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.
  • As work gets underway on a levelling up white paper, there is an opportunity to take forward a more broad-based approach to improving prosperity. We examine what a strategy to level up should contain, assess the approach taken by the government so far, and outline some key elements that should feature in the forthcoming white paper.
  • While there are 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: a strategy to improve health and reduce inequalities that genuinely aligns priorities across different government departments; a real partnership between national and local government; and a greater role for the NHS in improving population health.