How does the NHS promote public health?

The NHS England Long-Term Plan outlines the vision and priorities for the NHS in England, emphasizing the importance of prevention and health promotion. By focusing on public health, the NHS aims to improve the overall health and well-being of people’s health and local communities, reducing the burden on healthcare services and promoting sustainable healthcare for the future. The NHS works with the Department of Health and Social Care (DHSC), the Office for Health Improvement and Disparities (OHID), the UK Health Security Agency (UKHSA) and other partners and providers.

Prevention: A cornerstone of the NHS long-term plan

Prevention lies at the heart of the NHS Long Term Plan, recognising that good health involves more than just healthcare. The plan emphasises the need to work in partnership with local government, health professionals and other stakeholders to prevent diseases and promote population health through healthy lifestyles. The three levels of prevention – primary, secondary, and tertiary – are key components of the plan’s approach.

Primary prevention: Promoting healthy choices

Primary prevention focuses on preventing diseases or injuries before they occur. The NHS aims to make it easier for people to make healthier choices and reduce the risk of developing illnesses and premature death. Collaborating with partners such as the government, Public Health England, and local authorities, the NHS aims to implement initiatives to promote healthy behaviours such as physical activity and create supportive environments for healthy living.

Secondary prevention: Treating risk factors

Secondary prevention involves early detection and treatment of diseases to prevent their progression and complications. The NHS aims to provide tailored support for individuals with risk factors such as smoking, alcohol dependence, and obesity. By offering interventions and treatments, the NHS aims to reduce the risk of early ill health and improve outcomes for individuals at higher risk of developing diseases.

Tertiary prevention: Managing chronic conditions

Tertiary prevention focuses on managing chronic conditions and preventing further complications. The NHS aims to improve the management of long-term conditions such as diabetes and mental health disorders. By providing comprehensive care, promoting self-management, and addressing social determinants of health, the NHS aims to enhance the quality of life for individuals with chronic conditions.

Smoking cessation: Supporting tobacco-free lives

Smoking remains a significant public health risk, contributing to various diseases and reducing overall life expectancy. The NHS Long Term Plan includes several initiatives to support smoking cessation and reduce the prevalence of smoking in England.

Embedding the Ottawa Model in Trusts

The NHS aims to embed the Ottawa Model for smoking cessation in all Trusts by 2023 to 2024. This model ensures that every person admitted to the hospital who smokes is offered NHS-funded tobacco dependency treatment. By integrating smoking cessation support into healthcare settings, the NHS aims to increase the number of successful quit attempts and improve long-term quit rates.

Smoke-Free pregnancy pathway

Pregnancy presents a unique opportunity to support smoking cessation and improve the health outcomes of both mothers and babies. The NHS plans to deploy a new smoke-free pregnancy pathway, adapting the Ottawa Model for expectant mothers and their partners. This approach ensures that the entire family receives treatment together, creating a supportive environment for smoking cessation during pregnancy and beyond.

Specialist Mental Health Services for Smoking Cessation

Smoking rates among individuals with mental health conditions are significantly higher compared to the general population. Recognising this disparity, the NHS Long Term Plan specifically focuses on offering smoking cessation support within specialist mental health services. By providing tailored interventions and access to alternatives such as e-cigarettes, the NHS aims to address the unique challenges faced by individuals with mental health conditions.

Obesity Management: Tackling the Epidemic

Obesity is a growing public health concern, contributing to numerous health problems and placing a significant burden on healthcare services. The NHS Long Term Plan outlines several strategies to tackle obesity and support individuals in achieving and maintaining a healthy weight.

Doubling the Diabetes Prevention Programme

The NHS plans to double the Diabetes Prevention Programme over the next five years, expanding its reach and impact. This program focuses on preventing the onset of type 2 diabetes through lifestyle interventions and support. By identifying individuals at high risk of developing diabetes and offering targeted interventions, the NHS aims to reduce the incidence of this chronic condition.

Treating Severe Complications in children with obesity

Obesity can result in severe complications, particularly in children and young people. The NHS aims to treat an additional 1,000 children per year for obesity-related complications by 2022/23. By providing timely interventions and specialized care, the NHS aims to prevent the need for more invasive treatments in the future, improving the health outcomes of children and reducing the long-term burden on healthcare services.

