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** 16 August 2021
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** UK
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** The cost of Boris Johnson’s levelling up will be close to £2 trillion (#1)
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** Trusts told to plan for “unrealistic” efficiency savings while Treasury talks continue (#2)
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** Nearly 1 million more people in England are now addicted to alcohol, official data suggests (#3)
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** North West: Blackburn with Darwen launches new animated stop smoking campaign (#4)
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** International
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** US: Alcohol and tobacco sales increased in South Dakota during the COVID-19 pandemic (#5)
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** UK
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**
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** Boris Johnson’s plan to “level up” the UK will require a similar scale of funding to Germany’s near-£2 trillion reunifications after the fall of the Berlin Wall, a leading thinktank has said.

Centre for Cities said the schemes outlined so far by the government were a “drop in the ocean” and that closing the north-south divide would cost hundreds of billions of pounds over decades if done properly. The researchers said England’s biggest cities, including Birmingham, Manchester, and Leeds, have the lowest productivity and life expectancy in western Europe.

In Madrid, the average person can expect to live nearly a decade longer than someone in Glasgow or Liverpool, where life expectancy is four years lower than the European average. The figures show that people in Manchester, Newcastle and Birmingham live on average two years less than those on the continent. The UK has one of the lowest life expectancies in Western Europe. Compared to other EU countries, the UK has the 17th lowest female life expectancy (83.1 years), with only Denmark, Poland, Bulgaria, and Romania being higher. In Glasgow, a woman will live to be nearly 80 years old, compared to 88 in Madrid and 87 in Lyon, Toulouse, and Nantes.

Paul Swinney, policy director of Centre for Cities, said: “We’ve had this North-South divide for at least 85 years now. It’s a huge challenge [to address].”

Levelling up has been a keystone of Johnson’s domestic policy since his election in 2019, but there has been no new policy to match the rhetoric. The government is expected to offer more policies in a white paper in autumn, but experts have been underwhelmed by what they describe as a lack of coherence, urgency or ambition in the prime minister’s announcements so far. A government spokeswoman said it was investing billions of pounds to regenerate parts of Britain, including the £4.8 billion levelling up fund and £2.4 billion distributed to 101 areas through the towns fund.

The spokeswoman said the white paper would show how “bold new policy interventions will improve livelihoods across the country” and added: “We are taking decisive action to level up health inequalities across the country, providing extensive support to protect and improve the public’s health and wellbeing during the pandemic and beyond.”

Jo Bibby, the director of health at the Health Foundation, said the UK’s generally poor health was holding back the country’s economic performance. She said that mental health issues are the biggest cause of people being out of work and are an “obvious place to start” in the levelling-up agenda. “You won’t level up the economy unless you level up health,” she added.

Source: The Guardian, 15 August 2021

See also: The Telegraph - ‘Levelling up’ cost will be close to £2tn price of German reunification, says think tank ([link removed])

Centre for Cities – So you want to level up? ([link removed])
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** Trusts have been asked to plan for baseline efficiency savings of 1.5% for the remainder of the financial year, as the NHS continues negotiations with the Treasury over its full funding package. This efficiency target is still only guidance rather than a formal requirement, which will not come until NHS England agrees funding for October to March with the government.

If trusts can deliver baseline savings 1.5% in the second half of 2021-22, the assumption is this would equate to an annualised 3% saving from April 2022.

Policy experts have suggested the guidance is unrealistic. NHS Providers chief executive Chris Hopson told HSJ the actual efficiency requirement will depend on the negotiations between NHSE and the Treasury, adding: “We have argued very strongly that central government must be realistic about what can be achieved. It will be challenging to say to providers, in the middle of September, you’ve got to start realising 3 per cent [annualised] savings for the second half of the year from the beginning of October as it will give them very little run-up,” he said.

“It’s not something that you can just do at the drop of a hat. It takes preparation and then the hard slog of actual delivery.” He said the ongoing pressures from covid mean trusts’ ability to realise savings is “very constrained”, and the pandemic means “it now costs more to deliver the same level of activity they were delivering before covid.”

