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It takes a village to raise a child

The National Medical Director for NHS England and Improvement and the President of the Association of Directors of Public Health discuss why prevention is key to the NHS Long Term Plan:

‘It takes a village to raise a child’ – this wonderful saying beautifully captures how an entire community of people must interact with children for them to experience and grow in a safe and healthy environment.

It encapsulates the interconnectedness of our society, across the generations and across all aspects of our lives.

If you think about it, it’s also true for us every stage of our lives: the community, or society we live in – our family and friends, our education, jobs, homes, income – all play their part in shaping our health and wellbeing throughout our lives.

We know the NHS is there for us, supporting us to bring the next generation into the world, through to old age. Giving children the best start in life, alongside the skills to take care of their health, provides the best investment we can make to improve everyone’s chances of a healthy, long life. Creating good health is a much better approach than treating things when they go wrong.

Healthcare is there for us when we become ill – but increasingly we recognise that the NHS also has a key role in keeping us well and out of hospital.

The NHS is part of our nation’s ‘village’, along with local government, the police, fire service, voluntary and community sectors. Working together, with the child, young adult, middle-aged or older person at the centre, we can increase our reach and impact to deliver a healthier population. In turn, this will help us keep the NHS sustainable for the next generations.

The NHS Long Term Plan shows the NHS playing its part in not only being there when we are ill, but also shifting focus and resources to preventing ill-health.

The Long Term Plan has a strong focus on preventative medicine – in areas such as smoking, alcohol and obesity – and we need to ensure these are implemented effectively, integrating where appropriate with other local services, ensuring always that people are at the centre of pathways with positive behaviour change and improved health being the goal.

But we can’t rely on these new programmes to deliver the size of the shift needed. Helping people stay well is already part of the way the NHS works but we need this focus to be broader, running through everything the NHS does. The reach of the NHS provides millions of opportunities for staff to engage with people, making every contact count in helping people live more healthily.

New structures and arrangements through Integrated Care Systems, provide a great opportunity to work pragmatically across organisational boundaries, to join up our local systems and boost efforts to improve our populations’ health and wellbeing. Local authorities, with their leadership and influence across many aspects of the places in which we live our lives – and the third sector, with its deep roots into communities and ability to innovate and deliver are critical to the work of the ‘village’.

It’s time to work together as a system to support people to be healthy, happy and fulfilled throughout their life-time.

Professor Stephen Powis

Professor Stephen Powis is the National Medical Director of NHS England and Professor of Renal Medicine at University College London.

Previously he was Medical Director, and latterly Group Chief Medical Officer, of the Royal Free London NHS Foundation Trust from 2006 to 2018. Professor Powis was also a member of the governing body of Merton Clinical Commissioning Group for five years and a Director of Healthcare Services Laboratories LLP.

He is a past Chairman of the Association of UK Universities (AUKUH) Medical Directors Group and has been a member of numerous national committees and working groups, including the Department of Health Strategic Education Funding Expert Group. He is a past non-executive director of the North Middlesex University Hospital NHS Trust, including a period of eight months as acting chairman.

Professor Powis is also a past chairman of the Joint Royal Colleges of Physicians Training Board (JRCPTB) Specialty Advisory Committee (SAC) for Renal Medicine and a former board member of Medical Education England. He was Director of Postgraduate Medical and Dental Education for UCLPartners from 2010-13. He is a past treasurer and trustee of the British Transplantation Society and a former member of the UK Transplant Kidney Pancreas Advisory Group.

He has also served as a member of the Renal Association Executive Committee and was Editor of the journal Nephron Clinical Practice from 2003 to 2008. In 2017 he became the inaugural Editor-in-Chief of the journal BMJ Leader. He has been a trustee of several charities, including the Royal Free Charity and the Healthcare Management Trust.

Dr Jeanelle De Gruchy

Dr Jeanelle de Gruchy is President of the Association of Directors of Public Health (ADPH), having been elected in May 2018 for 3 years.

Jeanelle’s priorities as ADPH president are to continue to develop the Association as a well-respected and vibrant voice for prevention and public health. She is passionate about ADPH advocating for equality in all its forms.

Jeanelle is also Director of Population Health for Tameside and Glossop Strategic Commission, an integrated NHS Clinical Commissioning Group (CCG) and Local Authority organisation, led by both local politicians and NHS clinicians. She has a role in leading population health system reform developments in Greater Manchester.