While things are slowly but steadily improving across the NHS, the healthcare system in the UK is essentially reactive – which is always going to be less efficient and more costly than a preventative approach.
I have long been interested in the pro-active community approach that Brazil adopted in the 1990s. It started with the recognition that good health should be seen as a universal right – meaning that the state had a duty to try and deliver it. The system was inspired by a number of successful local outreach projects – trained members of the community were tasked with reducing hospitalizations by making early healthcare and lifestyle interventions within their communities: vaccinations, prenatal care, nutrition, exercise, health advice and so on.
The idea has been trialled in several places in the UK. Community Health Workers (CHWs) work with GPs and health centres, regularly visiting every household on their patch, building relationships and identifying issues. They help bridge the gap between residents and health services, and focus on preventative care, education, and social support.
The results are startling – deaths from heart attacks and strokes, for example, have reduced by a third, and other key metrics show significant improvements.
The NHS 10-Year Health Plan (Fit for the Future) focuses on shifting care from hospitals to the community and it seem to me that developing this approach might deliver excellent results, especially in a cash-strapped NHS. I’m hoping that we can look again at this model of health/social care and properly incorporate it into our future plans and make good health a right for everyone.
