Table 3 Drivers for short-term planning

Organisational systems

   m Politicians and public perceived as thinking in terms of short term electoral payback

   m Policies perceived to have limited shelf life

   m Commissioning framework is short term

   m Evidence-based policy making leads to a focus on short term interventions evaluated by randomised control trials (RCTs)

   m Disruption caused by reorganisations

   m System set up (the NHS and the government)

   m European legislation

Difficulty of long term forecasting

   m Service reorganisations

   m Perceived poor quality evidence for long-term intervention

   m Research not produced in a timely fashion to inform decisions

   m Focus on short term targets and deadlines

   m Accuracy of forecasting limited

   m Uncertainty of effects of major long term processes like climate change and global food shortages on public health

   m Public heath professionals perceived to have limited influence on long term planning process

   m Lack of long-term perspective think tank