Creating a ‘pre-NHS’ focused on preventative healthcare could free up billions for the UK within two decades, according to the head of a task force investigating radical new improvements to the country’s well-being.
Professor John Deanfield, the first-ever government champion of personalised prevention, has concluded that a parallel health service is needed to save the NHS as it struggles to cure an increasingly sick population.
Deanfield, who was asked by the previous Foreign Secretary Steve Barclay to set up his taskforce, said: “The NHS still operates on the traditional, founding principles of 75 years ago, which is sick care. But we need to move to a system of upstream, preventative health intervention.”
He added: “Our current approach to health is unsustainable, both for the health of the population and for the economy. A refocus on prevention is the only way to avert the growing health and welfare crisis.”
The “size of the prize” for prevention was enormous, Deanfield added. “It is estimated that implementing known, evidence-based preventive interventions earlier and more widely could deliver an extra 20 healthy days per person per year in the UK – a 33% reduction in ill health.” That could, according to an estimate by the previous Conservative government, add about £320 billion to GDP over 20 years.
Deanfield wants to move preventive services, such as weight, cholesterol and blood pressure checks, to where people live, work and socialize. “In this way, we normalize prevention as part of everyday life,” he said.
He also wants healthcare to be personalised through a new ‘prevention portal’ – developed as part of the NHS app – which will give people access to their health data and individual prevention plans, and signpost them to digital and in-person services.
Deanfield recommends a new, national openness to testing and adopting medical innovations. He points to drugs such as inclisiran, the cholesterol-lowering drug now offered only to people with high cholesterol or a cardiovascular event.
David Prior, chairman of the NHS until 2022, said Deanfield’s recommendations would help fix a “broken system”, have a profound impact on the country’s growing healthcare inequality and improve the number of cases where the NHS delivers substandard care.
Lord Prior said a new preventative model would quickly become as integral to the country as the NHS itself, and health experts would welcome it rather than challenge service delivery.
He added: “A preventative system gives us hope that we can actually crack the current healthcare crisis. Go to any NHS hospital and you will see it is full of people with chronic, long-term conditions. But hospitals are the worst places to treat people with these conditions: it is far better to treat them outside of hospital before they become too bad.
“But it would be asking too much to expect the NHS to take on this preventive work. The current system is broken and will continue to deliver poor quality care and growing inequality without this kind of help. The NHS would welcome a preventive care system alongside it, if it meant a reduction in demand on its facilities, which are bursting at the seams.”
after newsletter promotion
Deanfield’s recommendations are also backed by Sir John Bell, professor of medicine at the University of Oxford, who led the national scientific advisory panel on Covid testing and chaired the government’s group that approves tests.
“The dream is to have a system similar to when we all got our Covid jabs: a tent would be set up in the Sainsbury’s car park and we would queue up to get a jab for Covid, flu, pneumococcal and shingles at the same time,” said Bell, who chairs the Office for the Strategic Coordination of Health Research.
“Then we would have blood tests and genetic testing and our family history would be looked at. And then those who were at some risk, even if they didn’t have symptoms yet, would be given a long-acting injectable to lower cholesterol, lower blood pressure or control weight.”
Martin Marshall, chairman of the Nuffield Trust and emeritus professor of healthcare improvement at UCL, who was president of the Royal College of General Practitioners until 2022, said GPs would welcome the proposals. “We need to change the model because GPs can’t solve this problem on their own and they would like some help to do it,” said Marshall, who was previously deputy chief medical officer for England and director general of the Department of Health.
The NHS and the National Institute for Health and Care Excellence (Nice) declined to comment on Deanfield’s recommendations. Nice said its committees could only recommend drugs based on the population defined in the marketing authorisation and whether they were also cost-effective.