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Public Health

TOPIC: What areas should we invest our cash in to improve the health outcomes of the nation?

What areas should we invest our cash in to improve the health outcomes of the nation? #1

There are so many areas that are important what are the forum members experience of what is or could be the most prudent health effective investments?

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #2

The Healthy Start (HS) scheme for vitamins A, C and D has a very poor uptake. Research shows that a deficiency of vitamins A and C is unlikely, but that Vitamin D deficiency is a concern for all children aged six months to five years. As a result the CMO’s across the UK have issued a directive to public health highlighting the need for universal supplementation of vitamin D. Could the Department of Health consider withdrawing the HS vitamins and instead issuing free vitamin D for all children? They would also be less costly than the HS combined vitamin preparation?

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #3

I think we need to raise awareness of the health needs of people with learning disabilities and mental health needs, due to the community care ACT 1990 people are living in the community but professionals like G.Ps, dentists etc do not understand their needs leading to what is known as diagnostic overshadowing and they may present with health issues rather late which may have an impact on the health budget
Last Edit: by Matthew Abbott.

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #4

“Smoking is the biggest cause of preventable death in the UK, taking more lives than the next 5 causes added together. Spending money on preventing children from taking up smoking in the first place, and helping adult smokers to quit, will do more to reduce health inequalities between rich and poor than any other activity. Smoking costs society nearly £14 billion a year – spending a fraction of this to save in the future makes economic as well as moral sense”

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #5

In time of austerity, budget of academic research widely shrinks, so will our ability to know. This for sure will weaken our ability to spend money unwisely and produce population health gains. We need to continuously invest into research to ensure we are spending only where we should.

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #6

Promoting the benefits of a healthy lifestyle (exercise, diet, talking etc) without the usual scare tactics used when focusing on one condition/outcome. Promote the fact many conditions can be improved without neccesarily taking medication or by makiing lifestyle changes alongside medication

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #7

Focus on mental health because the widespread cuts to services and benefits will not only cause people who have a pre-existing MH condition to get worse but also bring more people into contact with MH services for the first time. There is doubtless going to be many people facing poverty and MH problems for the first time and the stigma these people will go through needs to be minimised

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #8

Public health has been defined as:
'the science and art of preventing disease, prolonging life and promoting health through the organised efforts and informed choices of society, organisations, public and private, communities and individuals' (Wanless 2004, p.3.).
I am privileged to be a health professional as well as having a large family; it makes it easy to have a sample population at all times. In the last few years what I have noticed is the power of education and communication.
My main focus would be preventing of disease by educating the public on the basics in various forms. Working with all ages I have come to learn that we all absorb information at different rates and styles. Taking an example of the flu season in my home environment, with the first sneeze I'll ensure that a reminder to use tissues, keep warm and vitamin c not forgetting keeping the environment clean and tidy is given.
I have noticed a gap in information provided for the public between acute hospitals, schools and the community. Whereas my local hospital has "catch it bin it kill it" leaflets and posters, adverts on television, there was nothing at my GP surgery until I took the initiative to provide some.
Keeping in mind that the human being race is busier than before health professionals need to work more closely to avoid gaps in the information provided. We have to educate the population at every given opportunity bearing in mind that we all have different preferred styles / rates of learning. Children are classic when you least expect them to take note they'll be reminding you as an adult months later.
I guess I agree with the ex- prime minister education, education, education!!!

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #9

Invest in the main asset of the NHS - the people who deliver the front line care and expertise. Ask any committed health practitioner for their problems = poor staffing levels, stress, fatigue, unexplained demands from management, equipment and workspace problems, IT problems, hierarchy issues, bullying, being ignored, personality clashes, lack of confidence, bewilderment in some situations, frustration when trying to explain to others what concerns them, victimization if they raise a problem - even dismissal, shock and hurt caused by mistakes made whilst doing their best - the list goes on= HUMAN FACTORS! Invest in proper staffing levels for patient care,ergonomics evaluation and changes, human factors training and implementation for all 1.4 million staff! safe reporting culture where appropriate and useful action is taken on every report, briefing and debriefing would be normal, training, assessment and support training would take place annually for everyone. Yes - you may have heard it all before - would you get on a plane if you thought it was less well run than this? I thought not. Think Kegworth air crash, then think Hudson river air crash - the difference - investment in ergonomics, plus training pilots, cabin crew, ATC, managers, and ground crew in Human Factors, plus proper fatigue management = staffing levels management. thank you for reading this far - Sue

