We can transform the future health of the nation forever

By Ian Walker, Executive Director of Policy Information and Communications at Cancer Research UK

Imagine a scenario where you receive a text from your health provider to say you need to come to the surgery today, because you’re going to have a heart attack tomorrow. Or a reminder to get a test because you have an early cancer symptom.  

This might sound futuristic, but innovations like these are already being developed around the world and given the current situation, it could be just what the NHS needs. 

Healthcare in the UK is at a tipping point. Over seven million people are currently waiting for hospital treatment through the NHS in England, with 1.22 million people waiting for key tests* which could be used to diagnose cancer.  

Thirty years from now some people in England could be routinely living until 90 – some may even make it to 110.  

Critically, this means not only an increase in global population, but changing demographic and health demands. We already know from a Cancer Research UK report from February this year that by 2040, there will likely be half a million cancer cases diagnosed each year within the UK, the majority of which will be in people aged 70 and over who are more likely to struggle with treatments and have multiple comorbidities. 

We are also seeing other key metrics going very much in the wrong direction, with adult obesity rates going through the roof. By 2040, more than 21 million UK adults will be obese. This trend is mirrored in many countries across the globe, as is the increasing number of cancer, diabetes and Alzheimer’s cases. 

And we’re not alone in facing some systemic changes to the way we will need to treat health. 

Our whole health system has very limited interaction with the majority of the people in the country. Until we are ill, that is.

The US spends close to $4 trillion (2021) a year on healthcare, making it the biggest healthcare spender per capita in the world. And yet it has a stagnating life expectancy, currently positioned in the WHO rankings between Turkey and Ecuador, barely making it into the top 40 countries globally.  

The UK has slipped to 25th in global life expectancy, which a recent study from the University of Oxford and the London School of Hygiene and Tropical Medicine, showed is inextricably linked to inequalities. While resources and investment are paramount in delivering the best outcomes for patients, we also need a fundamental rethink about how we deliver healthcare. 

When laid out on paper, the size of the problem can seem almost insurmountable. But it’s certainly not unfixable. I’m fortunate that my role enables me to spend time with some of the world’s brightest minds, futurists, innovators and entrepreneurs. These are people who understand the concept and necessity of exponential improvements, rather than incremental ones. By accepting the principles of transformative change, we can start to consider a route forwards, and importantly, how we take the first steps. 

If we take cancer as an example, your smart toilet could identify blood in your poo, a long-term trend of elevated biomarkers in your urine and suggest a diagnostic test that week. Researchers at Stanford University have already begun this work and now we need to be even more ambitious in the UK.  

Our whole health system has very limited interaction with the majority of the people in the country. Until we are ill, that is. This represents a shortcoming in a health model that only fixes something once it’s broken. We don’t treat our cars like that. To truly revolutionise the health system, we need to pivot our attention towards wellbeing, prevention, and to how we can maintain the best possible health for the population for as long as possible.  

Wearables and smart phones with innovative apps can already tell us so much. Just a quick glance at my own smart watch can tell me my pulse, respiration rate, temperature, stress level, sleep, fitness and heart rate variation, as well as daily activity. This repertoire of data is a brilliant resource, available at every minute of the day. If interpreted by artificial intelligence, it could even provide a broad view on personal risk.   

This isn’t about creating a nanny-state, but re-modelling our attitudes to health so that we give it the attention it deserves all the time, not just when we’re at greatest need. It’s about allowing our trained professionals to support and inform us and empowering us as individuals to move our lifestyle from where it is, to where it needs to be. 

Clearly, none of this can happen overnight. In fact, it will undoubtedly take many years, but we must make a start. And soon. At Cancer Research UK, we’re working on a Manifesto for Cancer Research and Care – a blueprint for politicians to follow, which aims to transform cancer care in this country.  

Without system-wide transformation, we will never achieve a health system which works for all. But with the right vision, ambition and leadership, we can tip the system the other way, we can transform the future health of the nation forever, and we can exploit technology and innovation to do this in a sustainable way. 

*Radiology tests include MRI, CT, non-obstetric ultrasound and barium studies. Endoscopy tests include colonoscopy, cystoscopy, flexi-sigmoidoscopy and gastroscopy. However, waitlists include all people referred for these tests, not just those ordered for suspicion of cancer.