Health for all - everyone, everywhere
Posted on Monday, April 8, 2019 by Maire Gerrard — No comments
Yesterday was World Health Day, an annual event formed by the WHO to celebrate health across the globe, whilst also serving to remind leaders of the importance of easy access to quality healthcare.
This is underpinned by the idea of ‘universal health coverage’, which is defined by the WHO as ‘the means that all people have access to the quality health services they need, when and where they need them, without financial hardship’. The starting point for this relies on primary health care and the commitment from governments to ensure this is widely available and of a high standard.
Primary health has a very wide remit, providing comprehensive care throughout a person’s lifespan. Its coverage ranges from promotion of health causes, prevention, treatment, rehabilitation and palliative care. It is very much the everyday front line of health care, making it as important as the emergency attention we may seek at points in our lives.
While on a global level we are lucky to have free access to primary health care, the NHS recognises concerns about increasing inequalities in our current system within its ‘Long Term Plan’. Here there are guarantees that over the next five years, investment in primary medical and community services will grow faster than the overall NHS budget. In addition, Sustainability and Transformation Partnerships (STPs) and Integrated Care Systems (ICSs) have committed to building service-wide implementation plans during the current financial year, which will ensure local populations have a sustainable programme in place to improve health outcomes.
However, our Associate Director, Adam Britton has noticed a change in attitudes towards where the responsibility lies with regards to improving the overall health of the nation:
“Everything used to revolve around Public Health, but the emerging concept of ‘Population Health’ acknowledges that the responsibility to reduce inequalities in health and make improvements lies with more institutions than just Public Health bodies or the NHS. It takes a lot of multi-agency collaboration.”
As the bodies with overall responsibilities for their relative populations, local authorities are one of the agencies that need to be involved in these processes. However, they can often face difficulties implementing population health initiatives, especially with regards to the prevention element of primary health care. Matthew Andrews has worked as a consultant through Venn Group on health strategies in this sector:
“Keeping our population healthy is the main way to improve people’s quality of life and reduce the cost to the public purse of treating illness and injury. Prevention is the key way to do this…[as] much of the burden of illness and injury comes from preventable causes…behaviours such as smoking, drinking alcohol, sedentary lifestyles, unhealthy eating and violence. In recent years, despite the stated intention to focus more on the prevention of illness and injury, budgets have been reduced and strategic focus has wandered, leaving many of our successes from earlier years at risk, and the harm to our population from these causes increasing”
Phil Veasey, who has also worked within public health in local authorities as a Venn Group consultant, acknowledges the difficulty in improving primary health care in the current system:
“The actors in the health systems that surround us – CCGs, the NHS and Public Health to name but 3, sometimes make it difficult to join things up and provide the best solutions for our patients or residents. When it comes to the prevention agenda, for example, approaches may often be fragmented with no one partner able to take the lead…”
Phil believes that ‘social prescribing’ could be the way to combat this. In brief, this is a way of connecting primary care patients with alternative sources of support within the community. It offers a non-medical referral option that can operate alongside existing treatments to improve general health and wellbeing:
“Social prescribing allows us to change this narrative, bring new partners into the mix and sprinkle a little bit of innovation…If we get this right in our most vulnerable communities, we may be at the threshold of a new adventure of joined-up working with fantastic results! Many in the health systems refer to the potential of social prescribing to reduce the burden on the NHS. Better still – social prescribing provides the best possible approach and solution for our residents or patients.”
To conclude, while we cannot reasonably claim to have achieved ‘Health for All’ yet, there is innovative thinking taking place to give us hope that it can be achieved. To end on another thought from Matthew Andrews:
“Maybe World Health Day gives us an opportunity to reaffirm our commitment to preventing illness and injury, and to provide substance, expertise and resource to make one of the biggest differences we can to improving the health of the population.”
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