The NHS will become an ‘activist agent’ of social change in a ‘radical upgrade’ of prevention and public health, under plans announced today.

The approach is outlined in The NHS Five Year Forward View, which sets out NHS leaders’ collective view on how the service will tackle rising demand and funding constraints.

The document says the health service has been “prone to operating a ‘factory’ model of care and repair” with “underdeveloped advocacy and action on the broader influencers of health and wellbeing”.

In future, it says, the NHS will support “hard hitting” advocacy on public health, and back stronger public health related powers for councils and elected mayors.

“The first argument we make in this forward view is that the future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain, all now depend on a radical upgrade in prevention and public health,” it said.

The forward view warns that without a greater focus on prevention, “recent progress in healthy life expectancies will stall, health inequalities will widen, and our ability to fund beneficial new treatments will be crowded out by the need to spend billions of pounds on wholly avoidable illness”.

Lady smoking

The NHS will carry out more ‘hard hitting’ advocacy on public health in future

The document added: “While the health service certainly can’t do everything that’s needed by itself, it can and should now become a more activist agent of health related social change.”

Councils and elected mayors could “make an important impact” on improving public health, it says.

It praised London Borough of Barking and Dagenham Council for working to limit junk food outlets near schools, and said the NHS agrees with the Local Government Association that “English mayors and local authorities should be granted enhanced powers to allow local democratic decisions on public health policy that go further and faster than prevailing national law – on alcohol, fast food, tobacco and other issues that affect physical and mental health”.

It also supported a controversial proposal by the LGA to give volunteers within health and social care a 10 per cent discount on their council tax bill. It called for a broader role for the health service to help people “get in and stay in employment”. This could involve offering “targeted support” to keep people in work.

The health service would seek to improve access to care for “at risk” individuals in a programme that would see the Department for Work and Pensions save “downstream” costs “if money can be reinvested across programmes”, the forward view said.

Another proposal would see the NHS develop new “workplace incentives” to improve employees’ health.