Public health matters

https://publichealthmatters.blog.gov.uk/2019/01/08/the-nhs-long-term-plan-10-key-public-health-points/

The NHS Long Term Plan: 10 key public health points

Male doctor and older man sitting on a sofa and smiling during home visit

The NHS Long Term Plan (LTP) aims to relieve pressure on services and ensure sustainability for future years. There are a multitude of aims and initiatives within the 136 page document; this blog gives a brief overview of the key public health priorities.

  1. Prevention

Each element of the LTP has prevention at its heart, emphasising an effort to move away from a system that simply treats, into one that also helps to keep people well for longer. The LTP recognises good health is about more than healthcare alone, and that to be implemented effectively the NHS must work in partnership with local government. We welcome this understanding and look forward to working with the public health family, NHS England and NHS Improvement to deliver the LTP.

  1. Smoking

    • the Ottawa Model for smoking cessation will be embedded in all Trusts by 2023 to 2024, meaning every person admitted to hospital who smokes will be offered support to quit
    • a new smoke-free pregnancy pathway will be deployed, adapting the Ottawa Model for expectant mothers and their partners, so the entire family can be treated together
    • a new universal smoking cessation offer will be made available as part of specialist mental health services. This will include the option to switch to e-cigarettes while in inpatient settings
  2. Obesity and type 2 diabetes

    • the Diabetes Prevention Programme will be doubled over the next five years and will include a new digital option to widen patient choice
    • by 2022/23, NHS England expect to treat a further 1,000 children a year for severe complications related to their obesity. It is hoped this will prevent children needing more invasive treatment at a later stage
    • access to weight management services in primary care will be targeted to people with type 2 diabetes or hypertension with a BMI of more than 30
  3. Diet and alcohol

    • in early 2019, the Government will consult on the mandatory fortification of flour with folic acid to prevent foetal abnormalities
    • by Easter 2019 the Government will set out the details of how the salt reduction programme's targets will be met
    • hospitals with the highest rate of alcohol dependence-related admissions will establish Alcohol Care Teams, which could prevent 50,000 admissions over five years
  4. Antimicrobial resistance and vaccines

    • continue to optimise use and reduce the need for antibiotics, as well as supporting the development of new antimicrobials
    • ensure access to old and new treatments, preventative measures (including vaccines) and appropriate tools (including diagnostics and electronic prescribing)
    • prioritise improvements in childhood immunisation, reaching at least the base level standards in the NHS public health function agreement
  1. Cancer

    • by 2028, the proportion of cancers diagnosed at stages 1 and 2 will increase from around half to three-quarters
    • by 2020 the HPV primary screening for cervical cancer will be implemented across England
    • personalised and risk stratified screening will be utilised to test the family members of cancer patients where they may be at an increased risk of cancer
  2. Mental health

    • by 2023 to 2024, an additional 110,000 people living with severe mental health problems will receive physical health checks each year, bringing the total to 390,000 annual checks
    • a specific health check for people with autism will be piloted and if successful, will be extended widely
  3. Air pollution

    • business mileages and fleet air pollutant emissions will be reduced by 20% by 2023 to 2024
    • at least 90% of the NHS fleet will use low-emissions engines by 2028, and primary heating from coal and oil fuel in NHS sites will be fully phased out
    • care provision will be designed for a greater use of ‘virtual’ appointments so to reduce the need for patient and staff travel
  4. Children and maternity care

    • by 2023 to 2024, an additional 345,000 children and young people aged 0-25 will be able to access support via NHS funded mental health services and school or college-based Mental Health Support Teams
    • accelerated action to achieve 50% reductions in stillbirth, maternal mortality, neonatal mortality and serious brain injury by 2025
    • by 2024, 75% of women from BAME communities and a similar percentage of women from the most deprived groups will receive continuity of care from their midwife throughout pregnancy, labour and the postnatal period
  1. Gambling

    • NHS specialist clinics will be expanded to help more people with serious gambling problems. Therefore helping more people than can currently access support through one national clinic

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14 comments

  1. Comment by Elcena Jeffers posted on

    Very good start..
    We all now need to buy the NHS back for one pound.
    £1.00 PER PERSON
    UK WIDE - IN All seriousness, the population must voluntarily buy this opportunity to make real change.

  2. Comment by Mark Harlham posted on

    What a joke! Sneaking out £85m cuts to Local Authority Public Health Grants just before the Christmas break , and then asking the NHS "sickness service" to undertake Public Health work despite not having any interest or track record in prevention. Incompetent Policy making at best

    • Replies to Mark Harlham>

      Comment by lee adams posted on

      totally agree

      • Replies to lee adams>

        Comment by Manda posted on

        Ooo I think I misinterpreted it, I thought a bigger mental health team would be embedded into ED team. It would be really nice to have more mental health trained nurses and specialist mental health in substance use, depression and children's mental health working in partnership, taking over the care of the patient, assessing, treating,discharge or admitting on to their own specialist unit.

  3. Comment by Pauline posted on

    what about Breastfeeding- this cross cuts many of these strands and is evidenced based prevention

    • Replies to Pauline>

      Comment by Emily posted on

      Improvement in breastfeeding rates is mentioned in section 3.18 of the full LTP.

      • Replies to Emily>

        Comment by Pauline posted on

        This is about maternity services and not Community services and is not far reaching in that commissioners of Health visiting services need to also ensure the Baby Friendly initiative is commissioned and resourced/ supported appropriately against the backdrop of cuts in services. It is not sufficient to provide breastfeeding support in maternity services if it is not mandated in community services also.

        • Replies to Pauline>

          Comment by Daphne posted on

          on top of that, it does not help that local children's centres are being closed throughout the country where breastfeeding support and advice happens each and every day with all centre staff BFI UNICEF trained. What a waste and again it is women who end up feeling the blow of the cuts.

  4. Comment by Chris posted on

    More mention of inequalities needed in this blog.

  5. Comment by Sam Goold posted on

    What about exercise? It's what works, what we want to do (more of) but are often constrained by our sedentary lifestyles. Come on government, put your tracksuit on and lead by example!

    • Replies to Sam Goold>

      Comment by Rad posted on

      Great point Sam....I was wondering about the same! Where on earth is mentioned physical activity and exercise which may tackle the rest of the problems too. Also, obesity has been left out even though we have overtaken the USA in child obesity!

  6. Comment by Martin posted on

    Following on from the exercise comment, the Physical Activity Clinical Champions programme needs a decision on funding for next year if we are to be able to take bookings to deliver training sessions for after the end of the current fiscal year.

  7. Comment by Linda Dobraszczyk posted on

    Addressing early trauma has been shown to reduce all the unhelpful coping mechanisms (and thus all the health problems as a result of them like cancer and diabetes)-smoking, over-eating , gambling, alcoholism. Why don't we treat the root causes and spend the money on supporting families to ensure good attachment of parents to infants, support good parenting skills and support anyone who has experienced trauma in order to break the transgenerational cycles?

  8. Comment by Sarah Jane posted on

    •a specific health check for people with autism will be piloted and if successful, will be extended widely....fantastic BUT what if the person is an undiagnosed Autistic despite every effort to rectify this. His GP did screening with various blood tests last year but no help re mental health or a correct diagnosis .He had a high cholesterol score but again no help was offered and no help was forthcoming from ASC despite him living alone in a private rent .
    At 51 years old he still has a diagnosis of severe learning disability dating back to the age of 4 years in 1972.
    It would be brilliant to have a specific health check for this man but with no diagnosis how can it happen?