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Organisational systems
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m Politicians and public perceived as thinking in terms of short term electoral payback
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m Policies perceived to have limited shelf life
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m Commissioning framework is short term
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m Evidence-based policy making leads to a focus on short term interventions evaluated by randomised control trials (RCTs)
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m Disruption caused by reorganisations
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m System set up (the NHS and the government)
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m European legislation
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Difficulty of long term forecasting
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m Service reorganisations
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m Perceived poor quality evidence for long-term intervention
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m Research not produced in a timely fashion to inform decisions
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m Focus on short term targets and deadlines
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m Accuracy of forecasting limited
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m Uncertainty of effects of major long term processes like climate change and global food shortages on public health
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m Public heath professionals perceived to have limited influence on long term planning process
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m Lack of long-term perspective think tank
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