Sally Gainsbury, senior policy analyst at the Nuffield Trust, said: “We would warn the NHS against agreeing to what would be yet another settlement which assumes huge and unachievable levels of efficiency. There’s covid, but you also just have to look at the NHS’ financial performance in recent years to see this [is] an unrealistic target,” she added.

An NHS England spokesperson said: “There has been no formal planning ask of trusts in the second half of the year as the government hasn’t yet agreed a funding settlement with the NHS for the second half of the year.”

Source: HSJ, 13 August 2021
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**
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** Official data suggests that nearly one million people in England became addicted to alcohol due to Covid lockdowns. Government polling before the pandemic estimated 1.5 million adults drank at least 50 units every week. However, this increased to a little under 2.5 million this summer, which experts attribute to the never-ending cycle of virus-controlling measures.

Alcohol charities said the data showed drinking in older people has reached a level of crisis “that is happening now”. It comes after Public Health England (PHE) figures last month revealed deaths directly caused by alcohol soared by 20% during the first year of the coronavirus pandemic.

Data from the study, which quizzed 4,061 in several different waves, showed the largest uptick in alcohol dependence was among over-65s. Before the coronavirus pandemic, just over 190,000 (3.4%) of people in the age group drank that much. By the end of June, this jumped to more than 453,000 (8.1% — an increase of around 260,000 people (138%). Proportionally, the second-biggest increase was seen among 18- to 24-year-olds, who jumped from 71,000 to 170,000 (140%).

The huge spike in boozing comes despite the Government has slashed funding for addiction services. Eight out of England’s nine regions have seen a real-term reduction in cash since 2014. Some £162 million has been cut in spending on drug and alcohol addiction services since then, falling from £877 million in 2013-14 to £716 million in 2017-18.

Dr Tony Rao, a clinical research fellow at King’s College London, said: “Ministers need to address the balance, not just in funding local authority budgets but in levelling up the Cinderella service of alcohol addiction. An increase of nearly 1 million people drinking at levels suggestive of alcohol dependence is a huge cause of concern, particularly in older people.”

Lucy Holmes, director of research and policy at Alcohol Change UK, called on the Government to improve specialised addiction treatment services for older people.
Increasing alcohol duty and following Scotland and Wales in introducing a minimum price for a unit of alcohol are “common sense” measures, she said.

Source: Daily Mail, 13 August 2021
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** Blackburn with Darwen Council has launched its stop smoking campaign to coincide with Step Four of the Government’s Covid roadmap, stressing that good respiratory health is now more important than ever. The campaign uses a series of animations to explain how smoking harms nearly every organ of the body, with messages specifically around the impacts on lungs, mental health, heart, skin, brain, and vision.

The animations, which are being distributed through the borough’s digital advertising assets and social media, also highlight that quitting does not have to feel painful and that support is available.

Councillor Brian Taylor, the assistant executive member for health and wellbeing, said: “We know smoking causes cancer and dramatically reduces both quality of life and life expectancy. Our campaign is designed to educate and inform as well as point smokers in the direction of help. As a previous smoker, I have personal experience of quitting and know stopping smoking is one of the best things a smoker will ever do for their health. We have support available for smokers to quit locally.”

Source: Lancashire Telegraph, 13 July 2021
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** International
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** South Dakotans bought far more alcohol and tobacco than usual during the COVID-19 pandemic. Health experts say the pandemic brought on social isolation, job loss, grief and ongoing anxiety about the future, all factors that likely contributed to the heightened use of alcohol and tobacco.

Healthcare professionals are concerned that residents who consume more unhealthy products may experience long-term physical and mental health consequences.

According to state Department of Revenue data, in South Dakota, gross sales in liquor stores increased by about 21% from 2019 to 2020, from roughly $96 million in 2019 to about $117 million in 2020.

Gross sales at tobacco stores and stands rose by 42% from 2019 to 2020, from about $17 million to $24 million.

Source: Aberdeen News, 15 August 2021
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