Addressing public health policy: SCW’s response to the Government’s Green Paper

Whilst we can expect further debate about the Government’s Green Paper ‘Advancing our Health: Prevention in the 2020s’, it marks a welcomed focus to encourage everyone in the system to work together and place prevention at the heart of decision-making.

Last week the Government published its new public health Green Paper Advancing our Health: Prevention in the 2020s, seeking to place prevention at the centre of all decision-making throughout the health and care system, and local and national governments.

Though the document attracted comment for its lack of fanfare and it was published in the last days of Theresa May’s government, it is, nevertheless, an important statement of the direction of travel for public health policy as we approach the 2020s and a decade the green paper calls one of ‘proactive, predictive, and personalised prevention.’

NHS South, Central and West (SCW) and our partners are well placed to grasp the opportunities mapped out in the document. For example, it sets out ‘a new wave of intelligent public health’ where a combination of carefully analysed NHS data and smart `wearables’ provide for many more personalised health interventions.

We are already a part of this movement  – delivering a pilot in Berkshire, working with a cohort of 400 NHS staff, to test how wearable devices impact on people’s activity levels and how sustainable the results can be.  This is exactly the kind of project that falls with the Green Paper’s aspiration to help people move from being passive recipients of care to being the ‘co-creators of their own health,’ equipping  them with the skills, knowledge and confidence they need to help themselves.

Working with our partners, including the Dartmouth Institute and Johns Hopkins University, with whom we have adapted and validated a range of predictive algorithms for use on the UK population, SCW are already supporting the development of new models of care focused on the needs of a population identified through the use of Population Health Analytics using our extensive expertise in analysing, presenting and interpreting population information. 

Some of our customers are also benefiting from patient-level risk prediction as part of our Population Health Management approach; we supply a range of predictive models through our Insights Population Analytics (IPA) solution, ranging from risk of emergency admission to risk of persistent high cost. We support customers in building bespoke case-finding reports using the predictive model most suitable for their requirement, and incorporating other information to enrich the patient profiles, such as patterns of healthcare utilisation and cost, and information about disease profiles and complexity.

We are learning more and more about the burden of poor health, both in terms of its geographical variations and its determinants, leading to co-morbidities, a terrible cocktail of conditions like high blood pressure, heart disease, diabetes, obesity, early onset dementia, and poor mental health. Here, the paper calls for a ‘parity of esteem’, not just for how conditions are treated, but also for how they are prevented. This is a genuine opportunity for innovation in prevention as well as, perhaps, a chance for so-called Cinderella services in areas like mental health to receive their fair share.

The paper sets out goals for a smokefree society – with a plan to be smokefree by 2030.  We’ve made so much progress in the last 10-20 years, thanks to effective legislation such as the plain packaging of tobacco products and hard-hitting media campaigns, we now have one of the lowest smoking rates in Europe, with less than one in six adults smoking.  But 14% of our population does still smoke, with many of them living in deprived inner city areas.   And we know that social housing tenants are much more likely to smoke – 30% of adults in the social rented sector are estimated to be smokers, double the national average.

The paper suggests there may be mileage in a `polluter pays’ approach – long mooted here and already introduced in France and parts of the USA – where tobacco companies help fund services to stop people smoking and campaigns to discourage people taking it up in the first place.

Let’s see if it develops from here…

Programme Director, Behaviour Change