The 2020s will be the decade of proactive, predictive, and personalised prevention. This means:
- targeted support
- tailored lifestyle advice
- personalised care
- greater protection against future threats
New technologies such as genomics and artificial intelligence will help us create a new prevention model that means the NHS will be there for people even before they are born. For example, if a child had inherited a rare disease we might be able to diagnose and start treatment while they are still in the womb, so they are born healthy.
Using data held by the NHS, and generated by smart devices worn by individuals, we will be able to usher in a new wave of intelligent public health where everyone has access to their health information and many more health interventions are personalised.
In the 2020s, people will not be passive recipients of care. They will be co-creators of their own health. The challenge is to equip them with the skills, knowledge and confidence they need to help themselves.
- embedding genomics in routine healthcare and making the UK the home of the genomic revolution
- reviewing the NHS Health Check and setting out a bold future vision for NHS screening
- launching phase 1 of a Predictive Prevention work programme from Public Health England (PHE)
Over the decades, traditional public health interventions have led to significant improvements in the nation’s health.
Thanks to our concerted efforts on smoking, we now have one of the lowest smoking rates in Europe with fewer than 1 in 6 adults smoking. Yet, for the 14% of adults who still smoke, it’s the main risk to health. Smokers are disproportionately located in areas of high deprivation. In Blackpool, 1 in 4 pregnant women smoke. In Westminster, it’s 1 in 50.
Obesity is a major health challenge that we’ve been less successful in tackling. And clean air will continue to be challenging for the next decade. On mental health, we’ve improved access to services. In the 2020s, we need to work towards ‘parity of esteem’ not just for how conditions are treated, but also for how they are prevented. On dementia, we know ‘what’s good for your heart is also good for your head’. A timely diagnosis also enables people with dementia to access the advice, information, care and support that can help them to live well with the condition, and to remain independent for as long as possible.
The new personalised prevention model offers the opportunity to build on the success of traditional public health interventions and rise to these new challenges.
The NHS is also doing more on prevention. The Long Term Plan contained a whole chapter on prevention, and set out a package of new measures, including:
- all smokers who are admitted to hospital being offered support to stop smoking
- doubling the Diabetes Prevention Programme
- establishing alcohol care teams in more areas
- almost 1 million people benefiting from social prescribing by 2023 to 2024
These measures will help to shift the health system away from just treating illness, and towards preventing problems in the first place.
- announcing a smoke-free 2030 ambition, including options for revenue raising to support action on smoking cessation
- publishing Chapter 3 of the Childhood Obesity Strategy, including bold action on: infant feeding, clear labelling, food reformulation improving the nutritional content of foods, and support for individuals to achieve and maintain a healthier weight. In addition, driving forward policies in Chapter 2, including ending the sale of energy drinks to children
- launching a mental health prevention package, including the national launch ofEvery Mind Matters
3. Strong foundations
When our health is good, we take it for granted. When it’s bad, we expect the NHS to do their best to fix it. We need to view health as an asset to invest in throughout our lives, and not just a problem to fix when it goes wrong. Everybody in this country should have a solid foundation on which to build their health.
This is particularly important in the early years of life. Most children are born into safe and loving homes that help them develop and thrive. But this is not always the case. We must help all children get a good start in life.
This ‘asset-based approach’ should then follow through to other stages of life, including adulthood and later life. It’s difficult to live a fulfilling life if you’re worried about money, live in cold or damp conditions, or feel cut-off from those around you.
At national level, we will lay the foundations for good health by pushing for a stronger focus on prevention across all areas of government policy. At local level, we expect different organisations to be working together on prevention. This means moving from dealing with the consequences of poor health to promoting the conditions for good health and designing services around user need, not just the way we’ve done things in the past.
- launch a new health index to help us track the health of the nation, alongside other top-level indicators like GDP
- modernise the Healthy Child Programme
- consult on a new school toothbrushing scheme, and support water fluoridation
The commitments outlined in this green paper signal a new approach for the health and care system. It will mean the government, both local and national, working with the health and care system, to put prevention at the centre of all our decision-making. But for it to succeed, and for us to transform the NHS and improve the nation’s health over the next decade, individuals and communities must play their part too. Health is a shared responsibility and only by working together can we achieve our vision of healthier and happier lives for everyone.