Underinvestment in Primary Prevention
Lack of ringfenced government funding for primary prevention initiatives, leading to reactive rather than proactive approaches.
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Committee recommendation
80match
#5 - Define government health prevention spending and increase flexible funding for local systems.
Given the constraints on public spending, it is highly likely that re- focusing attention from sickness to prevention cannot be achieved without re-allocating existing NHS funds in the same direction. Senior ICB leaders report a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than 5 treating it. Furthermore, the public...
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terms: prevention
Committee recommendation
78match
#20 - Progress on health prevention hindered by acute care focus and reduced public health grants.
Senior ICB leaders reported to the National Audit Office a continued lack of progress with the government’s long-standing aim to move towards preventing ill health rather than treating it. One of the most important reasons cited by ICBs has been the focus on other pressing national priorities, particularly elective care backlogs and acute services, which has meant they...
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terms: prevention
Committee recommendation
66match
#22 - Inadequate definition and tracking of prevention spending impedes accurate assessment of policy progress.
Currently, NHSE does not even track spend and activity on prevention by ICBs at local levels, due to unavailability of data and the lack of consistency about what counts as prevention spending. While DHSC funds some prevention activities that sit outside the NHS, primarily through its Office for Health Improvement and Disparities (OHID), it similarly lacks a precise...
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terms: prevention
Committee recommendation
66match
#21 - DHSC believes prevention requires cultural and legislative change, not solely additional resource allocation.
DHSC told us it did not view providing more resources, or redirecting them from elsewhere, as a substantive part of the solution to the lack of progress with prevention. Instead, it considers that a shift towards prevention might be achieved through longer-term changes in culture, public attitudes and the legislative environment.36 There is a role for GPs to...
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terms: prevention
Committee recommendation
62match
#13 - Commission community pharmacies to provide HIV-prevention PrEP and all routine adult and child immunisations.
In the shorter term, and in light of the large body of evidence and long-running calls for these services to be offered in community pharmacy settings, we recommend that NHS England commissions community pharmacies to provide the HIV-prevention medication PrEP and all routine and seasonal immunisations for adults and children.
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terms: prevention
Committee recommendation
61match
#12 - Government commits to preventative oral healthcare measures including supervised toothbrushing and water fluoridation
The new government’s commitment to contract reform includes reference to a focus on prevention,27 and also to a programme of supervised toothbrushing for three, four, and five–year olds “most in need”.28 Tooth decay is a leading cause of hospital admissions for children in this country,29 and as DHSC told us in the session, prevention is preferable to needing...
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terms: prevention
Committee recommendation
57match
#24 - Overall NHS productivity remains low despite increased elective activity and community investments.
Despite carrying out 15% more elective activity than before the pandemic, the NHS is less productive overall once the activities of mental health trusts, community trusts and GPs are considered.42 NHSE told us that, while government has had a long-term aim to shift more care and services into local communities, funding increases for these services had often been...
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Committee recommendation
57match
#13 - DHSC acknowledges long-term healthcare shifts but prioritises immediate acute service pressures.
DHSC and NHSE told us that they were fully supportive of the new government’s aims to shift healthcare spending from treatment towards prevention, from hospitals to the community, and from analogue to digital. However, DHSC contended that these shifts would be hard to do and should take place only over the long term and not at the expense...
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terms: prevention
Committee recommendation
57match
#14 - Spending shifts from preventative to late intervention services, increasing later costs and worsening outcomes.
MHCLG recognises the importance of investing in prevention but also the challenge of funding it when finances are constrained.34 Preventative services help stop, delay or reduce the need for statutory services and can help to deliver better outcomes.35 Over the period 2015–16 to 2023–24, local authorities have spent more on some later intervention services and less on 26...
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terms: prevention
Committee recommendation
57match
#72 - Prioritise strategic funding deployment for early intervention in SEND to improve outcomes.
Funding must be strategically deployed to deliver the best outcomes for children and young people with SEND. This should include prioritised investment in early intervention. Timely and targeted support is essential 170 and can prevent some needs such as speech and language and SEMH needs from escalating, reducing long-term costs to the system, and improving educational and life...
