Health Service Focus

Prevention, public health and primary care

With the Government making sweeping changes to NHS health checks, Jo Churchill, the newly appointed minister for prevention, public health and primary care, looks towards a more predictive and preventative health service.

This is an exciting time to be a health minister in this government. That statement may surprise many of you, given the continuing twists, turns and distractions in Westminster, but I stand by it. 

Why? As the minister now overseeing prevention, primary care and public health policy, I know these areas of health and care are among the most critical elements in our efforts to deliver better services, healthier populations and happier lives. 

My brief is about much more than pills, potions and lotions, it’s also about the way we protect, sustain and prolong good health – through education, better lifestyle choices, and improvements in the environments we live, learn and work in. It is a privilege to now be playing my part in this grand enterprise. 

These are also the areas that stand to benefit the most from the latest advances in health technology and cutting-edge analytics, spurring what I believe is an unstoppable shift towards predictive prevention – a shift that will shape health and care services around the needs of the individual, rather than a one-size-fits-all approach. 

The proposed changes to our well-established and highly regarded NHS Health Checks are a case in point. Since their inception, this free service offered by GP surgeries, pharmacies and other authorised providers in England has been assessing health risks, raising awareness and identifying the early signs of a range of preventable conditions. These include common risk factors such as high blood pressure, heart disease and type 2 diabetes. Clinicians have been using these diagnostic red flags to prevent, treat or mitigate the onset of serious health conditions for many thousands of patients. 

There is now an opportunity to make these highly effective checks even more targeted and relevant to the specific health needs and concerns of local populations, making the most of advances in health tech, medical and behavioural science to pinpoint particular demographics and the health risks they present. 

That’s why we’ve announced an evidence review to explore the provision of bespoke, personalised NHS Health Checks. We want to take them to the next level where age, location, risk factors and lifestyle preferences are all carefully considered. 

The review will explore how a more predictive system that is data-led and could offer checks based on a range of different factors can encourage more people to take a preventative approach to their own health. 

Of course, it makes sense to start thinking about protecting and prolonging our good health much earlier in life. Currently, health checks are offered on a standard basis to everyone over the age of 40, up to 74. The closer to 40 the better of course – much like pension planning, we wouldn’t be advised to start saving for retirement at 64.

This is about convincing people their health really matters. If they act early and maintain healthier lifestyles, they will enjoy a huge lifetime benefit in reducing their risk of, among other things, heart disease. By successfully harnessing the latest technology, techniques and data, we will be able to move away from standardised health checks towards tailored programmes that are even more effective in preventing the most devastating diseases of our time. 

We’re not side-lining health professionals in favour of algorithms, AI and automata either. This is about helping them deliver care at its most personal – and human. 

For example, an intelligent check might target more bespoke drinking advice at 40 to 49-year-olds, as alcohol use is more common in this age group. Health professionals are already well aware of these higher risk groups, but a targeted assessment would help them identify and target their interventions more keenly. 

Similarly, those at low risk of cardiovascular disease may also benefit from less frequent, online check-ups, while people with mental health problems, who in general find it harder to access standard care and are at higher risk of cardiovascular disease, would be unlikely to use digital services, and so we can adapt our approach. 

These changes - if successfully adopted - could form part of a wider, societal shift, as clinicians, commissioners and educators embrace the concept of a modernised, personalised and future-proofed system that takes risk and personal choices into account. 

This is all very much in the spirit of the NHS Long Term Plan, which commits the health service to preventing 150,000 heart attacks, strokes and dementia cases over the next 10 years. 

Indeed, over a five-year period, we expect the NHS Health Check programme to identify over 700,000 people at high risk of cardiovascular disease and save an estimated 500 lives each year. But there is clearly huge potential for people to benefit even more from a more bespoke service. 

More than 14 million people, 90% of the eligible population, have been offered an NHS Health Check in the last five years and almost seven million have taken up the offer. If we can use the review to find ways to boost the uptake of a more personalised service, we can save and transform many more lives.

 As I’ve already suggested, tailored, targeted NHS Health Checks offering more personalised interventions based on risk, location and predisposition to diseases could be the way to do this – even to the point of specific checks for particular age groups. Again, this is not about taking these assessments out of surgeries and into cyberspace but enhancing an already highly effective service with health professionals at its heart. 

In the meantime, these health checks remain a world-leading early warning system, helping our amazingly dedicated health and care professionals deliver timely, effective, preventative care to thousands of people across the country. 

What we are now proposing will help future-proof the system to keep pace with the increasingly complex health and care needs of an ageing, growing and diversifying population. Effective management of the nation’s health should be a reassuring constant, not a worrisome unknown.

For more information

Tw: @Jochurchill4

W: www.healthcheck.nhs.uk