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Prioritising prevention for population health

Running in the park

Our ambition for population health is a society where we all spend more years in good physical and mental health. To achieve this requires a cross-government approach to ensuring we are world leading for health outcomes and reducing inequalities. This is vital to secure the long-term sustainability of the NHS.

The BMA has a well-established record of making the case for preventing physical and mental ill-health and investing in evidence-based population measures. We are now setting out our framework for a cross-government approach to prioritising population health.

Read our October 2019 response to the Department of Health and Social Care's consultation: Advancing our health: prevention in the 2020s.

 

Prioritising prevention for population health

As far back as 2002, Derek Wanless, in his review of the long-term trends affecting the health service in the UK, concluded “improved public health, through health promotion and disease prevention could have a significant impact on health status and ultimately the demand for health services and the resulting cost.” 

Since this landmark report, the evidence base that underpins prevention has developed further and further. There have been repeated political commitments to prevention and action in some areas, such as the introduction of minimum unit pricing in Scotland, or the adoption of a health in all policies approach in Wales.

Yet, overall there has repeatedly been an inconsistent and inadequate approach to prevention. For example, in England, despite rhetoric public health funding has been repeatedly cut in recent years as the BMA has consistently highlighted.

 

Changes to public health grant in England

See further analysis of changes to public health funding.

This short-term approach is having long-term consequences on the sustainability of the health service. Our 2018 paper, Prevention before cure: securing the long-term sustainability of the NHS, set out the health and economic case for investing in prevention:

  • Preventable ill-health accounts for an estimated: 50% of all GP appointments, 64% of outpatient appointments and 70% of all inpatient bed days
  • 40% of the uptake of health services may be preventable through action on smoking, drinking alcohol, physical inactivity and poor diet

The case for investing in and prioritising prevention is clearly compelling. The BMA is therefore now setting out our framework for a cross-government approach to prevention.

 

The BMA's framework for preventing physical and mental ill health

20190157 Prevention before cure report graphic 16x9 1 

While each individual factor in the framework is important, it is only by collectively addressing all four areas in a comprehensive approach, that we believe it is possible to effectively improve physical and mental ill-health. For further information read our policy paper below.

Prevention before cure: prioritising population health

 

Are we prioritising prevention?

  • Feeling the squeeze: local impact of cuts to public health funding

    Doctors have expressed particular concern that recent budget changes will result in public health services that are inadequate for meeting the needs of the local populations which they serve.

    Our briefing explores whether recent changes to public health funding are reflective of local population health needs, and assesses the impact that public health funding cuts are having on the delivery of services locally.

    Read our briefing

  • Public health funding constraints

    Across the UK, commitments to prioritise ill-health prevention are not being matched by funding commitments.

    • Spending on various public health activities in Northern Ireland and Wales has declined, with relatively stable but low levels of funding in Scotland.
    • In England, significant cuts to local authority public health funding are reducing vital public health services and impacting on patient care.
    • Spending on prevention and public health (around 4-5% of total health spending) in the UK is significantly lower than spending on treatment.

    With the NHS at breaking point, we need to see funding for public health and prevention prioritised to reduce pressure on the health service and its staff.

    Read our briefing

     

  • Cost effectiveness of prevention and early intervention

    Public health interventions have consistently been proved to be cost-effective.

    However new efforts are needed to maximise the potential of early intervention and prevention activities.

    Read our briefing

     

  • Inconsistent use of evidence in developing policies

    Despite some successes - such as action to reduce smoking rates - evidence-based policies are not being consistently used to improve public health.

    Read our briefing