{"id":1678,"date":"2021-10-15T11:55:39","date_gmt":"2021-10-15T11:55:39","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjopen\/?p=1678"},"modified":"2021-10-15T11:55:39","modified_gmt":"2021-10-15T11:55:39","slug":"uk-austerity-since-2010-linked-to-tens-of-thousands-more-deaths-than-expected","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjopen\/2021\/10\/15\/uk-austerity-since-2010-linked-to-tens-of-thousands-more-deaths-than-expected\/","title":{"rendered":"UK \u2018austerity\u2019 since 2010 linked to tens of thousands more deaths than expected"},"content":{"rendered":"<p dir=\"ltr\"><em>Findings echo other research on stalled life expectancy improvement<br \/>\nExtra social care spend more than twice as \u2018productive\u2019 as extra healthcare spend<\/em><\/p>\n<p dir=\"ltr\">Central government austerity measures since 2010 are linked to tens of thousands more deaths than expected, <a href=\"https:\/\/bmjopen.bmj.com\/content\/11\/10\/e046417\" target=\"_blank\" rel=\"noopener\">finds research<\/a> published in the online journal\u00a0<a href=\"https:\/\/bmjopen.bmj.com\/\" target=\"_blank\" rel=\"noopener\"><em><strong>BMJ Open<\/strong><\/em><\/a>\u00a0on the joint impact of social care, public health, and healthcare spend on death rates before and after 2010.<\/p>\n<p dir=\"ltr\">The findings echo those of other research on stalled improvements in life expectancy since 2010, when austerity measures came into force, and show that additional spend on social care is more than twice as productive in terms of saving lives as the equivalent additional spend on healthcare.<\/p>\n<p dir=\"ltr\">A slowdown in life expectancy improvement in England has coincided with government spending constraints on health and social care since 2010.<\/p>\n<p dir=\"ltr\">And a recent time trends analysis found that austerity measures applied to health and social care spend in England between 2010 and 2014 were associated with many more deaths than expected. But that study didn\u2019t include public health spend.<\/p>\n<p dir=\"ltr\">To redress this, the researchers used the spend on public health and on adult social services by each local authority in England for 2013<span style=\"font-weight: 400\">\u2013<\/span>14 <span style=\"font-weight: 400\">\u2014 <\/span>the first financial year in which local authorities became responsible for public health.<\/p>\n<p dir=\"ltr\">Information on healthcare spend was obtained from the budget returns for the 212 bodies responsible for commissioning health services in 2013<span style=\"font-weight: 400\">\u2013<\/span>14 <span style=\"font-weight: 400\">\u2014<\/span> clinical commissioning groups.<\/p>\n<p dir=\"ltr\">The average local authority spend on adult social care was \u00a3307 per person, although this varied considerably, ranging from \u00a3209 in Barnsley to \u00a3660 in the City of London.<\/p>\n<p dir=\"ltr\">Equivalent average figures for healthcare and public health spend were, respectively, \u00a31152 and \u00a353 per person.<\/p>\n<p dir=\"ltr\">Total healthcare spend (\u00a365 billion) was about four times that spent on social services (\u00a317 billion), while the latter was six times the size of public health spend (\u00a32.5 billion).<\/p>\n<p dir=\"ltr\">The joint impact of social care, public health, and healthcare spend on deaths in England was assessed, and changes in health and social care spend before and after 2010 were extracted from the previously published time trends study.<\/p>\n<p dir=\"ltr\">The difference between these levels of spend and the responsiveness of death rates to any changes in expenditure from 2013<span style=\"font-weight: 400\">\u2013<\/span>14 were used to estimate the number of additional deaths associated with spending constraints after 2010.<\/p>\n<p dir=\"ltr\">The time trends study found that real social care spend rose by 2.20% per head of the population between 2001<span style=\"font-weight: 400\">\u2013<\/span>02 and 2009<span style=\"font-weight: 400\">\u2013<\/span>10, but fell by 1.57% between 2010<span style=\"font-weight: 400\">\u2013<\/span>11 and 2014<span style=\"font-weight: 400\">\u2013<\/span>15.<\/p>\n<p dir=\"ltr\">If this annual difference (3.77%) in social care spend before and after 2010 is applied to each of the 4 \u2018austerity\u2019 years, then the total spending gap attributable to austerity is 15.08%.