How can practices use prevention strategies to improve population health? 

The NHS is looking to prevention to improve population health – how can practice managers make sure their practices work to prevent, as well as treat?

As the NHS expects higher demand from patients, practice managers should work to prevent, as well as treat, to minimise the number of appointments they will face this winter.

The NHS Long Term Plan refers to prevention as a key strategic objective to improve health outcomes. In the plan, the NHS outlines its commitment to prevent tobacco and alcohol dependency, obesity and antimicrobial resistance. 

Types of prevention 

• Primary prevention – a population-wide intervention to promote wellbeing or prevent disease or ill-health before it occurs – for example, smoking cessation, social prescribing, reducing loneliness or isolation.
• Secondary prevention – early intervention that slows down, or reduces, any further deteriorationincluding through detection of early disease and preventing disease progression, reoccurrence or relapse by reducing the impact of a disease that has already occurred (including screening) – for example, home adaptations, cancer screening and addiction services.
• Tertiary prevention – a formal intervention aimed at managing or reducing the impact of lasting illnessor injury – for example, chronic disease management.

How can practice managers make sure that your practice is meeting the prevention commitments of the NHS Long Term Plan?

Tobacco dependency 

Practices must ensure that patients who smoke are offered NHS-funded tobacco dependency treatment by 2023/24. This incudes all expectant mothers throughout their antenatal care, and partners of pregnant women, to make sure that all new-born babies have a smokefree home.

This offer will also become available to patients accessing higher risk outpatient services, including specialist mental health and learning disability services for long-term users, who are more likely to smoke. 

Alcohol dependency 

To support patients dependent on alcohol, practice managers should ensure they have NHS-funded alcohol services. Alcohol care teams can reduce the time patients spend in hospital. Reducing alcohol-related admissions will offer positive outcomes for patients, families and communities. Practices can focus on the areas of most need by holding specific activities and interventions to prevent alcohol harm and offer support resources and services. 

Obesity

As 63% of adults are now classified as overweight or obese; practice managers must support individuals to achieve and maintain a healthy weight. To do this, practices can:

• build confidence in the frontline workforce so that all staff feel able to discuss weight and deliver high quality advice and treatment to their patients, children and families;
• test at scale community weight management services for patients with obesity and type 2 diabetes or obesity and hypertension and provide enhanced secondary treatment services for patients with obesity and comorbidities in a small number of high-rate areas;
• build the evidence-base for existing and new interventions, and support the development of new services across the UK;
• continue action to deliver healthy food and environments across NHS premises for staff, patients and the public.

Antimicrobial resistance

Alongside the NHS Long Term Plan, practice managers must also support the UK five-year national action plan on Antimicrobial Resistance. Practices should work to deliver:

• optimised use of antimicrobials, with good stewardship across all sectors;
• a lower burden of infection, better treatment of resistant infection and minimising transmission;
• new diagnostics, therapies, vaccines and interventions in use and accessed by all.