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Priority 4: Supporting the development of a sustainable health and care system focused on prevention and early intervention

Introduction

We have a national leadership role, supported by using information and evidence, when developing public health strategies and working in partnership with NHS Wales and communities on public health activities. The health and care system is working together to make sure healthcare is sustainable and fit for current and future generations. Our approach will reflect evidence-based prevention activity and action.

The ambition of A Healthier Wales is for everyone to have long, healthy, happy lives, and to set out how the health and social-care system will work together to deliver sustainable healthcare. Sustainable healthcare is high-quality care that does not damage the environment, is affordable now and in the future, and has a positive effect on society. Our work includes moving services out of hospital into communities and having more services which detect illness or prevent it altogether. This will include helping people manage their own health and long-term illnesses. It will also make it easier for people to remain active and independent in their homes and communities.
 

Overview - why this is a priority

More people in Wales are living longer and needing more health and social care than before, but resources are stretched. An ageing population, inequalities in health and health outcomes, and the consequences of the Covid-19 pandemic have resulted in huge pressures on the health and care system. This is having a significant effect on patients and their families, relating to access to treatment, waiting times and overall outcomes. These issues are likely to be further affected by other immediate pressures, such as the cost-of-living crisis, which will further widen the gap between the better-off and the less well-off. As part of the recovery from Covid-19, we have an opportunity to support physical developments and improvements, particularly in relation to secondary prevention.

Current pressures within the NHS and social care are having a significant effect on health outcomes and raising questions about the long-term future of the whole system. While there are several immediate pressures, it is still extremely important that we focus on prevention, early intervention and health equity to develop care that meets people’s current and future health needs, reduces harm and improves outcomes. 

We have a key role in supporting the health and care system to develop detailed care plans which focus on good outcomes. We will work with key partners to co-ordinate efforts across the system. We learned a lot from the pandemic about future infectious diseases and how healthcare agencies are able to work together to meet healthcare challenges. We will build on this to make sure we work together to achieve fair health outcomes for people. There is significant evidence of the benefits of primary and secondary prevention in relation to reducing the incidence of disease and dying from disease, including many cancers and cardiovascular disease.

Our aim is to prioritise resources to get the best possible benefits of healthcare for people in Wales, making sure we meet the needs of individuals and groups and focus on reducing health inequalities. We can improve people’s health by preventing and detecting disease early or improving health-related outcomes through using effective interventions or treatments.
 

What this priority covers

This priority is central to our role in shifting the balance of our health and care system in Wales to focus on prevention, early intervention and health equity in order to improve people’s health. We will:

  • have a leadership role in working with NHS Wales and care agencies to support public health, with a particular focus on evidence-based preventative measures  
  • have a clear role in healthcare public health locally and nationally, through developing a Public Health Wales Framework for Health Care Public Health with key stakeholders
  • help lead the way in co-ordinating and supporting how prevention, early intervention and health equity are transformed throughout the whole system 
  • promote ways to better understand our population and use impact assessments to identify ‘at risk’ groups to help see how to deliver the most effective interventions, particularly with secondary prevention
  • identify vulnerable people, marginalised groups and local health inequalities, advise people on how to meet their healthcare needs and apply these principles to healthcare services we directly provide, for example screening programmes and
  • lead and support the healthcare system in Wales to use its role to influence and affect health and well-being.

We will support our partners by assessing and planning the health needs of certain groups. This will include considering the effect of taking a preventative approach to include primary, secondary and tertiary prevention.

We will also provide and co-ordinate resources with the aim of making sure everyone in Wales now and in the future has access to effective and efficient healthcare that meets their needs. This will support the wider system in understanding health and well-being in Wales, centred around reducing death and disease. We will also make sure there is a consistent approach to collecting and sharing information nationally, including information about health behaviours, patients, clinicians and the wider workforce.

We will support a framework for reducing health inequalities which can be used consistently across Wales to deal with the differences in care plans (for example, through audits). This will maintain the quality of patients’ experience, safety and outcomes. It will also make sure we use resources efficiently, through setting priorities, reviewing options and assessing our effectiveness.

We will also support the transformation of primary care (healthcare services in the community, such as GPs, dentists and so on). By leading the way on this in Wales, we can make sure that improvements in healthcare public health and people’s health, and in reducing inequalities can guide wider primary-care reform. We will also help lead the NHS Wales Safeguarding Network, focusing on the use of quality improvement approaches, while learning together with NHS Wales.
 

Objectives

By 2035, we will have:

  • supported the system to shift the balance of health and care towards prevention, early intervention and equity
  • made the most of opportunities to prevent disease through focusing on secondary prevention and making every contact with patients count, and making sure resources are allocated fairly
  • supported moving care closer to home, making sure it is centred on the person
  • provided information, analysis, research and evaluation evidence to improve the health and well-being of people in Wales and tackle health inequalities and
  • supported our partners to use the whole of the healthcare system to positively influence the health and well-being of communities.