Prevention in action: Tackling the UK’s health crisis head-on

In September 2024, Lord Darzi’s review concluded that “the NHS is in serious trouble.” One of the most pressing challenges is the growing prevalence of preventable conditions. Currently, the NHS spends around 40 percent of its annual budget on treating preventable illnesses, and this is only part of the story. An estimated 2.8 million people are unable to work due to long-term sickness, costing the UK billions of pounds per year in lost productivity. Added to this are the less quantifiable (but very real) human costs of stress, pain, and reduced quality of life.

It’s no surprise that prevention is right at the top of the government’s agenda. The aim is to improve healthy life expectancy, close gaps in provision, and reduce demand on already-stretched services. These goals are achievable, as proven by pockets of success.

In our work within the NHS, three key themes have emerged as key catalysts for a preventative approach: strengthening collaboration, engaging communities, and embedding digital solutions.

Strengthen collaboration through aligned, long-term plans

Achieving a preventative healthcare system takes collaboration and alignment across government departments and the health sector beyond traditional political cycles. Together, the Department of Health and Social Care (DHSC) and NHS England can make prevention and personalisation the priority by co-creating long-term plans. An important part of these plans is incentivising leaders to focus on alternative metrics, rather than traditional indicators such as spend and performance. Creating a preventative healthcare system also means accepting that preventative initiatives have a longer pay-back – the challenge is creating space in an overspent budget to invest in schemes that don’t deliver an immediate return. When long-term plans are co-created with other departments and non-government bodies that understand the economic, societal, and productivity benefits of improved health and wellbeing, these organisations can pool resources and funds.

The WorkWell pilot programme, launched by the Department for Work and Pensions and DHSC, is an important step towards cross-government collaboration. The pilot delivers joined-up work and health support to 15 areas, connecting 59,000 people to tailored local services (including physiotherapy and counselling) to help them stay in or return to work. Examples like WorkWell are a good start, but realising the government’s ambition for preventative healthcare requires larger scale collaboration across the government and the NHS. Current governmental structures are not conducive to broader collaboration, and in the NHS, clinical specialisms can obstruct joined-up working.

Integrated Care Systems (ICSs) are working to achieve stronger collaboration at the local level, aiding the prevention agenda through a ‘whole society’ approach. The same approach could be replicated at a larger scale for prevention specifically, knitting together government departments, healthcare organisations, and a patchwork of local providers (such as housing associations) to address the clinical, social, and environmental determinants of health. Central to this would be an overarching body with a single focus on prevention across a broad church of relevant factors.

Engage neighbourhoods and community to connect with people

Good community spaces and services reduce social isolation, profoundly impacting people’ physical and mental health. It’s no wonder that NHS England is encouraging housebuilders, policy makers, and health authorities to build ‘Healthy New Towns’ that encourage healthier living. We helped NHS England to analyse a range of potential initiatives, identifying those with the best health and economic returns to inform the launch of the Healthy New Towns programme.

Improving accessibility and engagement across communities relies on building strong links with locally-led organisations, including the voluntary sector and local services. Personalised approaches that emphasise self-care and collective care within community networks, supplemented by digital tools, can build trust (with sensitivity to cultural norms, language barriers, or information access).

Moving from the notion of GPs and clinicians as gatekeepers towards network leaders is also key. These networks include both clinical and social components, making social prescribing just as important as traditional drug prescriptions. Involving the voluntary sector and local services – such as grocery retailers, pharmacies, and religious organisations – helps to boost accessibility across communities. The advantages of community involvement are clearly demonstrated in NHS Better Health’s free local Stop Smoking Service. Co-developed by experts and ex-smokers and delivered by professionals, the Service provides encouragement through a buddy network rather than mandating or prescribing ‘fixes’. And it works – with the right support in place, smokers are three times as likely to quit for good.

One key action for government and healthcare leaders is to implement a ‘single front door’ that enables citizens to access local services – not just primary and secondary care, but also voluntary and other support organisations. Currently, multiple entry points exist due to sporadic, siloed structures and specialisms. A single point of entry, with digital and non-digital options, would make it far easier for citizens to find the best pathways within their local context and in line with their holistic needs – rather than getting stuck in multiple concurrent and often conflicting processes.

Use digital solutions to embed new behaviours

Advanced accessible technology can support system change and drive new ways of working by placing the individual at the centre of design, with data underpinning it all. The most effective services enable people to take control of their health, blending digital and localised physical models to ensure accessibility. Digital solutions can change people’s attitudes, support healthy lifestyles, and cultivate a prevention-oriented culture.

Data-driven digitalisation has a critical role to play in delivering a future focused on prevention. Key to this is the establishment of a national Personal Health Profile or Record, giving individuals and providers alike full access to primary and secondary care data. Creating a record of this nature is achievable in the short-term and paves the way for future improvements such as combining data with other sources (private medical data, wearables, medical devices, and home tests) to strengthen prevention.

Rapid improvements in medtech are sparking opportunities in digital, personalised, preventative healthcare. The Oura ring, for example, provides increasingly detailed health monitoring data that enables people to predict when they might get ill. Apps such as Couch to 5K use gamification to encourage progress and reward achievements. A similar approach could be used for prevention, with individuals rewarded for beneficial behaviour.

In addition to consumer devices and apps, the NHS could expand its planned roll-out of at-home digital health checks. One of the first tests will be for those aged over 40, who will be able to complete a cardiovascular health risk assessment online, order a home blood testing kit (via finger prick), and detect cardiovascular complications. Making screening more accessible through home testing kits will increase early detection and positive health outcomes.

It’s also important to encourage professionals to prescribe new digital solutions – if they aren’t prescribed, people won’t benefit from them. Working with Essex County Council, we improved the take-up of services by putting care technology solutions at the forefront of the Council’s social care offer. Through our Argenti partnership, and our innovative approach to technology-enabled care, we delivered an end-to-end care service that changed attitudes among social care professionals. The service led to a 150 percent increase in referrals, supporting faster intervention before conditions could deteriorate.

Is prevention the cure?

The challenges faced by the NHS are driven by demographic changes, new demand, and increasing costs. Prevention strikes at the root of the issue, addressing conditions before they impact societal health.

Prevention isn’t a new approach. However, existing examples show that a holistic, cross-departmental approach works – especially when neighbourhoods and communities understand the relevance and impact of health initiatives. And, with new digital solutions and technologies at hand, it’s more than possible to embed preventative care across all levels of society. Through bold collaboration and innovation, preventative solutions can become a reality, and fulfil the UK government’s goal to create a sustainable, healthier future for all.