• Focus on prevention will mean greater emphasis on primary care
  • Attention must shift from treating a single disease to promoting the health of the whole individual
  • Targeted interventions to promote smoking cessation will be a major focus for acute hospital staff

Primary and community care’s share of the NHS England budget will rise in the long-term plan, health and social care secretary Matt Hancock announced today.

The NHS must focus on prevention and so it must put greater emphasis on primary and community care, Mr Hancock said.

“Our focus must shift from treating single acute illnesses to promoting the health of the whole individual, and from prevention across the population as a whole to targeted, predictive prevention,” he told a conference of the world’s public health officials in central London.

“We must see the proportion of funding on primary and community care in the NHS rise. That is exactly what will happen in the long-term plan,” he said.

He said the acute sector contributes “around a quarter of what leads to a longer, healthier life” yet “we spend the overwhelming majority of the £115bn NHS budget on acute care”.

He added: “Last year, we spent just £11bn on primary care where the bulk of prevention happens.”

Mr Hancock identified smoking cessation as an area where acute sector staff will be able to make “highly-targeted interventions”.

“We know smoking contributes to 4 per cent of hospital admissions in England each year. And smoking costs the NHS around £2.5bn annually,” he said. “If someone is admitted as a heart patient and we know that stopping smoking could save their life, then we will do everything we can to help them quit.”

He cited as inspiration a programme run in Ottawa, Canada, since 2002, which involves patients’ smoking status being recorded on admission. “Smokers who are patients are offered medication, behavioural support and follow-up checks when they go home,” Mr Hancock explained.

This kind of intervention is the next step to making the UK a smoke-free society, he added.

This echoed a call for the NHS to do more on smoking cessation made by Duncan Selbie, chief executive of Public Health England.

He told HSJ in September that NHS England and NHS Improvement should set a tariff in all relevant clinical pathways to help people quit smoking because hospitals treat the effect of smoking but do “very little when they’ve got someone in a hospital bed” to help them stop.