Health charities call on UK prime minister to put prevention at top of agenda
BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6642 (Published 06 November 2014) Cite this as: BMJ 2014;349:g6642
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The report of the Richmond Group is welcome, though its conclusions are a sad reflection upon the medical profession.
The problem of Non-communicable disease is well recognised both nationally & internationally. The solutions are widely known, but sparingly applied.
The fault would appear to lie in errors of omission & commission.
The medical profession must get its act together and doctors and healthcare professionals must be well grounded in the principles of Preventive Medicine. A recent report showed only 30% of patients attending general practices received optimal advice & management in preventive measures1.
Central and local authorities must act on a sustained basis informing the public about the dangers of NCDs and ways in which risks can be reduced.
The public must be convinced of the necessity of applying the relevant measures.
Changing established concepts, behaviours and attitudes is not easy, but much work has been undertaken on influencing change 2.
Teaching courses for the medical profession & healthcare professionals are available. Legislation exists to reduce availability and usage of alcohol & tobacco. Legislation exists, and other measures are mooted, to introduce dietary safe guards. Physical activity is being encouraged. Stress remains an ever present problem.
To reduce the worldwide burden of NCDs and the coincidental social and economic consequences much greater emphasis must be placed on teaching the medical profession and the public about the risks of NCDs and the ways of reducing this risk.
1, Sheppard Missed opportunities in prevention of CVD in primary care Br J Gen Pract 2014;64:28-29
2. Abraham & Mitchie Theoretical frameworks for behaviour change Health Psychology 2008 27, (3): 379-387
Competing interests: No competing interests
Re: Health charities call on UK prime minister to put prevention at top of agenda
There is a growing consensus that the UK must prioritise the prevention of ill health.(1-5) We agree with the Richmond Group, a coalition of 10 charities, that a new national plan is urgently needed to match the scale of the public health challenges.(5) There are common risk factors such as smoking, diet, alcohol consumption and inactivity that need to be included in the plan, but so too does the ubiquitous problem of inequalities. In addition, two areas that are often overlooked, and where there is scope for dramatic improvements, are accident prevention and mental health.(6,7)
However, these topics should not be promoted in isolation; a comprehensive multi-sectoral approach is needed and action is required, for example, in workplaces, schools and general practices.(8-10) A wide range of key people need to be galvanized into action including teachers, local government staff, nurses and doctors. This is a crucial role for public health professionals; they must help key people gain a greater appreciation of how their work, individually in different settings, can contribute to improving health.
Primary care is an important healthcare-delivery environment where there are many opportunities for maintaining and promoting the health of individuals and their families.(10) Besides knowledge about individuals, many practitioners have an intimate knowledge of their local community including information about local factors that may influence health. However, considerable support will be needed, including that from public health professionals, if health improvement responsibilities are to be met. Moreover, the vital issue of staff shortages will need to be addressed.(11-12)
We agree that the workplace is a setting where action is needed, and that all NHS organisations and local authorities must play their part in looking after and promoting the health of their staff. Guidance for effective approaches in the workplace is now available both in terms of theory and exemplars of good practice.(13-14) It is essential that a planned approach is undertaken and that sufficient thought is given to monitoring and evaluation. In addition, any approach must not just be an information giving exercise; healthy environments need to be created. For example, in relation to healthy eating relatively low cost steps such as changing portion sizes, offering greater choices and highlighting healthier options can help to re-model obesogenic environments.
Robust and well-resourced public health departments are vital to effective coordinated action across settings.(15) We, like the Richmond Group, urge all political parties to commit to making prevention of ill health and health promotion a higher priority. If this was to happen, we believe that together we could succeed in dramatically improving the quality of people’s lives.
References
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2) Marmot M, chair. Fair society, healthy lives (the Marmot review). UCL Institute of Equity, 2010. www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-....
3) NHS England, Public Health England, Monitor, Care Quality Commission, Health Education England. Five year forward view. October 2014. www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf.
4) BMA. Four steps to a healthier nation. http://bma.org.uk/working-for-change/policy-and-lobbying/general-electio....
5) Richmond Group of Charities. What is preventing progress? Time to move from talk to action on reducing preventable illness. 6 Nov 2014. www.richmondgroupofcharities.org.uk
6) Public Health England. Reducing unintentional injuries in and around the home among children under five years. London: PHE, 2014
7) Davies, S.C. Annual Report of the Chief Medical Officer 2013, Public Mental Health Priorities: Investing in the Evidence. London: Department of Health 2014.
8) Tones K and Tilford S. Health Promotion: effectiveness, efficiency and equity. Cheltenham: Nelson Thornes, 2001.
9) World Health Organization, Ottawa Charter for Health Promotion. Copenhagen: World Health Organization, 1986.
10) Watson, M., Going for gold: the health promoting general practice. Quality in Primary Care. 2008; 16:177-185.
11) Goddard M, Gravelle H, Hole A, Marini G. Where did all the GPs go? Increasing supply and geographical equity in England and Scotland. Journal of Health Services Research & Policy. 2010. 15(1): 28–35.
12) Limb M. Increase GP trainees by 450 a year to avoid crisis, says taskforce. BMJ2014;349:g4799.
13) Faculty of Public Health and the Faculty of Occupational Medicine. Creating a healthy workplace: A guide for occupational safety and health professionals and employers. London: Faculty of Public Health, 2006
14) Scriven A and Hodgins M. Health Promotion Settings. Principles and Practice. London: Sage, 2012.
15) Department of Health. The Report of the Chief Medical Officer’s Project to Strengthen the Public Health Function. London: Department of Health, 2001.
Competing interests: No competing interests