<\/p>\n<p dir=\"ltr\">In 2012, there were 467,000 deaths in England. And the analysis suggests that a 1% decrease in spend would generate 1569 extra deaths. So the \u2018loss\u2019 of 15.08% in social care spend between 2010<span style=\"font-weight: 400\">\u2013<\/span>11 and 2014<span style=\"font-weight: 400\">\u2013<\/span>15 will have caused 23,662 additional deaths, calculate the researchers.<\/p>\n<p dir=\"ltr\">The time trends study also found that real healthcare spend per head rose by 3.82% between 2001<span style=\"font-weight: 400\">\u2013<\/span>02 and 2009<span style=\"font-weight: 400\">\u2013<\/span>10, but only by 0.41% between 2010<span style=\"font-weight: 400\">\u2013<\/span>11 and 2014<span style=\"font-weight: 400\">\u2013<\/span>15.<\/p>\n<p dir=\"ltr\">If this annual difference (3.41%) is applied to each of the 4 austerity years, then the total spending gap attributable to austerity is 13.64%.<\/p>\n<p dir=\"ltr\">The analysis suggests that a 1% decrease in healthcare spend will generate 2484 additional deaths. So the \u2018loss\u2019 of 13.64% in healthcare spend between 2010<span style=\"font-weight: 400\">\u2013<\/span>11 and 2014<span style=\"font-weight: 400\">\u2013<\/span>15 will have caused 33,888 extra deaths, calculate the researchers.<\/p>\n<p dir=\"ltr\">In all, the calculations suggest that the constraints on health and social care spend during this period of \u2018austerity\u2019 have been associated with 57,550 more deaths than would have been expected had the growth in spend followed trends before 2010.<\/p>\n<p dir=\"ltr\">Similarly, the analysis suggests that a 1% change in healthcare spend either way changes the number of deaths by more than a 1% change in spend on social care or public health.\u00a0But, point out the researchers, a 1% boost in the healthcare budget would cost about four\u00a0times as much as a 1% boost in the social care budget.<\/p>\n<p dir=\"ltr\">This is possibly because social care has direct and indirect effects on deaths <span style=\"font-weight: 400\">\u2014 <\/span>directly by staving off life threatening conditions, brought on by falls, for example, and indirectly, by freeing up access to other health services, such as hospital beds, suggest the researchers.<\/p>\n<p dir=\"ltr\">They acknowledge some limitations to their findings. The calculations assume that all health benefits occur contemporaneously with spend, which is unlikely to be the case.<\/p>\n<p dir=\"ltr\">And primary care and specialised commissioning spending weren\u2019t included in the measure of overall healthcare spend, because responsibility for these returned to central government in 2013, while data on local spend for these services isn\u2019t available.<\/p>\n<p dir=\"ltr\">\u201cAusterity\u2019-related reductions in the growth of healthcare and social care expenditure have been associated with a much larger number of deaths than would have been expected had pre-austerity expenditure trends continued,\u201d write the researchers.<\/p>\n<p dir=\"ltr\">And they conclude: \u201cAll three forms of public healthcare-related expenditure save lives and there is evidence that additional social care expenditure is more than twice as productive as additional healthcare expenditure.<\/p>\n<p dir=\"ltr\">\u201cOur results are consistent with the hypothesis that the slowdown in the rate of improvement in life expectancy in England since 2010 is attributable to spending constraints in the healthcare and social care sectors.\u201d<\/p>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Findings echo other research on stalled life expectancy improvement Extra social care spend more than twice as \u2018productive\u2019 as extra healthcare spend Central government austerity measures since 2010 are linked to tens of thousands more deaths than expected, finds research published in the online journal\u00a0BMJ Open\u00a0on the joint impact of social care, public health, and [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmjopen\/2021\/10\/15\/uk-austerity-since-2010-linked-to-tens-of-thousands-more-deaths-than-expected\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":406,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[511,15012],"tags":[],"class_list":["post-1678","post","type-post","status-publish","format-standard","hentry","category-in-the-news","category-press-release"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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