Targeted weight management services in Primary Care

Primary care plays a crucial role in obesity management, offering support and interventions to individuals with obesity and related conditions. The NHS Long Term Plan aims to target weight management services in primary care to people with type 2 diabetes or hypertension and a body mass index (BMI) of over 30. By providing accessible and evidence-based interventions, the NHS aims to support individuals in achieving sustainable weight loss and improving their overall health.

Diet and alcohol: Promoting healthy choices

Diet and alcohol consumption are key factors influencing public health outcomes. The NHS Long-Term Plan includes measures to promote healthy eating and reduce alcohol-related harm.

Mandatory fortification of flour with folic acid

Folic acid plays a crucial role in preventing neural tube defects in babies. The NHS plans to consult on the mandatory fortification of flour with folic acid to ensure that women receive adequate levels of this essential nutrient during pregnancy. By increasing folic acid intake, the NHS aims to reduce the incidence of birth defects and improve the health outcomes of newborns.

Salt reduction programme

Excessive salt consumption is a major risk factor for hypertension and cardiovascular diseases. The NHS commits to reducing salt intake through its salt reduction program. By working with food manufacturers and suppliers, the NHS aims to set targets for salt reduction in various food categories to support individuals in making healthier choices and reducing their risk of developing chronic conditions.

Alcohol Care Teams in District General Hospitals

Alcohol dependence can have severe health consequences and place a significant burden on healthcare services. The NHS Long Term Plan includes the establishment of Alcohol Care Teams in district general hospitals with high rates of alcohol dependence-related admissions. These teams aim to provide specialized care and support to individuals with alcohol dependency, reducing the need for hospital admissions and improving outcomes for patients, families, and local communities.

Antimicrobial Resistance and Vaccines: Safeguarding Public Health

Antimicrobial resistance (AMR) poses a significant threat to public health, compromising the effectiveness of antibiotics and increasing the risk of untreatable infections. The NHS Long-Term Plan emphasises the importance of optimising antimicrobial use, ensuring access to treatments and prevention measures, and prioritizing childhood immunisation.

Optimizing antimicrobial use

The NHS aims to optimise the use of antimicrobials to reduce the development of antimicrobial resistance. By promoting good stewardship practices across all sectors, the NHS aims to ensure that antibiotics are used appropriately, preserving their effectiveness for future generations.

Ensuring access to treatments and prevention measures

Access to effective treatments and preventive measures is essential in combating AMR. The NHS commits to ensuring access to both existing and new interventions, including vaccines, diagnostics, therapies, and tools for antimicrobial management. By investing in research and development, the NHS aims to address the evolving challenges posed by antimicrobial resistance.

Prioritizing childhood immunisation

Immunisation plays a crucial role in preventing infectious diseases and reducing the burden on healthcare services. The NHS Long-Term Plan emphasizes the importance of achieving high vaccination rates among children. By focusing on shared outcomes and collaborative efforts, the NHS aims to ensure that children receive the recommended vaccinations, protecting them from vaccine-preventable diseases.

Cancer: Early detection and treatment

Cancer is a leading cause of morbidity and mortality worldwide. The NHS Long-Term Plan outlines strategies to improve early detection and treatment outcomes for cancer patients.

Increasing early diagnosis rates

Early detection of cancer significantly improves treatment outcomes and survival rates. The NHS aims to increase the proportion of cancers diagnosed at stages 1 and 2. By promoting awareness, implementing screening programs, and improving access to diagnostic services, the NHS aims to reduce late-stage diagnoses and improve patient outcomes.

Implementing HPV Primary Screening for Cervical Cancer

Human papillomavirus (HPV) is a major risk factor for cervical cancer. The NHS plans to implement HPV primary screening across England, enhancing the effectiveness of cervical cancer screening programs. By utilising advanced screening techniques, the NHS aims to detect precancerous changes early, preventing the development of cervical cancer and reducing the burden on public health services.

Personalised and Risk-Stratified Screening

Personalised and risk-stratified screening can improve the effectiveness of cancer screening programs. The NHS aims to utilize these approaches to test the family members of cancer patients who may be at increased risk of developing cancer. By identifying individuals at higher risk, the NHS aims to provide targeted interventions and surveillance, improving early detection and treatment outcomes.