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PFD report
53match
Michael Cooper
Chronic underfunding of mental health services led to a critical lack of inpatient beds and excessive Care Coordinator caseloads, causing delayed follow-ups and inadequate risk assessments.
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PFD report
53match
Bradley Morgan
Mental health services suffered communication breakdowns and severe underfunding, resulting in excessive staff caseloads and a lack of timely patient follow-up, which created a risk to life.
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PFD report
53match
Michael Wheeler
Inadequate mental health service funding led to a lack of psychiatrist review for a patient with severe paranoia and inpatient bed shortages, overstretching Home Treatment Teams.
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PFD report
53match
Maeve Boothby O’Neill
There is a critical lack of specialist healthcare provision and funding for research into severe Myalgic Encephalomyelitis (ME). Limited doctor training and inadequate NICE guideline details on managing severe ME are also significant concerns.
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Committee recommendation
52match
#5 - Pensioners face increased health risks and unsustainable care demand without a preventative, whole-system approach
As pensioners are generally on a fixed income, they face challenges responding to cost-of-living increases. Those on low incomes are likely to respond by cutting back on food, energy use and social interactions, adding to existing health risks. Various social and environmental risk factors such as poverty, bereavement and isolation and cold as well as lifestyle factors such...
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terms: prevention
PFD report
49match
Philip Dean
Mental health services were underfunded and under-resourced, leading to fragmented care, inadequate recording of critical information, and delayed professional assessments for severely unwell patients.
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PFD report
49match
Kate Dolby
Chronic underfunding and staff shortages in mental health services, particularly for doctors in the EIP team, led to precarious patient care and significant delays in treatment.
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PFD report
49match
Stephen Jackson
Mental health services failed to provide essential post-discharge follow-up from the home treatment team despite an urgent GP referral, leaving the patient unsupported due to underfunding.
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PFD report
49match
William Edge
A suicidal patient was discharged without adequate follow-up from the Home Treatment Team, who could not revisit despite an urgent family request, due to critical bed shortages and underfunding.
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Committee recommendation
49match
#30 - 3rd Report – Food and Weight Management: Fixing the food environment
The government needs to build and fund a more robust enforcement regime for existing and upcoming regulation, which should include: a. improved, ring-fenced funding and an improved training offer for local authority trading standards and environmental health teams to improve their capacity to address all enforcement issues; and b. stronger penalties that act as a real deterrent for...
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Committee recommendation
49match
#29 - 3rd Report – Food and Weight Management: Fixing the food environment
We are concerned by the lack of enforcement of policies and recommend the government review the extent to which its policies are being enforced and, in its response to us, set out detail on resources available for enforcement. (Recommendation, Paragraph 134)
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Committee recommendation
49match
#13 - 3rd Report – Food and Weight Management: Fixing the food environment
We therefore repeat the recommendation previously made by Sir Henry Dimbleby that the government should establish a “Community Eatwell” programme to provide healthy eating support to families and individuals on low incomes experiencing food-related ill health. The government should also work with industry to secure match-funding for this programme. (Recommendation, Paragraph 60)
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Committee recommendation
49match
#12 - 3rd Report – Food and Weight Management: Fixing the food environment
Local projects to support access to healthier foods are doing fantastic work in their communities and seeing real results, using local knowledge and building strong community relationships to drive change. Community projects need to be a core part of any work to address the challenges in the food system and the government needs to better recognise their value...
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Committee recommendation
49match
#2 - 3rd Report – Food and Weight Management: Fixing the food environment
The 2018 nutrient profiling model should be implemented as soon as possible, and certainly no later than by the end of 2027. The government will hear a lot of representations against this, but should hold firm. While we are aware of the debate around free sugars, we do not believe that it should be allowed to delay implementing...
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Committee recommendation
49match
#14 - Ninth report - Clearing the backlog caused by the pandemic
As part of its national health and care recovery plan, we recommend that the Government sets out the contribution that public health services will make, and ensures that this contribution is backed with a level of funding that acknowledges their crucial role.
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Committee recommendation
49match
#11 - Prioritise funding and support for local preventative services to reduce acute service demand.
The Ministry must prioritise funding and support for local preventative services to fix the foundations, reduce the demand for acute services, and bring down costs in the longer term. (Recommendation, Paragraph 50)
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Committee recommendation
49match
#10 - Temporary central government funding is required to rebuild damaged preventative services.
