26/02/2016 10:59 GMT | Updated 25/02/2017 05:12 GMT

Prevention in Action - Saving the NHS Through Prevention

Almost 70 years on, the NHS being underfunded, over-stretched and struggling to cope keeps making headlines...

The NHS is a vast, complex, beautiful institution that has been a source of pride since its inception in 1948. Whatever their disputes about the NHS may be, I think even the Prime Minister and leader of the opposition party would agree with that.

Almost 70 years on, the NHS being underfunded, over-stretched and struggling to cope keeps making headlines.

Since its creation, we as patients have changed - a lot. Our population has grown and we live longer. The NHS now sees over 1 million patients every 36 hours in England alone. Patients' conditions have changed too.

In the 1940s, thousands died from infectious diseases like typhoid and polio. Thanks to the NHS (and medical advances), we now rarely hear of these diseases taking lives in the UK.

Instead, people are living with more complex conditions: diabetes, chronic obstructive pulmonary disease, dementia, high blood pressure. More and more people are in need of social care. While many may still wish to argue it, there is growing evidence that there is interdependency between health and social care.

A national health service built to treat infectious diseases or see people through their last days is not equipped to respond to today's needs. But there is a solution.


We cannot prevent everything entirely so we need to make sure preventative services are provided across all stages of a patient's condition.

The Care Act 2014 recognises this, with three equally important forms of prevention being written into the statutory guidance (primary, secondary and tertiary). This triple definition of prevention helps ensure people's needs don't escalate at any stage of their condition (before, during or after).

Yet, a British Red Cross research study found that the Act's prevention duty is not being fully realised, despite its potential to improve wellbeing and allow for 'longer-term financial savings to the public purse'. And, while over a half of local authorities are fully engaging with the triple definition of prevention, only 12 joint health and wellbeing strategies across the country have adopted this language.

The NHS Five Year Forward View also fails to use this definition or emphasise the importance of tertiary prevention. But, adopting this language is imperative in order for the NHS to move with local authorities towards a preventative rather than palliative system.

But what does it actually mean in practice?

Take type 2 diabetes. Primary preventative initiatives, aimed at people who haven't yet developed the condition, come in the form of universal public health campaigns that promote healthier lifestyles, such as the Change for Life campaign.

Secondary prevention includes the NHS Health Check Programme. This initiative helps identify people with pre-diabetes who can then be supported to avoid developing the condition.

Tertiary prevention includes all those lower-level initiatives that help the one in 16 Brits that already have type-2 diabetes, minimise the deterioration of the condition and prevent further complications.

All conditions and illnesses can and should be addressed in this way. The triple definition has been largely overlooked by the rest of the health sector. But it is just as useful to the NHS as adult social care and public health.

Decision makers across health and social care must recognise that prevention is about more than just stopping a condition or illness arising. It is about preventing, reducing and delaying needs and associated costs. Only then can we hope to save our NHS, and help people stop reaching crisis point before they receive the health and social care support that they need and deserve.

Follow the Twitter conversation #PreventReduceDelay.