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Diagnosis Critical: England’s 32 Risk Zones

A new report launched today has shown that areas with hospitals in financial trouble and poor outcomes means that people are dying when they could not have.  ZPB’s managing director Alex Kafetz explains more and our involvement in the project.  

Almost one fifth of the population in England are having their health and life expectancy cut short because their local health services aren’t properly managed.  These are the stark findings from a new report published today by the Centre for Progressive Policy (CPP), with support from ZPB Associates.

The study identified 32 risk zones.  These are local authorities that are home to both below-average health outcomes and deficit-running NHS trusts. The study showed these areas have age-standardised mortality rates for causes considered avoidable, amenable and preventable that are 29% higher than in other local authority areas. It also identifies another 13 crunch zones, local authorities which have an elderly population weighing on an underfunded care sector, in turn compounding financial pressures on NHS trusts. 

In response to this, CPP has launched a 12 month ambitious programme of research and engagement on the future of health and social care in England. This includes data-led research and deliberative public and professional engagement, which will be guided by an authoritative group of clinical and non-clinical advisors. The programme will consider all options needed to create a truly sustainable, high quality system of health and social care for the future.  Solutions to funding, care organisation and policy to improve the life expectancy of the 17% of people who live in these risk zones, will be the primary aim of the study.

ZPB is partnering with CPP to make this all happen.  Specifically, we will be recruiting and supporting the advisory group (which our Managing Director, Alex Kafetz has been asked to join), mentoring the centre’s team of health economists to make the best use of NHS data and translate this in ways which will help land our recommendations with policy makers, clinicians and patients and citizens, and make sure the outcomes of the programme are spread far and wide. 

We are aware that there are a number of commissions, assemblies and policy councils all trying to grapple with long term solutions for health and care, but we differ, and believe we are better placed, to do this work for a number of reasons, including our first rate data analysis, our advisory group and our commitment to involving members of the public to systematically seek their views on the funding compromises that will need to be made. In addition CPP is independently funded, so will not be influenced by any vested interests – and we are garnering support from leading policy makers and influencers including Sarah Wollaston MP, Chair of the Health and Social Care select committee who has commented on the “stark detail” of our findings so far.

We’ll use these pages to keep people in the ZPB network up to date with the findings and progress of the work programme, but in the meantime if you or your organisation would like to contribute please email Charlie Smoothy (


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