Rebuilding and strengthening damaged preventative services will require temporary increases in central government funding before the demand for acute services starts to drop. (Conclusion, Paragraph 49)
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Committee recommendation
49match
#13 - Government obstructs FGM reconstructive surgery by failing to fund necessary research.
Many women who have undergone FGM seek reconstructive surgery to reverse FGM as far as possible. It is clear that the NHS is equipped to perform this surgery as it delivers it for other medical conditions. We acknowledge that the current medical evidence supporting reconstructive surgery for FGM survivors may be limited. However, it is unreasonable for the...
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Committee recommendation
49match
#32 - Increase government support for grassroots initiatives enabling Muslim women's participation in social activity.
The Government should increase its support for community-led grassroots initiatives aimed at supporting Muslim women and girls to participate in social activity. (Recommendation, Paragraph 118) 54
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Committee recommendation
48match
#30 - 2nd Report - Transition to State Pension Age
We welcome the Minister’s recognition that the different parts of government—including DWP and the NHS—are ‘in this together.’ As we said in our Pensioner Poverty report, a whole system approach to prevention is needed if the government is to achieve its goal of building a health and social care system that is sustainable for future generations. (Conclusion, Paragraph...
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terms: prevention
PFD report
45match
Mohan Acharya
Emergency department crowding is a significant risk factor associated with increased mortality among admitted patients, contributing to approximately 500 deaths annually.
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Committee recommendation
45match
#34 - 3rd Report – Food and Weight Management: Fixing the food environment
Throughout our inquiry we have seen examples where time and time again policy that has been designed to protect and improve children’s health and the health of the population is delayed or diluted in the face of threats from the food industry about the impact on food prices, jobs or the economy. Governments have consistently chosen to put...
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Committee recommendation
45match
#33 - 3rd Report – Food and Weight Management: Fixing the food environment
A more strategic and holistic view of food policy that seeks to improve the healthiness of food and the food environment is needed. The government should either extend the scope of existing regulation or create new regulation to ensure that the prominence and promotion of HFSS foods is reduced across all food retailers and not only supermarkets. It...
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Committee recommendation
45match
#32 - 3rd Report – Food and Weight Management: Fixing the food environment
The current regulatory framework does not create a level playing field across all settings where food is purchased, largely ignores the out-of-home sector, has a blind spot around delivery apps and is littered with loopholes that ultimately undermine the intended health improvement outcomes from these policies. We are concerned by insufficient thinking about the role that the out-of-home...
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Committee recommendation
45match
#31 - 3rd Report – Food and Weight Management: Fixing the food environment
The Food Standards Agency’s role should be expanded to cover the healthiness of food, as well as food safety. It should report to Parliament on progress towards healthier food production and on meeting targets for healthy food sales. This expanded role should be accompanied by additional funding and staff. (Recommendation, Paragraph 136)
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Committee recommendation
45match
#27 - 3rd Report – Food and Weight Management: Fixing the food environment
The Food (Promotion and Placement) (England) Regulations 2021 should be updated no later than January 2027 to: a. include a requirement to place fruits and vegetables in prominent instore locations like checkouts and store entrances; and b. extend the definition of a prominent location on a website to include ‘special offers’ pages. (Recommendation, Paragraph 123) Prioritising health in...
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Committee recommendation
45match
#25 - 3rd Report – Food and Weight Management: Fixing the food environment
Existing regulation could be better used to play a more active role in building healthier retail environments. While we are encouraged that changing shop layouts is one of the government’s suggested ways of achieving healthier sales, given there will likely be some time before the healthy sales targets are set, action should be taken now. (Conclusion, Paragraph 121)
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Committee recommendation
45match
#22 - 3rd Report – Food and Weight Management: Fixing the food environment
Advertising methods are changing quickly, with the rising prominence of social media advertising, digital advertising, sport sponsorship, online gaming and direct marketing through app notification. Existing regulations do not adequately address these forms of advertising. Further delay to strengthening restrictions must be avoided. Given it took nearly five years from announcing to implementing the policy to ban HFSS,...
