Carly Caton and Gerard Hanratty, partners at law firm Browne Jacobson, explore how to move the dial from curative to preventative healthcare systems
Healthcare systems around the world often operate in reactive mode, with a primary focus on treating illness once it manifests. We all talk about the need to move to a preventative system. Compelling arguments can be made for a shift towards preventative healthcare models, with Britain’s Shadow Health Secretary Wes Streeting stating these models are an ambition for the Labour Party if it wins the next General Election.
The potential benefits are vast – healthier populations, reduced treatment costs, and a more proactive approach to health and wellbeing. When we look at the key changes needed to achieve this shift, along with the legal considerations that must be taken into account, it is clear the path to prevention requires a multi-faceted approach.
Education is paramount
Equipping individuals with knowledge about healthy living is crucial for a successful preventative healthcare system. Schools play a critical role in shaping lifelong habits.
The UK government recently introduced statutory Relationships and Health Education (RHE) in all primary schools and Relationships and Sex Education (RSE) in all secondary schools. These curriculums cover a range of topics relevant to preventative health, including healthy eating and nutrition, physical activity and exercise, and mental and emotional wellbeing. It makes clear the importance of sleep, avoiding substance misuse and the positive impact of healthy relationships.
Equitable access to healthcare
Affordability is critical. Free or low-cost screenings, vaccinations and check-ups ensure everyone has a chance at preventative care, regardless of income.
A 2023 report by the Commonwealth Fund highlighted countries with universal healthcare systems, like Canada, tend to have higher rates of preventative care utilisation compared to those with private insurance-based models. These findings suggest that financial barriers play a significant role in people’s access to preventative services. Governments must therefore prioritise funding for preventative care initiatives and work towards universal access for all citizens, which will include looking at how different funding models, be they state-based, insurance-based or a blended approach, can support a cultural shift from sick care to health care.
Reaching outward
Under-served communities often face unique challenges, such as transportation difficulties, lack of cultural competency in healthcare settings, or language barriers. However, mobile clinics, community health fairs and targeted outreach programmes tailored to specific needs can bridge the gap and connect these populations with essential services.
A 2022 study published in the Journal of Community Health found that mobile health clinics significantly improved access to preventative care services, particularly for chronic disease screenings and mental health evaluations in low-income neighbourhoods. These results emphasise the need for equity of access and outcomes when addressing the development of preventative healthcare models.
Tech-powered prevention
Technology holds immense potential. Telemedicine facilitates remote consultations and screenings, especially for those in geographically remote areas. Wearable devices empower individuals to monitor health metrics like heart rate, blood pressure and sleep patterns, allowing them to track progress towards goals and identify potential health concerns early on. Additionally, data analysis of anonymised health information collected through these tools can help us identify effective preventative strategies and allocate resources more efficiently.
A 2021 research paper published in JMIR Public Health and Surveillance found that telemedicine interventions on diabetes patients were successful in promoting preventative behaviours such as medication adherence and healthy diet choices, as well as improving chronic disease management.
Integrating such technology into mainstream healthcare systems and incentivising its use to reward citizens for healthy lifestyles can revolutionise preventative care delivery. It can also allow patients and healthcare providers instant access to their medical history and wider social history, if agreed, to enable a holistic approach to prevention.
Unity is key
A united front is essential for a successful preventative healthcare system. In the UK, collaboration between the National Health Service (NHS), local authorities, charities and community organisations plays a crucial role.
The NHS, for instance, works alongside the Office for Health Improvement and Disparities (OHID), part of the Department of Health and Social Care, to develop national preventative health strategies. The OHID also collaborates with local authorities to implement these strategies at a regional level. Local authorities then partner with community organisations to reach under-served populations and deliver targeted outreach programmes.
In moving to a holistic approach to support the preventative health agenda, it will be important to draw on educational and social housing expertise, as well as developing an understanding and approach to environmental factors that can adversely affect health.
Learning from success
It is useful to look at the countries that are practising preventative healthcare to good effect. Japan, for example, boasts a culture of preventive screenings and readily available check-ups. The Japanese government actively promotes preventative health practices through public awareness campaigns and readily available health screenings covered by national health insurance. These screenings often target specific populations at higher risk for certain diseases, such as mammograms for women over 40. Japan’s emphasis on early detection and proactive healthcare management serves as a valuable example for other countries seeking to prioritise prevention.
