The Shift to Prevention: Proactive Health Models

One of the pitches The Rt Hon Wes Streeting made was in regard to prevention: a change from reactive care in acute settings to preventative care that would elevate the health of the UK population, and in the process reduce the volume of hospital attendance and the length of hospital stays. 

Fast-forward to July 2025 and we have a new NHS 10-Year Plan. Titled ‘Fit for the Future’, the plan proposes three key shifts in existing NHS strategy:

1. A move from Hospital to Community
2. A push from Analogue to Digital 
3. The change from Sickness to Prevention  

We’ve already produced an article on why prevention must take priority, so in this article we will look at this shift to prevention and detail the 10-Year Plan and what it says, the importance of public health and the responsibility of government to ensure it, as well as the benefits of preventative care measures and early intervention. We will also explore these new proactive health models and see what the UK government intends for the NHS, and how these models might be implemented.

The NHS 10 Year Plan is exactly what the name says: it is an operational strategy set out by government for how the UK’s National Health Service can best work to deliver the most quality care, but also the best value for money. 

Many governments have set out plans such as this, so the current Labour government aren’t breaking any new ground, but each administration has their own vision and understanding of how the NHS works and should work. 

With this in mind, Labour has set out three points – the ones mentioned in our introduction. They want a move from hospital to community care (to tackle overcrowding and delays), to shift from analogue reporting to digital logs (to optimise workflows, reduce admin burden, and to improve data accuracy), and to change the culture of the NHS from treating sickness to preventing it. 

Labour’s plan was, in part, guided by the Darzi report on the NHS; an independent investigation commissioned by the new Labour government for an assessment of the service – strengths and failures – so that they may plan how to improve going forwards. Lord Darzi, a former health minister, surgeon, and independent peer, was chosen to lead the investigation. 

Speaking about their plans, Prime Minister Sir Keir Starmer said: “The NHS should be there for everyone, whenever they need it. 

"But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future. 

"That ends now. Because it's reform or die." 

There are three types of preventative care that the government can introduce as part of its NHS reforms and the 10-Year Plan.  

1) Primary Prevention 

Primary preventive care is the most obvious and well-known of the three. It is where action is taken to stop a problem from happening. For example, if you prevent an infectious disease like polio, you can prevent it from happening and even fully eradicate it in time. 

By improving living conditions and working conditions, and reducing risks in other lifestyle aspects, the NHS can mitigate a sizeable amount of healthcare delivery.  

2) Secondary Prevention 

Secondary preventive care is more focused on early detection, leading to earlier interventions and earlier treatment than might ordinarily have occurred. This quite clearly would be beneficial to patients but requires support structures in place to deliver.  

Public Health Scotland’s article on the three levels of prevention explains how screening services for breast, bowel or cervical cancer are examples of secondary prevention, as are HIV testing services, early years health visitor checks, and even things such as prescribing statins to reduce cholesterol.  

It should be noted that in the 10-Year Plan, the government’s exploration of preventative care does detail the nation’s problem with obesity and the “moonshot” required to address the problem and benefit the public workforce. The report states that “In the past 30 years, obesity rates have doubled, and it is a leading cause of cancer, cardiovascular disease and type 2 diabetes. Around 1 in 5 children leave primary school with obesity – rising to nearly 30% among those living in the most deprived parts of the country.” 

It goes on to state that food choices – whilst sometimes individual – are impacted by the environment around us. This is especially true with children, so the 10-Year Plan proposes stricter advertising restrictions regarding unhealthy food and drink, restoration of the Healthy Start Scheme, and a new NHS Digital Weight Management Programme. Most notably it hints at wider usage of weight loss medication, adding “we will need to harness scientific innovation”.  

This last part leads on elsewhere too. The government refers to genomics and using it in combination with AI and predictive analytics. It might sound a bit like the movie ‘Gattaca’, but we already have genetic detection principles in place to test cells and blood. This is just a natural evolution and enhancement of said medical science and should provide a greater ability to pre-empt what the NHS needs to be focused on.   

3) Tertiary Prevention 

The last of the three types of preventive action is, unsurprisingly, tertiary prevention. This is the notion that micro-management actions can minimise the harmful impact of a problem. 

Again, using the NHS Scotland website for their examples, they refer to things like foot care for those with diabetes, or rehab for stroke victims.  

NHS prevention to-date: 

The 10 Year Plan says that the NHS has “too often been fatalistic about its role in prevention.” That’s quite a stern self-appraisal, and perhaps a good indication that this new plan – for all its complexities and the fact that it will take years to see measurable results – is not short-sighted or ignorant. 

The report details that over the course of the past decade, NHS spending on prevention has, for all intents and purposes, been cut in real terms by 28% per person. However, it goes on to promise more vaccinations, screenings, and early diagnosis through the course of this new plan, and a greater level of genomics for the population to hone predictive sciences and optimise care delivery.  