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Committee recommendation
45match
#21 - 3rd Report – Food and Weight Management: Fixing the food environment
The evidence is clear: advertising impacts on the consumption of HFSS foods. The government has already accepted this to some degree given the action already taken to restrict exposure to HFSS advertising, but it must be bolder. Its current approach leaves the majority of advertising untouched and undermines the intention of restricting exposure. No effort has also been...
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Committee recommendation
45match
#20 - 3rd Report – Food and Weight Management: Fixing the food environment
Working with the Office for Health Improvement and Disparities and directors of public health, we call on the government to: a. develop clearer definitions for the terms “hot food takeaway”, “fast- food outlet” and “reasonable walking distance” and develop guidance and provide practical support for local authorities to identify areas with high volumes of unhealthy food outlets and...
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Committee recommendation
45match
#3 - 3rd Report – Food and Weight Management: Fixing the food environment
The government should also commit to regularly reviewing and updating the nutrient profile model so that we do not go another 22 years, or more, between updates. Reviewing and implementing an updated nutrient profiling model on a 10-year cycle would strike a sensible balance between reflecting evolving scientific advice and providing certainty to industry. (Recommendation, Paragraph 15)
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Committee recommendation
45match
#6 - Ensure greater NHSE funding for community services, preventing redirection to hospitals.
NHSE’s long-held ambition to move more care from hospitals to the community has stalled. There would have been more investment and progress in mental health and community services, particularly GP surgeries and dental services, in 2023–24 had NHSE not redirected funding to prop up the day-to-day spending of local NHS systems. Despite carrying out 15% more elective activity...
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Committee recommendation
45match
#14 - Fund urgent research into FGM reconstructive surgery effectiveness, with NHS provision if proven beneficial.
The Government should facilitate and fund research into the effectiveness of reconstructive surgery for FGM survivors as a matter of priority. If evidence indicates that the surgery is effective, then the NHS should provide it. (Recommendation, Paragraph 44) Estimating the prevalence of FGM
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Committee recommendation
45match
#73 - Refocus High Needs Block funding towards early intervention and identification in mainstream settings.
The High Needs Block should be refocused to enable and incentivise earlier intervention. Currently, a significant proportion of this funding is directed towards supporting high-cost, specialist provision once needs have escalated. While such provision is vital for some, a more preventative approach is needed to reduce long-term need and improve outcomes. Redirecting a greater share of High Needs...
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Committee recommendation
44match
#13 - 3rd Report: Building more social housing
It is time for the Government to invest so the country can build 90,000 social rent homes a year. We appreciate that even with the funding we set out below, any programme will take time to scale up, but we expect the Government should be able to increase delivery to 90,000 within five years.
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Inquiry recommendation
41match
MAI-98 - Extend first aid education in National Curriculum
The Department for Education should consider extending the National Curriculum to ensure that pupils, once of an appropriate age, receive education in all first responder interventions.
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Committee recommendation
41match
#28 - 3rd Report – Food and Weight Management: Fixing the food environment
Policies to support a reduction in the consumption of HFSS foods stand no chance of success if they are not strongly enforced. Businesses need to be clear that there will be consequence for failing to meet their legal requirements to create healthier environments in their stores. (Conclusion, Paragraph 133) 57
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Committee recommendation
41match
#26 - 3rd Report – Food and Weight Management: Fixing the food environment
It is concerning that HFSS foods continue to feature prominently on pages on retailer websites that are not covered by existing regulations, particularly special offers pages. We know that price is a driver of shopping habits and so believe that special offers pages should be included as an example of a ‘prominent’ location online. (Conclusion, Paragraph 122)
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Committee recommendation
41match
#24 - 3rd Report – Food and Weight Management: Fixing the food environment
A holistic, consistent and watertight approach to restricting the exposure of children to all HFSS advertising needs to be developed. It should include: 56 a. bringing brand and range advertising into the scope of existing regulations as soon as possible and certainly not waiting for the five- year implementation period to gather evidence on this: evidence is already...
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Committee recommendation
41match
#23 - 3rd Report – Food and Weight Management: Fixing the food environment
On a local level, some local authorities are working hard to improve their own food environment through bans to outdoor advertising, but they are severely limited due to only being able to target council-owned assets. To ensure a consistent approach, to address the fact that areas of higher deprivation have a higher prevalence of outdoor advertising and to...
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