Prevention and the future of health
“Prevention is a bigger health topic than many people realise – and it’s about to get bigger”. These were the words of Secretary of State for Health and Social Care, Rt Hon Matt Hancock MP, last November as he launched his 'Prevention is better than cure' vision. Calling for greater investment in primary and community care, and the need to empower people to manage their own health needs, this vision marks a renewed commitment to prevention and public health. This ambition is not new. Back in 2015 the NHS Five Year Forward View highlighted the importance of “getting serious” about prevention, warning that the NHS would need “a radical upgrade in prevention if is to be sustainable”.
The challenges facing the public health system are myriad and complex. It is estimated that 24 per cent of all deaths in England and Wales could be avoided through good quality healthcare or wider public health interventions. The population is growing older and the prevalence of chronic disease and co-morbidities is on the increase. Smoking remains the nation’s single greatest cause of preventable illness and avoidable death, with 100,000 people dying each year from respiratory diseases and infections. Childhood obesity is a growing concern, with nearly a third of children aged 2-15 overweight or obese and a record number of under-25s diagnosed with Type 2 diabetes in recent years. Meanwhile, the gap in healthy life expectancies between the richest and poorest in society remains stubbornly high.
A focus on prevention is not only timely, but important. An overwhelming emphasis on urgent care and NHS system pressures in recent years has undermined the transformation agenda, crowding out consideration of the role of prevention in public health. NHS England's 10-year plan presents an opportunity to introduce a whole-system approach to prevention, health promotion and resilience. Tackling the wider determinants of inequalities in health must be at the heart of this plan and delivered through a coordinated effort across social care, health and local government. Technology has a definitive role in the long-term future of the healthcare system. If harnessed effectively, advances in genomics, precision medicine and predictive algorithms will transform all aspects of health, allowing for the early detection of diseases and the delivery of personalised treatments.
This is the time to start thinking differently about health and care. Whether the long-term plan will be able to deliver on the ambitions previously outlined in the NHS Five Year Forward View remains to be seen. However, a strategic approach to prevention which builds on the capabilities of the system, is appropriately funded, and places genuine focus on the social determinants of health will help realise the vision of a health system that is joined-up, effective and sustainable for future generations.