In Australia, there is a huge focus on healthy lifestyle and education within schools. The Australian government’s “Get Healthy, Stay Healthy” programme integrates health education into the national school curriculum, promoting healthy eating, physical activity and mental wellbeing among students. The programme also emphasises social and emotional learning, equipping students with life skills that contribute to overall wellbeing. By instilling healthy habits from a young age, Australia sets the stage for lifelong preventative care behaviours and reduces the burden of preventable diseases on the healthcare system.
Canada and Singapore are further examples demonstrating proactive approaches to public health with an emphasis on preventative measures such as immunisations, screenings and pre-natal care. Canada’s commitment to universal access to healthcare demonstrates that preventative care is not only feasible but also essential for promoting health equity and reducing healthcare disparities, while Singapore’s comprehensive approach to preventative care has contributed to its reputation as one of the healthiest nations globally.
Problems and solutions
The road to prevention isn’t without obstacles. A significant hurdle lies in funding preventative initiatives and, clearly, innovative solutions are required. A 2023 study published in Health Affairs found that investing in preventative care can generate significant cost savings in the long run by reducing the burden of chronic diseases on healthcare systems.
But who is going to pay in the first instance and where will the money come from while this shift is happening? How long will it take to see the improvements and drop in current costs spent on our curative systems? The Health Affairs study suggests that reallocating resources based on data-driven insights into preventative care effectiveness and cost effectiveness can help prioritise funding for initiatives with the greatest potential for impact.
One thing that governments can do is explore alternative funding mechanisms, such as public-private partnerships or health impact bonds, to finance preventative care initiatives and incentivise collaboration between healthcare stakeholders. It may also be time to revisit the relationship between state and insurance healthcare in countries where both exist, to look at how to provide equity of access and outcomes to all citizens.
Getting the balance right in commissioning
It has long been clear that many health systems are principally focused on physical health provision. However, even prior to the COVID-19 pandemic, it was becoming apparent that many health systems faced potentially being overwhelmed by the need for mental healthcare.
Recently, we have seen the impact of a worldwide shortage of medicine for those who suffer from ADHD and the impact that has not only on the individual, but also their family and carers. The same could be said for hormone replacement therapy, epilepsy and even some diabetes drugs.
An essential part of any preventative health plan must be to balance the physical and mental health wellbeing of citizens, while the broader ecosystem must also consider the security of global supply chains.
Legal considerations begin with regulatory framework
Implementing preventative care programmes may require changes to existing regulations and healthcare policies. For example, expanding telemedicine services across state or national borders may necessitate updates to licensing requirements and reimbursement policies.
Governments will need to work with healthcare stakeholders to develop regulatory frameworks that support the delivery of preventative care services while ensuring patient safety and quality of care. As previously discussed, it will also be important for any regulatory framework to place equity of health care provision as a central plank in enabling a system focused on prevention.
Data privacy and security
Leveraging technology for preventative care involves collecting and analysing large amounts of health data. Ensuring the privacy and security of this data is paramount to maintaining patient trust and compliance with regulatory requirements.
Healthcare organisations will need robust data privacy and security measures, such as encryption, access controls, and regular audits, to protect sensitive health information from unauthorized access or disclosure. Equally patients will need to be clear on how much they will share to maximise the opportunities to improve their health and wellbeing.
Informed consent
Engaging patients in preventative care initiatives requires obtaining informed consent for participation in the screening programme, interventions or data collection activities. Clear communication of the purpose, risks, benefits and alternatives of preventative care services to patients will be needed, allowing them to make informed decisions about their health.
Providing accessible educational materials, counselling and support services can help patients understand the importance of preventative care and actively participate in their own health management.
Is preventative care the answer?
In conclusion, shifting towards a preventative healthcare model holds huge potential for improving population health outcomes, reducing healthcare costs and promoting a culture of proactive wellness. By implementing a multi-pronged approach that includes education, access, outreach, technology and collaboration, healthcare systems can lay the foundation for a healthier future.
Despite the challenges and legal considerations involved, the benefits of preventative care will far outweigh the costs and ultimately, lead to a reduction in sick care cost. With concerted efforts and innovative solutions, we can transform healthcare systems from reactive to proactive, ensuring that prevention remains at the forefront of public health initiatives.
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