Politics Home Article | Why prevention planning must be at the heart of healthcare

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The NHS could make huge gains in efficiency by preventing illnesses, rather than simply treating them.

From encouraging people to monitor their blood pressure at home to tailoring breast and prostate cancer screening to individuals’ risk profiles, early action can reduce avoidable disease, improve people’s health and deliver better value for the public purse.

That’s the verdict of Planning for Prevention, a new report produced by experts at the University of Manchester and supported by Policy@Manchester, the university’s policy engagement unit.

The report uses cutting-edge research to give policymakers a range of evidence-based insights and recommendations on delivering preventative healthcare measures.

This week marks one year since the government’s 10-Year Health Plan for England established “sickness to prevention” as one of its three core pillars. As well as tackling deeply embedded health inequalities, a prevention-focused health service would significantly reduce costs. Every £1 spent on prevention yields an £8 return in direct healthcare savings and wider economic and productivity gains.

Manchester experts outline where health policy needs to go next in preventing long-term conditions such as cancer, diabetes and cardiovascular disease. They say that robust analysis and immediate interventions are vital to transform our healthcare system and improve patient experiences.

Writing in the report’s foreword, Professor Tracy Daszkiewicz, President of the Faculty of Public Health, said: “Cancer, cardiovascular disease, diabetes and chronic respiratory disease account for the majority of premature mortality and disability in this country, much of which is preventable, yet too often our collective response remains focused on treating illness rather than preventing it.

“If we are serious about improving health outcomes, reducing inequalities and securing the sustainability of our health and care system, prevention must move from aspiration to delivery. This publication shows us how.”

Genetic insights, for example, could enhance risk-based cancer prevention and detection strategies, particularly for breast and prostate cancer, two of the most dominant types of cancer. But while the 10-Year Health Plan for England and the National Cancer Plan signalled a shift towards personalised medicine, including the integration of genomic insights into screening and prevention strategies, the report’s authors point out that representation, equality and equity concerns must be addressed to ensure that it works for everyone.

“Disparities in screening uptake are already high,” said Dr Sam Merriel, Dr Lorna McWilliams and Professor Gareth Evans, who contributed to the report. “Women from deprived areas, some UK minority ethnic groups and rural communities may face barriers to access, including limited health literacy, cultural factors and logistical constraints.”

Similarly, while the NHS Diabetes Prevention Programme is a successful example of how prevention programmes can operate, the report emphasises that improvements are needed in engaging with underserved communities.

Previous University of Manchester research revealed that patients from ethnic minority backgrounds were over-represented in initial referrals to the programme but were less likely to complete it. Meanwhile, people living in deprived areas were under-represented, showing that if prevention programmes are not properly targeted, they risk widening health inequalities, as opposed to reducing them.

Tom Gordon, Liberal Democrat MP and Chair of the All-Party Parliamentary Group on Diabetes, agrees. He told PoliticsHome that diabetes prevention must serve all communities, especially those that have been overlooked.

“The Diabetes Prevention Programme is a genuine success story, a proof of concept that prevention works at scale.

“Now we need to build on that success by ensuring it reaches everyone who could benefit, particularly those in underserved communities where the need is greatest.

“As we mark one year of the 10 Year Health Plan, the task is to take what works and make it work for all – systematic, equitable, and properly resourced.”

The Planning for Prevention report also focuses on social prescribing – an invaluable way to connect primary care patients to non-medical activities and services to improve their health and wellbeing, particularly those who are lonely or socially isolated, living with long-term conditions, or requiring mental health support. In 2025, there were around 3,350 funded social prescribing link workers in England, but disadvantaged areas have disproportionately fewer numbers – even though patients in these areas benefit more.

High blood pressure, often called “the silent killer”, is another concern. It affects around a third of adults, but most have no idea that their blood vessels, heart and brain are under sustained stress. The Manchester experts’ recommendations include encouraging home and remote monitoring and launching a national campaign to explain the links between blood pressure control and vascular dementia prevention. Action on high blood pressure could help to reduce the future burden of dementia, with significant savings to the NHS and the wider economy.

A further article in the publication explains that social determinants of health remain a major driver of sickness. University of Manchester research has found that victims of abuse may suffer serious health consequences as a result of engaging with private family court proceedings, such as cases to determine child access arrangements between parents or carers.

“Family court systems are producing life-limiting, long-term conditions among women and children,” said Dr Elizabeth Dalgarno and Professor Arpana Verma, who want the Children Act 1989 in England to be revised and updated, a Family Justice Bill to be advanced, and court and perpetrator-induced trauma to be recognised as a public health issue.

“Addressing this requires treating court-related trauma not only as a legal failure but as a driver of chronic disease. Without urgent reform, these systems will continue to generate preventable illness, disability and premature mortality.”

The report highlights the huge gains in efficiency that could be made by preventing illnesses. However, Professor Matthew Sperrin and Dr Glen Martin argue that doing this “efficiently and well” requires better use of data and building models using statistics, machine learning and AI to predict who is at risk.

Dr Simon Opher, Chair of the Health All-Party Parliamentary Group, spent 30 years as a GP before becoming an MP and welcomed the report’s insights.

“We have to get better at preventing illness,” he said. “When people become patients, we have left things too late. Treating a patient is almost inevitably the most expensive option. We must ensure that commercial interests do not get in the way of us reducing obesity, and similar unhealthy outcomes. This report helps us re-think healthcare and begin to map out the next stage of this important journey.” 

Shadow Health Secretary Stuart Andrew stressed the importance of prevention but says that NHS reforms must be deliverable.

“Prevention must be central to NHS reform to improve patient outcomes and ensure cost efficiency,” he said. “However, extending regulation on lifestyle choices without clear evidence of benefit risks undermining personal responsibility for health.” 

He adds, “Real change must focus on what works, backed by local leadership and respect for individual choice.” 

Read Planning for Prevention here.