Going upstream: How do we engage with prevention?
Article
We had an entertaining, insightful and provocative discussion on Tuesday evening at Deloitte, focused on improving health and preventing illness.
Our speakers were Kevin Fenton, Regional Director, Office for Health Improvement and Disparities (London), Regional Director of Public Health, NHS London, and Steve Russell, Chief Delivery Officer and National Director for Vaccination and Screening, NHS England.
The main take aways were:
- Primary prevention along with vaccination & screening programmes matter with the potential to enable a significant increase in years lived in good health as well as life expectancy – and to reduce inequalities. At the same time, we need to recognise that some interventions have historically had low feasibility/impact and so actual return on investment (ROI) can be lower than theoretical/potential ROI.
- There’s lots we can do to improve uptake (and therefore impact) – some very practical steps such as improving booking systems to better information for users, challenging regulations for example where vaccinations can/can’t take place, using technology to help flag who has/hasn’t had a BP check or an immunisation at every interaction, working with employers. supermarkets and so on.
- This will require a much stronger leadership focus and tackling some thorny issues – for example fiscal policy, using social marketing to challenge the (very effective) marketing of big brands, considering incentives for individuals – and, most importantly spending more. We currently spend 25m in London on primary prevention vs £25bn spent on healthcare. We need to reduce spending on lower impact interventions to spend more on higher impact approaches (the allocative efficiency of commissioning) and continually question the costs of delivery – the more efficient service provision can be, the more money we have to focus on prevention.
Many thanks to our speakers, our generous hosts Deloitte, our Members and guests and our unofficial photographer, Murray Ellender.