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NHS plans 'radical upgrade' in public health

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The NHS will become an “activist agent” of social change as part of a “radical upgrade in prevention and public health”, under plans announced today.

The approach is outlined in NHS England’s five-year forward view report, which sets out how the health service will tackle rising demand and funding constraints.

The report said the NHS had been “prone to operating a ‘factory’ model of care and repair” with “underdeveloped advocacy and action on the broader influencers of health and wellbeing”.

In future, it said, the health service would back “hard hitting” advocacy on public health and would support stronger public health-related powers for councils and elected mayors.

“The first argument we make in this forward view is that the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health,” the document said.

In the report, NHS England warned that without a greater focus on prevention, “recent progress in healthy life expectancies will stall, health inequalities will widen, and our ability to fund beneficial new treatments will be crowded out by the need to spend billions of pounds on wholly avoidable illness”.

It said: “While the health service certainly can’t do everything that’s needed by itself, it can and should now become a more activist agent of health-related social change.”

The document said councils and elected mayors could “make an important impact” on improving public health.

It praised Barking & Dagenham LBC for working to limit junk food outlets near schools, and said the NHS agreed with the LGA that “English mayors and local authorities should be granted enhanced powers to allow local democratic decisions on public health policy that go further and faster than prevailing national law – on alcohol, fast food, tobacco and other issues that affect physical and mental health.”

It warned of the link between deprivation and poor health outcomes, noting that the rate of smoking during pregnancy ranged from 2% in west London to 28% in Blackpool.  

NHS England also said it supported a controversial proposal by the LGA to give volunteers within health and social care a 10% discount on their council tax bill.

It called for a broader role for the health service in helping people to “get in and stay in employment”. This could involve offering “targeted support” to keep people in work.

The health service would seek to improve access to care for “at risk” individuals, in a programme that would see the Department for Work & Pensions save “downstream” costs “if money can be reinvested across programmes”, it said.

Another proposal would see the NHS developing new “workplace incentives” to improve employees’ health.

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