The ‘One You’ campaign’s importance for the future of the NHS should not be underestimated
Edmund Stubbs, 7 March 2016
It is perhaps surprising that it has taken so long for Public Health England (PHE) to launch a campaign to reduce preventable diseases in adults. While the campaign against childhood obesity has been established for some years, with regular reminders of healthy diet and behaviour appearing on billboards and television, it seems that the worsening health of adults has finally become so serious that it can no longer be ignored by the one body that has real power to remedy the situation.
PHE reports that around 40 per cent of all deaths in England are related to unhealthy behaviour, but it should not be forgotten that many years of ill health due to that behaviour can precede any individual’s death. This obviously represents a highly undesirable situation for the individual concerned but also for society in general; the treatment of behavioural-related poor health is enormously expensive for the NHS.
PHE’s ‘One You’ campaign targets middle-aged adults in an attempt to encourage them to modify their detrimental behaviour patterns before they result in debilitating chronic conditions that will seriously impair their later years, and in particular limit their enjoyment of retirement.
Chronic conditions, by reason of their duration and the necessary expense of their treatment, represent an especial drain on the resources of British health services. For this reason PHE believes that individuals ought to accept some degree of personal responsibility for maintaining their health. However, while this as general advice cannot be challenged, it must be acknowledged that social, emotional, economic and environmental pressures make it more difficult for some individuals to adopt healthy lifestyles than others. In the words of Professor Muir Gray, clinical adviser to the ‘One You’ campaign, ‘environmental pressures make it difficult to make healthy choices, having to sit 8 hours a day at work for example, and then drive an hour home.’ It is therefore perhaps unwise to indiscriminately apportion blame to certain groups of the population as regards their poor health; instead, positive action needs to be taken by the whole of society.
Will PHE’s campaign be cost-effective? Almost certainly if what PHE claims is true, that living healthily in middle age can double your chances of remaining healthy after the age of 70. Consequently, even modest improvements in the behaviour of the currently unhealthy middle-aged population should result in a reduction of hundreds of thousands of medical interventions in the senior population in terms of outpatient, inpatient and GP visits. Fewer prescriptions would have to be financed and the requirement for home visits and care home places in the social care sector would be reduced.
It is important therefore that PHE’s ‘One You’ campaign should be supported. The NHS, on an individual Trust or GP practice basis needs to recognise that the success of this campaign could make their lives considerably easier in the long term by reducing demand and thereby freeing up staff and resources. The social care sector should similarly experience a reduced demand for their presently over-stretched services. Practically, placing informative literature wherever it is most visible to patients and their relatives would seem sensible. Healthcare staff too could promote the ‘One You’ programme to those middle-aged adults deemed at risk on an individual one to one basis. Employers should be encouraged to support PHE’s campaign in the knowledge that a healthier workforce will be a more productive one, with fewer absences due to sickness and higher levels of productivity. Cycle to work schemes, fitness classes and even in-house gyms might well prove cost-effective for large organisations.
Nevertheless, it must be admitted that whatever encouragement is offered, the success or failure of the ‘One You’ campaign will result from the willingness or otherwise of individuals to take the advice given by PHE and their continued motivation to actively change their lives. At best however, this extremely welcome initiative could prove vitally important for the NHS’s future and for that of our senior citizenry.
Edmund Stubbs is Healthcare Researcher at Civitas, @edmundstubbs1