Making the economic case for prevention

In this Public Health Matters blog, John Newton and Brian Ferguson explore the economic case for prevention, acknowledging that more than ever before, ‘public health’ has to make the strongest possible economic case for what it does.

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Public health interventions may offer society a return on investment of £14 for each £1 spent

Each £1 invested in public health interventions could offer an average return on investment to the wider health and social care economy of £14 | NIHR Signal

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This systematic review looked at 52 studies where the return on each £1 ranged from -£21.3 to £221. Legislative interventions such as sugar taxes, and health protection interventions such as vaccination programmes, gave the highest returns on investment. Interventions such as anti-stigma campaigns, blood pressure monitoring and early education programmes, provided smaller (but still favourable) returns. National campaigns offered greater returns than local campaigns. Falls prevention provided the quickest return, within 18 months.

These findings apply to high-income countries. There are some limitations to the data, as a variety of calculation techniques were used and the quality of the included studies varied. However, these are unlikely to alter the direction or approximate size of these effects. The study shows how cost-effective public health interventions can be and should inspire future research into how to better implement what is already known.

Big cuts planned to public health budgets

Plans to cut public health budgets by £85m this year ‘self-defeating’ | story via Kings Fund

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Public health services such as sexual health clinics and services reducing harm from smoking, alcohol and drugs are to be cut by £85m this year by local authorities, despite having their budgets severely reduced in recent times, new research has found.

In findings released by the King’s Fund which analysed Department of Communities and Local Government data, it was revealed that councils in England were planning to spend £3.4bn on public health services in 2017-18.

However, on a like-for-like basis excluding the impact of changes to how budgets are calculated over different years, councils will only spend £2.52bn on public health in 2017-18 compared to £2.60bn last year.

Once inflation is factored in, the King’s Fund experts also discovered that public health spending is more than 5% less in 2017-18 than it was four years ago, in 2013-14.

Full story at The Kings Fund

Related: Kings Fund blog: Chickens coming home to roost: local government public health budgets for 2017/18

 

NHS bosses warn of mental health crisis with long waits for treatment

 Report finds 80% fear they cannot provide timely, high-quality care to the growing numbers seeking help | The Guardian

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Image source: The guardian

Mental health services are so overwhelmed by soaring demand that patients are facing long delays to access care, a powerful group of NHS mental health trust bosses have warned.

Widespread shortages of specialist nurses and psychiatrists mean Theresa May’s pledge to tackle the “burning injustice of mental illness” is at risk according to chief executives and chairs from 37 of England’s 53 specialist mental health trusts.

Their concerns are contained in a new report by NHS Providers, which represents almost all of England’s 240 NHS hospital, mental health and ambulance trusts. The report concludes that children, older people and people in a mental health crisis too often receive inadequate care for conditions such as anxiety, depression and eating disorders.

Read the full news story here

Every £1 spent on public health in UK saves average of £14

Every £1.00 spent on public health returns an extra £14 on the original investment, according to a systematic review published in the Journal of Epidemiology & Community Health. | via OnMedica

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Researchers identified 52 suitable studies published over four decades that had calculated a return on investment (ROI) for local and national public health initiatives and/or had worked out the overall value for money of a project or proposal—otherwise known as the cost-benefit ratio, (CBR).

Analysis of the data from these studies showed that the average ROI for a public health initiative was 14.3 for every unit cost spent on it, while the average CBR was 8.3.

When the overall impact of all 29 interventions was assessed, the ROI on local initiatives was 4.1, meaning that every £1 spent returns £4 plus the original £1 investment, while the average CBR was 10.3.  Even larger benefits accrued for national policies. Analysis of the data from these showed that the average ROI was 27.2 while the average CBR was 17.2.

The authors of the research warn that recent cuts made to public health budgets in the UK are therefore a “false economy” and are set to cost an already overstretched NHS and the wider economy “billions”.  They calculate that the recent £200 million cuts to public health funding in the UK will cost more like eight times as much – £1.6 billion.

Full reference: Masters R, Anwar E, Collins B, et al Return on investment of public health interventions: a systematic review Journal of Epidemiology and Community Health, published online first: 29 March 2017

 

Cuts to sexual health services are putting patients at risk, says King’s Fund

Cuts to sexual health services in parts of England are placing the care of patients at risk, a new report has warned.

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The research by the healthcare think tank the King’s Fund concluded that budget cuts of more than 20% to genitourinary medicine (GUM) services in some parts of the country had led to service closures and staffing cuts that have harmed patient care. Experts said that the findings were particularly worrying given that numbers of diagnoses of sexually transmitted infections such as syphilis and gonorrhoea were rising.

Current pressures on services were also having a negative effect on staff morale and leading some staff to consider alternative careers, the report warned.

Problems identified in the Genitourinary medicine services:

  • Public health budgets were cut by £200m (6.7%) in 2015-16

  • Around a quarter of local authorities cut GUM spending by more than 20% between 2013-14 and 2015-16. Around one in seven increased spending by this amount

  • The commissioning of sexual health, reproductive health, and HIV services has been split between local authorities, CCGs, and NHS England, resulting in fragmentation

  • New attendances at clinics rose from 1.6 million in 2011 to over 2.1 million in 2015

“You give a blank sheet of paper to local government to do something really exciting, and then you take the money away”—consultant

Read the full article here

Read the original King’s Fund report here

Smoking cessation services face cuts

Smoking cessation services are being hit as cash-strapped local authorities and Clinical Commissioning Groups (CCGs) look to save money | OnMedica

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Evidence obtained under the Freedom of Information Act by The Observer reveals that an increasing number of CCGs have been instructing GPs to stop providing the services with many CCGs arguing it is no longer their responsibility as local authorities are now responsible for public health.

Local authorities hold a £2.8 billion ring-fenced public health budget but, as the grants have been pared back in other areas, councils have pulled their funding for stop smoking services.

Read the full article here