NHS ten-year health plan: turning a vision into reality through prevention

I have been in the healthcare industry since leaving university and have had the opportunity to work in several different countries and health systems. They all have the same goal: to make a difference for patients. Historically, a lot of focus has been on treating disease, and I am proud of the role industry has played in this. However, there needs to be a significant change to be able to address today’s challenges. The government has made prevention a priority for health, and I strongly support this. But what does that mean, in practice, to move away from a sickness-based service and towards a wellness service? Put simply, we must overcome a traditional reluctance to invest in prevention.  

“…the return on investment for public health interventions including vaccines can be as high as 14:1”

To truly understand the importance and value of prevention, it must be considered (and treated) as an investment rather than a cost. As an example, the return on investment for public health interventions including vaccines can be as high as 14:1.  For every pound spent on vaccines, savings of £14 are generated by the NHS.  However, we spend a relatively small amount of the NHS budget on vaccines - approximately 1.1 per cent. To realise the potential benefits of vaccines, this needs to change. Levels of uptake of vaccines remains stubbornly low, and inequalities are high. Both lag significantly behind many comparable countries and the WHO recommended thresholds.

“Respiratory disease is a perfect example of where early intervention to prevent the progression of a disease could have a huge impact”

The continued worsening of health disparities is a real concern requiring urgent attention. Addressing health inequalities can, and must, be part of the solution to shift from sickness to prevention. Respiratory disease is a perfect example of where early intervention to prevent the progression of a disease could have a huge impact, with COPD being identified as the health condition with the largest mortality disparity between the most and least deprived areas in England, followed by lung cancer and asthma. People living in the poorest communities are also seven times more likely to die from a lung condition than those in the richest communities. The economic burden of respiratory disease on the NHS is enormous. COPD and asthma alone cost the NHS £9.6 billion a year in direct costs, with wider reductions in productivity due to illness and premature death of £4.2 billion per year and an overall negative impact of £13.8 billion on the economy in England.

“As a country we must do better”

For COPD specifically, 75 per cent of people living with the disease do not receive the five basic care measures that NICE recommends. If COPD was being managed effectively and people received earlier preventative intervention, imagine the impact this could have upon their lives, as well as the number of GP appointments and hospitalisations it would save. As a country we must do better.

Looking beyond vaccines, the Treasury has estimated that a 1 per cent increase in the number of people aged 50-64 in work would increase GDP by around £5.7 billion a year. The Tony Blair Institute has also estimated that between a 10 per cent and 20 per cent reduction in working days lost to sickness each year could generate £60 billion for the UK economy. Those are staggering numbers. 

Investing in prevention is beneficial on multiple fronts - it enhances public health, alleviates the strain on overburdened primary and secondary care services, boosts workforce participation, increases economic productivity, and lowers the welfare burden.

Making prevention a ‘must do’, not a ‘nice to do’ will need the reform of financial flows and incentives, as well as action at government level and a culture shift among managers and clinicians both nationally and locally. 

I believe that working together, the government, the NHS, industry and others can deliver on this bold agenda. It may well be the NHS’s greatest challenge, but it could also be its greatest success.

Neale Belson is general manager of GSK UK. 

Content lab reference: NP-GB-AAP-BRF-250004