With pressure on medical services at an all time high, the Tony Blair Institute for Global Change is calling for investment in disease prevention – treating people when they are asymptomatic.
The institute says governments are aiming at the wrong target by dealing with late stage symptomatic disease, rather than managing illness in its early, asymptomatic phase. Diagnostics and therapeutics, combined with new public health policies, could change this trajectory.
According to a new report from the institute, called Moving From Cure to Prevention Could Save the NHS Billions: A Plan to Protect Britain, although people are living longer, they're not living more healthily – 7.77 million people were waiting for medical treatment at September 2023.
This situation is causing a drag on the economy and ruining the quality of life for individuals living with chronic diseases that compromise their ability to work.
By age 75 the average Brit is 60 per cent more likely to possess two or more significant conditions, with this increasing to 75 per cent for those between the ages of 85 and 89.
The Blair thinktank says a change in approach could prevent this, halting disease progression before irreversible damage is done.
The risk factors which cause heart attacks, strokes, dementia and diabetes in later life present much earlier in the form of raised cholesterol, hypertension and increased body mass: this is when interventions should be made, including health screening and vaccination.
For example, health screening to identify low-density lipoprotein cholesterol, blood pressure and BMI for cardiometabolic disease. Circulating tumour DNA blood tests could identify cancer early. Genomics and artificial intelligence could be used to understand the lifetime risks carried by individuals in order to create personalised prevention plans.
A new generation of long-acting therapies could be used to manage risk factors, such as high cholesterol and blood pressure based on annual injections: effectively serving as vaccines against heart disease and stroke.
Treating someone for five years after a stroke can cost the NHS up to £45,000, while Inclisiran could prevent 55,000 heart attacks and strokes.
The report argues we have the tools but they are not being deployed, for example shingles vaccinations could reduce the risk of dementia by up to 20 per cent and there is emerging evidence that flu vaccines can give positive cardiovascular outcomes.
The solution is early detection, early therapy and anticipating disease with targeted prevention, to create a health system, rather than the sickness system we now operate, say the report's authors.
The new system needs to work outside, but alongside the NHS. The NHS must prioritise fixing other challenges in treatment waiting lists and acute care. This must be done in a convenient, accessible, digitised and community-based way: COVID vaccination programme showed this is possible. Finally, it is essential to effectively communicate with the public about how to proactively protect their health.
