Prevention is better than cure

In a letter to The Times on Monday, leading figures from the health world, including the heads of The Royal College of Physicians and The Royal College of Nursing, called for a national conversation on the future of NHS funding. This was an issue raised about a year ago in this blog, where I argued that a proper debate was needed about what the NHS can and cannot realistically afford, and who should pay for it.

This is a welcome call by the signatories of this letter. It highlights that we can no longer hide from reality – that we need to look at options and take appropriate measures in order for the NHS to survive. Recent years have demonstrated that despite many NHS organisations making progress to meet the Nicholson Challenge of creating £20 billion pounds of efficiency savings by 2015, these savings alone are not going to plug the huge financial gap. Instead we need to consider the various options available to ensure that the NHS is sustainable, potentially through higher taxation, a system where the patient funds some elements of care or a complete review of what is available on the NHS.

Addressing NHS funding must be a priority for the government, however equally important is placing individual’s wellbeing at the heart of public policy. As the Health Select Committee recently pointed out, the NHS faces “one of its greatest challenges” dealing with patients with long-term conditions, such as diabetes. They account for 70% of health spending but only 30% of patients. In other words, prevention is better than cure and more must be done to curb the rise of chronic diseases.

Getting healthcare professionals and government both at national and local levels, as well as communities and industry to work together are a prerequisite to making this happen. We need to be ambitious, creative and think outside of the box to find solutions to our healthcare ticking time bomb.

An interesting example of this is an experiment that started in two small towns in northern France to tackle obesity in children and attempted to engage a whole community in an effort to combat the lifestyles that cause obesity. Everyone, from the mayor to shop owners, school teachers, doctors, pharmacists, caterers, restaurant owners, sports associations, the media, scientists, and various branches of the town’s government joined in an effort to encourage children to eat better and move around more. The towns built sporting facilities and playgrounds, mapped out walking itineraries, and hired sports instructors. Families were offered cooking workshops, and families at risk were offered counselling.

Over the course of 13 years, obesity in children had dropped to 8.8%, while in similar neighbouring towns it had risen to 17.8%. This experiment, which is also a great example of integrated care, has now successfully spread to more French towns and other countries.

Closer to home, earlier this week the BBC reported how doctors are being encouraged to work in conjunction with local authorities and voluntary community organisations and prescribe trips to lunch clubs and museums as part of new measures to tackle loneliness, which can have a serious impact on a person’s health.

These examples are encouraging and we need to foster these types of ideas along with more coordinated approaches between various stakeholders to enable people to change their lifestyles. Not only will it help improve their wellbeing, it should in the longer term have a huge impact on NHS finance.

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