“While primary prevention and action on the social determinants of health is how we will bend the NHS’ cost curve in the long run, it will be secondary prevention that achieves NHS financial sustainability in the short term.” 

There’s an inherent logic that early intervention in healthcare can save money by avoiding increased severity of conditions, or by reducing the duration of treatment required. Whilst critics might argue about the cost factor, the adage “you’ve got to spend money to make money” is applicable here. 

An example of this comes from a news article on the Oxford Health NHS Foundation Trust website, which states that “early intervention services can save NHS millions”. Professor Belinda Lennox is a consultant psychiatrist at Oxford Health and works in the Department of Psychiatry at Oxford University. She led a study into early innovation back in 2016, which was subsequently published in the British Medical Journal. Their research from the Thames Valley area revealed that early community intervention to tackle psychosis could lead to an estimated £63 million in savings for the UK economy – with £33.5 million of that coming from the NHS budget alone based on savings estimates of £4,031 per patient, per year. 

Professor Lennox said: “We have now shown that each person treated in an early intervention service is twice as likely to become employed and 50% more likely to go into stable housing, compared to people with early psychosis who are treated in other services.”  

The charity Mind of My Own also has a piece on cost savings from early intervention. Figures also cited from 2016 at the Early Intervention Foundation point to £17 billion being wasted on late intervention in children’s services. More recent figures from 2021/22 show an increase in local government spending on these children’s services by £800 million – presumably per year – but notably 80% of that figure (£640m) was focused on late intervention; things like foster care or residential care. 

The organisation has this to say on early intervention: “While everyone likes to save money, at Mind of My Own we believe in early intervention because it reduces the social and emotional costs for children and young people. Life chances are significantly better for those whose issues and problems are prevented from reaching crisis point and that is one of the reasons why we build our digital tools.” 

When the government talks about broader societal benefits, these are the kinds of examples they mean. They want a more productive economy, and by engaging earlier in this scenario, adults can go from suffering with psychosis to being back in work and back in reliable housing. Children can go from crisis point to being happy in their physical and mental development and become fully functioning adults with a part to play in wider society. That’s a huge turnaround, not just in the sense of productivity, but in giving people their lives back and giving them the independence and capacity to be an active participant in society.

This brings us to the key part of our article: proactive healthcare models. These are the new frameworks that the government will need to introduce to determine how NHS services are organised, delivered, and financed. 

Integrated Care is likely to be the main existing model that is adapted to accommodate the new desire to pursue greater early intervention and preventive care principles, but it’s still early days.  

Social prescribing and technology-enabled care (TEC) are two other tools already helping to lay the groundwork for more proactive models. Social prescribing connects individuals to non-medical support in their communities, addressing wider determinants of health like housing, debt, and loneliness before they escalate into clinical issues. Meanwhile, TEC supports people with long-term conditions to live independently at home, enabling earlier intervention and reducing pressure on acute services. 

A recent seminar held by the Professional Records Standards Body (PRSB) titled ‘How can we move from illness to prevention?’ saw Sarah Arnold, Senior Policy Lead at The King’s Fund flag this very issue. To paraphrase, Ms Arnold praised the ambition of the vision set out in the new 10-Year Plan, but urged caution until further information was given about who takes the lead on the delivery or execution of said services.  

At present, there’s very little information in regard to who has the authority and who will be handling the budgets to deliver Labour’s ambitions, and until this is established, it will be difficult to appraise the healthcare model(s) the NHS will turn to.

As we discussed in the earlier segment on early intervention, prevention saves lives and saves money. It also builds trust: both in the NHS and the elected government.  

For the NHS, preventive care shows that they are alert to the dangers and challenges facing the British public. The healthcare system is aware that there are benefits to early intervention both financially and in sparing people hardship. 

For the government, preventive care shows that they are delivering on manifesto pledges. NHS performance is a big part of why the Labour government was elected, and it’ll be a big part in whether they stay in office for a second term in four years’ time. Sir Keir Starmer and Health Secretary Wes Streeting will be desperate for preventative measures to come into place to help curb the amount of pressure on GP surgeries or A&E departments. If they can show a reduction in demand or time spent in these places, they earn votes at an election.  

We end with this from Joanna Seymour, the Director of Partnerships and Development at Warm Wales. They are Wales’ oldest community interest company (CIC), with a primary focus on fuel poverty but a broader remit to promote preventive care across Wales to deliver savings for NHS Wales and financial gains to the Welsh economy. 

Joanna penned this back in December 2024 for The Access Group, neatly summing up why prevention is the key to wellbeing. 

“Prevention is not just a strategy; it’s an imperative. If we continue to address housing, income, and other social determinants as integral parts of health and wellbeing conversations, we can reduce health inequalities and secure a healthier future for all.”