Mental Health: Integrating Physical and Mental Well-being

Mental health is a critical component of overall well-being. The NHS Long-Term Plan emphasises the integration of physical and mental health services to provide holistic care for individuals.

Physical Health Checks for people with Severe Mental Health Problems

Individuals with severe mental health problems often experience physical health disparities. The NHS aims to provide annual physical health checks for an additional 110,000 people living with severe mental health problems. By addressing physical health needs, the NHS aims to improve outcomes, reduce premature mortality, and enhance the well-being of individuals with mental health conditions.

Piloting Health Checks for people with Autism

People with autism may face unique challenges in accessing healthcare services and managing their health. The NHS plans to pilot specific health checks for people with autism to ensure their health needs are appropriately addressed. By tailoring interventions and support, the NHS aims to improve health outcomes and promote inclusivity for individuals with autism.

Air Pollution: Protecting Health and the Environment

Air pollution has detrimental effects on both health and the environment. The NHS Long-Term Plan includes measures to reduce air pollution and promote sustainable healthcare practices.

Reducing Business Mileages and Fleet Air Pollutant Emissions

Business-related travel contributes to air pollution. The NHS aims to reduce business mileage and fleet air pollutant emissions by 20% by 2023 to 2024. By promoting alternative modes of transportation and encouraging sustainable practices, the NHS aims to minimize its environmental impact and protect public health.

Transitioning to low-emissions engines and Green Heating

The NHS aims to transition to low-emissions engines for at least 90% of its fleet by 2028. Additionally, primary heating from coal and oil fuel in NHS sites will be fully phased out. By adopting greener technologies and practices, the NHS aims to reduce air pollution and create healthier environments for patients, staff, and the wider community.

Promoting virtual appointments to reduce travel

Travel to healthcare facilities can contribute to air pollution and increase carbon emissions. The NHS aims to design care provision that incorporates a greater use of “virtual” appointments, reducing the need for unnecessary patient and staff travel. By leveraging technology and telemedicine, the NHS aims to improve access to care while minimizing environmental impact.

Children and Maternity Care: Ensuring the best start in life

Children and maternity care are crucial components of the NHS Long Term Plan, aiming to promote the best start in life for every child and ensure high-quality care for expectant mothers.

Expanding NHS-Funded Mental Health Services

Mental health support for children and young people is a priority within the NHS Long-Term Plan. The plan aims to expand NHS-funded mental health services, ensuring that an additional 345,000 children and young people aged 0-25 can access the support they need. By providing timely interventions and support, the NHS aims to improve mental health outcomes and prevent long-term consequences.

Accelerating Action on Maternal and Neonatal Health

The NHS aims to accelerate action on maternal and neonatal health, targeting a 50% reduction in stillbirth, maternal mortality, neonatal mortality, and serious brain injury by 2025. By implementing evidence-based interventions, improving access to high-quality care, and promoting continuity of care, the NHS aims to enhance the safety and well-being of mothers and newborns.

Continuity of Care for Women from BAME Communities and Deprived Groups

Continuity of care is essential for ensuring positive pregnancy and childbirth experiences. The NHS Long Term Plan aims to ensure that 75% of women from Black, Asian, and Minority Ethnic (BAME) communities and deprived groups receive continuity of care from their midwife throughout pregnancy, labour, and the postnatal period. By providing personalised and consistent care, the NHS aims to address health inequalities and improve outcomes for marginalised groups.

Gambling: Supporting individuals with gambling problems

Problem gambling can have severe consequences for individuals and their families. The NHS Long Term Plan includes measures to expand NHS specialist clinics for gambling addiction, ensuring that more individuals can access the support they need. By providing specialized services and interventions, the NHS aims to reduce the harm caused by gambling and support individuals in their recovery.

Conclusion

The NHS Long-Term Plan demonstrates the commitment of the NHS to health protection and improve the well-being of individuals and communities. From smoking cessation to obesity management, the plan outlines a comprehensive approach to preventing diseases and addressing public health challenges. By working in partnership with various stakeholders and implementing evidence-based interventions, the NHS aims to create a healthier and more sustainable future for all.

Sources

• NHS England » Working together to improve public health and wellbeing
• What is public health? | Health Careers
• The art of the possible: The role of the NHS in improving health – The Health Foundation
• NHS Long Term Plan » Treating and preventing ill health