Prevention - better than cure?

As soon as Dr Adrian Hayter stepped into the role of Medical Director for Clinical Policy at the beginning of the year, he knew he wanted to make preventative medicine a clinical priority.  "Unless we start to tackle the preventative medicine agenda now, we're going to be storing up problems for later," he explains.

Prevention has become a bit of a catch-all term over the years, describing anything that moves the discussion away from more reactive, treatment-based medicine. But Adrian – a GP of 30 years who currently practises in Windsor, and was previously NHS England’s first GP National Clinical Director for older people - thinks of it as being based over the entire life course: "starting well, living well, ageing well and dying well".

He describes prevention as "health promotion", with GPs being "the eyes and ears on the ground" in their communities. As such, he explains they understand the health of their local patient population, their specific needs, and the opportunities that could help improve their health.

“The key point is that GPs have trusted relationships with their patients and are used to treating people holistically,” Adrian says.

He points to examples where preventative medicine has really made an impact: encouraging patients to cut down on smoking or alcohol and to consider losing weight when necessary. But he also cites large scale vaccination programmes, the push for improved cardiovascular health and work on preventing older people from having dangerous falls – and how general practice has had a pivotal role in all these important interventions.

The decision to make Preventative Medicine the College’s clinical priority was made in consultation with its clinical advisor network, with members of the group being asked to recommend areas they feel are under-resourced, under-represented or lacking clinical guidance. It was passed by the College’s governing Council in June.

In Adrian’s view, healthcare should be organised so that it isn’t simply jumping from crisis to crisis, but empowering people to protect their health and the health of future generations. Investment in prevention pays off with savings in the long term, he says, and ‘when people have fewer long-term conditions, they are much more able to join the workforce, which benefits the economy.’