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The NHS 5 Year Forward View – getting serious about prevention

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We are now one year on since the NHS Five Year Forward View was published.

Setting out a clear direction for the NHS, the plan showed why change is needed to secure the future of the nation’s healthcare system and what this would look like.

A key element at the heart of the Five Year Forward View is prevention of non-communicable disease, which starts with encouraging behavioural change.

To help make the NHS sustainable, people need to be more proactive about prioritising their health and wellbeing to reduce their risk of developing lifestyle related health conditions. This requires concerted collaborative effort between partners in the health system, at a local and national level.

The NHS and organisations within the wider system have recognised that more needs to be done to respond to the prevention challenge.  Plans to act on this have already taken shape in the form of the NHS Prevention Programme Board, which was established in January 2015.

Chaired by Duncan Selbie from Public Health England, the Board has made a strong start since the first meeting to make sure we deliver on our promise to get serious about prevention. Work that has been underway in the past year includes the NHS Diabetes Prevention Programme (NHS DPP) along with a programme to improve the health of the NHS workforce and work to identify public health interventions which will contribute to the NHS efficiency programme.

Establishing the NHS DPP was an early priority for the Prevention Board. Type 2 diabetes is one the biggest public health challenges of our time, costing the NHS £8.8bn a year. However the WHO estimates that 80% of Type 2 diabetes cases are preventable.  Investing in prevention and stopping or delaying people getting Type 2 diabetes will reduce costs further down the care pathway, as risk factors for Type 2 diabetes are risk factors for other serious conditions like cardiovascular disease.

The NHS DPP offers people already identified as being at high risk of developing Type 2 diabetes the chance to take part in an evidence-based behaviour change programme. It aims to change participants’ perception of nutrition and physical activity, encouraging them to make healthy changes to their lifestyle. The programme aims to support up to 10,000 people at high risk of Type 2 diabetes by April 2016 with national roll-out commencing in 2016/17.

Another key priority is a major drive to improve the health of the workforce of the NHS and other Arm’s Length Bodies.  NHS England has pledged a £5million programme of work designed to develop and support new workplace incentives to promote employee health and to cut sickness-related absence.  Due to be piloted at 12 NHS Trusts, the project will look at a range of opportunities from leadership to investment, training, on-site food, and access to a range of services.

Without hard hitting action to address the threats to the nation’s health and wellbeing across the public health system, we face the burden of avoidable illness.

As well as these main focuses, the NHS Prevention Board will continue to play an active role in the wider prevention debate, providing strategic direction and oversight to stimulate national action on obesity, smoking and other major health risks, and the wider determinants of health.

Improving the country’s mental health is also a priority for PHE and the work of the Mental Health Taskforce, established by NHS England, is an important part of the 5 Year Forward View. In September the taskforce published its engagement report, highlighting the views of 20,000 people on the priorities for the country’s mental health.  A quarter of respondents cited prevention as a key priority for action before 2020. We’ll be looking to make a real impact over the next 5 years, placing prevention at the heart of mental health.

Additionally, the Cancer Taskforce was also borne out of the 5 Year Forward View, charged with delivering its vision of better prevention; swifter diagnosis; and better treatment, care and aftercare for all those diagnosed with cancer.

The taskforce published its strategy in the summer, placing prevention and tackling inequalities, in terms of cancer survival, at its heart.

Without hard hitting action to address the threats to the nation’s health and wellbeing across the public health system, we face the burden of avoidable illness. It's vital that we get serious about prevention: not just to save money and ensure a sustainable NHS, but to improve the quality and access to health services and create a healthier population.

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  1. Comment by Francesco Palma posted on

    Getting serious above Prevention would be better served if Local authorities Public Health were able to increase NHS Healthchecks to the 40-74 population, few LA has past the 66% mark and it would be good to hit 75% mark in 2017/2018. Screening for High Blood Pressure in particular will further the Prevention agenda.
    Out of interest take a look at the upper tier Local Authority areas that has maintained a position in the top 10 of the most deprived areas since the indices were published in 2000 (Indices of Multiple Deprivation) with the additional funding allocations given to those areas to LA's and PCT/CCG's how does PUBLIC Health explain the unwillingness of the population not to change its behaviours to improve their health and well being. Agreed that Prevention is the key but explain to me how Public Health will change the mindset of the population in any of the LA's that occupy the top 10 in the IMD 2015 list.