The NHS Long Term Plan has a strong focus on the treatment and prevention of illness by supporting patients to adopt improved healthy behaviours. This will both help people to live longer, healthier lives, and reduce the demand for and delays in treatment and care.

We are taking forward the specific commitments set out in the NHS Long Term Plan whilst supporting the NHS to drive a consistent focus on prevention across all of its services. This is an exciting and significant challenge. We are building on the achievements to date and will focus on services to support patients to overcome tobacco addiction, treat alcohol dependence and to prevent and treat obesity – particularly in areas with the highest rates of ill health.

We are working in collaboration with local authorities and their funded services to deliver joined up and seamless care to patients and their families.

What do we mean by treatment and prevention?

In relation to the NHS Long Term Plan commitments, primary prevention means working with partners such as Government, Public Health England and local government to prevent disease or injury before it ever occurs.  We want it to be easier for people to be able to make healthier choices and so reduce the risk of developing ill health, disease and premature death.

Secondary prevention includes treatment to support the changes in behaviours or lifestyle factors that are needed to improve a person’s healthy life expectancy. For us, that means tailored help for tobacco addiction, alcohol and obesity, with treatment to reduce the risk of early ill health and diseases such as cancer, cardiovascular disease, stroke, respiratory disease and mental ill-health.

These interventions are designed to target individuals who are at increased risk of ill health because of their lifestyle – and other risk factors – with a particular focus on how we close the gap in inequality of health outcomes for individuals and communities in deprived areas.

Our work on prevention

Treatment of tobacco dependency

Through the NHS Long Term Plan commitment we will support the NHS to ensure that every person admitted to hospital (both physical and mental health sites) who smokes will be offered NHS-funded tobacco dependency treatment by 2023/24.  This includes all expectant mothers throughout their antenatal care.  We will also explore how we can best help partners of pregnant women so that any new-born baby goes home to a smokefree home.

Through the NHS Long Term Plan commitment we will support the NHS to ensure that every person admitted to hospital (both physical and mental health sites) who smokes will be offered NHS-funded tobacco dependency treatment by 2023/24.  This includes all expectant mothers throughout their antenatal care. We will also explore how we can best help partners of pregnant women so that any new-born baby goes home to a smokefree home. See a patient story from a local service where a similar campaign has helped to encourage the entire family to try to quit smoking and resulted in the successful birth of a healthy baby boy.

The offer of treating tobacco dependency will also become available to patients accessing higher risk outpatient services. This will include specialist mental health and learning disability services for long-term users because both of these settings support people who are more likely to smoke.

The models we will use are based on evidence based evaluation of service models such as the CURE model in Manchester and the Ottawa model in Canada.

Alcohol care teams in district general hospitals

Through the NHS Long Term Plan commitment we will support healthcare systems to ensure they have optimal acute alcohol services in their general district hospitals, providing NHS funded treatment for people who are alcohol dependent.

Working in partnership with local authority funded community alcohol services, alcohol care teams in general district hospitals can reduce length of time spent in hospital, reduce alcohol related admissions and improve outcomes for patients, their families and their communities.

Focusing on areas of greatest need, we will close the gap in health inequalities by targeting investment to those healthcare systems where alcohol dependence related harm and rates of deprivation are high.

Public Health England has published ‘All Our Health’ alcohol information to help all health professionals learn more about specific activities and interventions that can prevent alcohol harm and think about available support resources and services.

Resources co-produced with Public Health England can be found below. Including:

• A brief: what are we proposing and why
• A core service descriptor: what good looks like
• A self-assessment checklist: how does my current service compare to the optimal model
• Case study: what might this look like in practice

Obesity

The NHS is facing an obesity epidemic with 63% of adults in England classified as overweight or obese. The NHS Long Term Plan sets out new commitments for action  the NHS will take to support individuals to achieve and maintain a healthy weight. It does so while recognising that a comprehensive approach to preventing and tackling obesity also depends on action that spans individuals, companies, communities and national government.

We will challenge and change the current thinking on obesity by:

• building confidence in the frontline workforce so that all staff feel able to discuss weight and deliver high quality advice and treatment to their patients, children and families.
• Testing at scale community weight management services for patients with obesity and type 2 diabetes or obesity and hypertension and enhanced secondary treatment services for patients with obesity and comorbidities in a small number of high rate areas.
• building the evidence base for existing and new interventions and support the development of new services across England.
• Continued action to deliver healthy food and environments across NHS premises for staff, patients and the public.

In addition to the modifiable behaviours described above, the NHS Long Term Plan also refers to wider threats to people’s health; and makes commitments on how the NHS will contribute to work taking place across government to prevent these threats becoming a reality.

Antimicrobial Resistance (AMR)

The NHS Long Term Plan committed the NHS to continue to support implementation and delivery of the UK five-year national action plan on Antimicrobial Resistance (AMR), which was co-produced with a range of government departments, agencies and NHS England & NHS Improvement.

The National Action Plan sets out to contribute to delivery of the UK’s vision of a world in which AMR is contained and controlled by 2040 by delivering:

• optimised use of antimicrobials with good stewardship across all sectors
• a lower burden of infection, better treatment of resistant infection and minimising transmission
• new diagnostics, therapies, vaccines and interventions in use and accessed by all

In taking forward the human health commitments in the Plan, NHS England recognises that preventing infections, and managing infections well when they do occur, will have the biggest impact in containing and controlling AMR. We also recognise that to achieve these, we need strong leadership in all health and care settings. For this reason, and to improve co-ordination and alignment of work taking place across the NHS on this wide-ranging threat to public health, we have created a single AMR programme; which incorporates the following areas of activity:

• Prescribing
• Infection prevention and control
• Diagnostics
• Sepsis
• New drugs
• Data