by Sebastian Rees, Researcher, Reform.
At Reform, we’ve long advocated for prevention to be central to any proposals for building a healthier Britain. Tackling the drivers of ill health early reduces demand on health care services further down the line, easing pressures on our already strained system. Far more importantly, averting or delaying the development of preventable conditions allows people to live for longer in better health. If the goal of our health system is to help people build happier, healthier lives, prevention must remain a priority.
Earlier this year, we partnered with MSD to produce A New Deal for Prevention, an essay collection on how preventative medicine can be put back on track and accelerated after the COVID-19 pandemic. Expert contributors detailed how preventative approaches had helped virtually eliminate new cases of HIV and HCV in the community, how vaccination programs remain the single most effective tool for preventing infectious illness and how new technologies are helping us identify communities at higher risk of contracting non-communicable diseases, allowing us to detect and intervene early and drastically improve patient outcomes.
Prevention is central to meeting increases in healthy life expectancy and reducing the costs of treating life threatening non-communicable diseases. Yet our ambitions for prevention must stretch more widely. Preventing the onset of conditions that see people live in unnecessary pain for prolonged periods, such as musculoskeletal (MSK) conditions, must be given adequate attention by the public health community.
Arthritis and musculoskeletal conditions affect over 17 million people across the UK. As with other long-term non-communicable conditions, a strong economic case has been made for prevention and early intervention in relation to of MSK conditions. Each year, NHS England spends more than £5 billion on treating MSK conditions, constituting the third largest NHS programme budget. Joint work by ARMA and NHS England in 2017 revealed that as much as 40 per cent of these costs could be prevented by tackling risk factors that lead to MSK conditions.
Acting early and alleviating known risk factors is essential to improving the experience of those living with MSK conditions. Many feel their quality of life and independence has been significantly undermined by their condition and over half of people (57 per cent) living with arthritis say that they experience pain every day. As ARMA’s position paper Musculoskeletal and Mental Health makes clear, living with MSK conditions can lead to a range of mental health challenges- depression is four times more common for those living with persistent pain than without.
Preventing the onset of MSK conditions and providing support for those living with them early can make a world of difference to patients and their families. ARMA’s policy paper on prevention provides a road map for doing just that: by promoting lifelong good musculoskeletal health, tackling risk factors such as obesity and inactivity, and treating conditions early, needless disability can be avoided, pain intensity reduced and quality of life drastically increased.
The links between prevention and improved health outcomes are undeniable and increasingly recognised at the highest levels of government. The Government’s decision to replace Public Health England with a new Office for Health Promotion offers an opportunity to rethink the ways in which preventative health care is organised and delivered. But pressure must remain on the Department of Health and Social Care to ensure that prevention remains at the heart of reorganisations of the public health landscape. If prevention is truly better than cure, the right structures and funding mechanisms must be put in place to give it the attention it deserves.