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #10

Indeed, surely the most cost-effective method of health improvement is to treat the cause rather than the outcome. The country, and much of the world, is suffering from an obesity epidemic and many of the medical interventions required by health professionals can be at the very least reduced by everyone leading healthier lives with a combined reduction in BMI. Weight management has long since been a side issue in the NHS, with a fragmented and often minimal approach. For example if someone has 6 stone to lose to reach a healthy BMI is there a distinct possibility that a 12 week food education approach will enable a consistent weight loss to goal for that person? Unlikely.
I have over many years offered the Lipotrim Pharmacy programme as part of my weight loss and weight management service through Waistaway. Being a community Pharmacist places me in an ideal position to tackle this difficult problem and since Lipotrim fits easily within a coordinated and dynamic service the results can be amazing. The audit, using the lipotrim patient tracker software, of my service has shown that an average of over 10% weight reduction across all ages, sexes, starting weights and BMIs means the Lipotrim programme really needs to be held as a great example of how weight loss can be realistically achieved. The programme revolves around a total food replacement programme to tackle the weight in one hand, buy allowing rapid weight loss the patient is rewarded for their efforts and sees the light at the end of the tunnel. On the other hand because they are adopting as near to a no food lifestyle for a period of time as possible, they are in fact being helped as though addicted to food. By taking the substance of abuse away from them the patients respond by having to automatically adopt a different lifestyle and life-approach to food and drink whilst on the weight loss phase but also taking this into their weight management.
At this point it must be said that this service is a patient funded service, ie the patient pays me for my time and products they use, and this in my opinion is where the results are optimised. Rather than making these services a free for the public, the cash investment needs to be applied to enabling the delivery of a collaborative, inclusive approach to the weight loss and weight management options available out there. Use the money to educate the public on what weightloss and weight management options are out there and enable them to access these options via a coordinated approach through the many health professionals caring for them. If a coordinated approach is taken then when patients inevitably struggle they are still within the network of help thus keeping their efforts alive.

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #11

How can local authority public health professions, such as environmental health, develop the research and publication skills and ethos needed in the new public health system, with its emphasis on the evidence-base? (I am particularly interested in how local government employees can gain access to the peer-reviewed papers and journals, which are available to their healthcare colleagues.)'

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #12

It seems that before we ask what effective investments in public health might be, it would be sensible to survey the field of health interventions that have already been tried across the world, in terms of what has been successful (and what were the measures of success), and what has been unsuccessful. It is no secret that the most efficient hospitals in the world are in India, that measures to restrict trans-fats in New York have been effective, and that the family nurse partnership programme developed in the USA has improved health, education, and social outcomes in participants. Of course, there are many, many more examples. I believe a 'prudent investment' would be the development of a database of all health/public health interventions/approaches that have been implemented across the world, with cost, outcomes, and potential cost/benefits if implemented in the UK, so that a robust, evidence-based approach can be taken to health policy and planning in this country. In the shorter term, engaging with the academic sector would be an essential component of ensuring effective policy making, as researchers are uniquely placed to be able to take an evidence-based approach.

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #13

Physical activity is the best buy in public health. We need to invest so as a nation we can address the ‘silent killer’ that is sedentary behaviour. Inactivity is the 4th biggest cause of premature death so it makes sense to spend what is comparatively small amounts of money on funding programmes that get people into the pool, into the gym or out walking rather than spending the hundreds of thousands of pounds it costs to treat them for diseases which are largely preventable by increasing physical activity. It is estimated that physical inactivity costs the UK between 1 and 1.8 billion pounds a year and we know that participation rates are falling. As a leisure operator I know the fitness industry has to get better at providing new routes to health and fitness and we have to get better at engaging the community and better at driving more people to be more active , more often. But as whole communities we have to work as a collective to help people see and feel the benefits of physical activity and help them find the kind of activities that are right for their particular needs. At DC Leisure one way we are doing this is through our Swim4Health programme, offering people a tailored journey to increased activity using the pool as a safe, accessible exercise space.

As a nation we need to start engaging people at a younger age and address the growing problem of increasing numbers of our nation’s children starting secondary school either overweight or obese. At DC Leisure our response to this is Gugafit – which is fun, accessible activity for primary school children which also gives free online access to a healthy habits website where children and their families can record what they eat and the kind of activity they do and for how long.

As a nation we also have to have a more youth centred approach and ask young people what they want and invest in places and spaces so they can do it. Activities need to be fun and inclusive – not just for ‘sporty types’. This generation is 20% less active than two generations ago so we have to move with the times … make use the technological age that young people feel comfortable in to increase their participation – for example using digital media to enhance sports like skateboarding or snowboarding; investing in community walking and cycling schemes with MYZONE heart rate monitors to gather data and motivate participants; making fashionable urban sports like Parkour more accessible to greater numbers with funded projects in the heart of communities.

And the great news about physical activity is that if people get more active they can be more likely to make other healthy lifestyle changes such as eating more healthily, drinking less or stopping smoking. A great investment would therefore be to fund a physical activity specialist in every GP surgery. After all , a well trained fitness professional is best placed to advise on physical activity and signpost patients to appropriate routes to moving more and enjoying improved health and wellbeing.
Last Edit: by Matthew Abbott.

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #14

We need to invest our cash in screening and prevention.
This will prevent spend in the future on LTC.
With the footfall in pharmacies being sometimes 10x greater than GP practices, that could be a great venue to host screening clinics and public awareness canmpaigns.

Re: What areas should we invest our cash in to improve the health outcomes of the nation? #15

We need to invest in improving access to healthy lifestyle services and the wider determinants of health such as housing, employment, education etc. most people put health below all these other things and need to have them in order before focussing on improving their health.
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