2022). Challenges and recommendations for high quality research using EHRs. Frontiers in Digital Health. NHS Confederation (2024). Frontline digitisation: creating the conditions for a digital NHS.  Dearing & Cox (2018). Diffusion of innovations theory, principles and practice. Health Affairs. 

The UK is becoming more ethnically diverse: nearly 20% of the population reports being from a minority ethnic background and projections suggest growing diversity is the future. People from minority backgrounds in the UK experience a variety of inequalities. But what is the latest evidence telling us?   A comprehensive analysis of race and ethnicity, recently published as part of The IFS Deaton Review of inequality, finds no single story of advantage or disadvantage across ethnicities. Instead, it presents a complex picture of inequality across and within ethnic minority groups. The findings highlight entrenched inequalities – including access to the building blocks of health such as a good education, stable employment, secure housing and fair pay.  So what do we know about the groups that experience inequalities, what drives these – and how do they relate to health? And what do policymakers need to understand to respond effectively?  To discuss, our Chief Executive Jennifer Dixon is joined by: Heidi Safia Mirza, Emeritus Professor of Equalities Studies in Education at IOE (UCL Institute of Education) and co-author of the race and ethnic inequalities chapter of the Deaton Review. Shabna Begum, Chief Executive Officer, Runnymede Trust, a charitable think tank working to reduce racial inequality in the UK. Show notes Oxford Open Economics (2024). Dimensions of Inequality: The IFS Deaton Review.   Mirza H S, Warwick R (2024). Race and ethnic inequalities.  Runnymede Trust (2022). Broken Ladders.  Runnymede Trust (2020).  Colour of Money.  The King’s Fund (2023). The health of people from ethnic minority groups in England.  Runnymede Trust (2024). Health Foundation supported report on ethnic inequalities and the wider determinants of health. (Forthcoming.) 

Since the early 1990s, there’s been a concerning uptick in cancer incidence among adults younger than 50 years. Scientists are racing to understand what’s driving these trends. Some evidence points to roles for established risk factors – including smoking and obesity. But some research is also exploring environmental exposures – such as microplastics and forever chemicals – and asking if these could be changing the microbiome and potentially causing inflammation within the body.  So what do these trends mean for cancer research, for health services and national policy? And faced with such stark trends, where are there grounds for hope?  To discuss, our Chief Executive Jennifer Dixon is joined by: Kimmie Ng, specialist in oncology and Director of the Young-Onset Colorectal Cancer Centre at the Dana Farber Cancer Institute in Boston, and Associate Professor of Medicine at Harvard Medical School.  Charles Swanton, Deputy Clinical Director at Francis Crick Institute, Chief Clinician at Cancer Research UK, and a consultant oncologist at University College London Hospitals NHS Foundation Trust. Show notes Nature Reviews Clinical Oncology (2022). Is early-onset cancer an emerging global epidemic? Current evidence and future implications. BMJ Oncology (2023). Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019. Gupta S et al (2023). Birth Cohort Colorectal Cancer (CRC): Implications for research and practice. Financial Times (2023). The unexplained rise of cancer among millennials.The New England Journal of Medicine (2024). Microplastics and nanoplastics in atheromas and cardiovascular events. Cancer Grand Challenges. Team OPTIMISTICC: Opportunity to investigate the microbiome’s impact on science and treatment in colorectal cancer. The Health Foundation (2023). How chronic stress weathers our health.  The Health Foundation (2024). Rising cancer incidence in younger adults: what is going on?  (Forthcoming)

There’s a new Prime Minister in Downing Street and a new political reality in the UK. But what does it all mean for health and care? The incoming government faces a range of complex policy challenges – many of them linked to health and care – and a daunting fiscal inheritance.  While the public might show patience for a few months, they will expect to see some results quickly – and health is a top priority for voters. So how is the new government going to navigate these tensions? What will being ‘mission-led’ mean in practice? And where is the money going to come from? To discuss, our Chief Executive Jennifer Dixon is joined by: Hannah White, Director and CEO of the Institute for Government.  John McTernan, Senior Adviser at BCW Global. John was formerly director of political operations for the Labour government from 2005 to 2007.