The preventative healthcare opportunity and the role of outcomes-focused health PR
A recent report by the Office for Health Economics showed that investing in public health prevention can be 3-4 times more cost-effective than investing in treatment - highlighting the enormous value of public health campaigns and preventative healthcare products and services.
Currently, only 5% of total NHS funding is allocated to preventative care and, given the fact that new figures from the British Medical Association show that the treatment waiting list has now grown to 7.75m, that is unlikely to change any time soon. That’s despite the fact that a systematic review found that prevention delivers a median ROI of 14:1.
The report outlines four gaps contributing to the missed opportunities and many of these could be tackled through effective healthcare PR strategies.
1. There is low uptake of existing programmes such as the NHS Health Check.
Only 4 in 10 people who were eligible for the NHS Health Check accessed it between 2015-20. That could be the result of low interest among patients and/or less than optimum communication nationally, or by individual practices or local authorities.
Communicating in a way that triggers action is not easy but, as a healthcare PR agency that is focused on delivering tangible outcomes, at Evergreen PR we have developed the MERTO framework to increase certainty of objectives being achieved. What’s more, we believe that anyone can use the principles of MERTO to trigger behaviour change in priority audiences.
The success of any programme, including the NHS Health Check, usually requires actions to be taken by a wide variety of audience groups and stakeholders. At first it may appear that the only audience that matters for the NHS Health Check is the one that it is aimed at - people aged 40-74 without pre-existing conditions.
However, in order to more fully engage that group, a number of other stakeholders might need to be activated - including, potentially, GP practice staff, local authority staff, NHS Trusts, national and regional media, community groups and many more. Each will have their own behavioural barriers and drivers and own external context, for example processes and procedures that they need to follow.
The skill lies in taking all of this into account and using data, knowledge and experience to identify the priorities in terms of audiences, messages and activities that will drive the action that you want to see. This is prioritisation and behaviour science in action.
In a previous role at a commercial lifestyle company, I worked alongside Government to drive tens of thousands of people to sign-up to behaviour change interventions and, at Evergreen PR, we have triggered action at-scale, for example engaging 140,000 people to sign a petition for more funding for research into tinnitus.
2. Capacity to deliver the stated preventative ambitions is insufficient
The example given in the OHA report is the NHS Diabetes Prevention Programme (DPP), which has been shown to reduce the chances of developing diabetes by 37% and is highly cost-effective, but currently it is only being accessed by a relatively small proportion of the people that would benefit from it.
While the OHA puts this low engagement down to capacity challenges, the evidence in the report is unclear and our experience is that it is more of an issue of lack of public uptake than lack of capacity, as many NHS Trusts have confirmed that they want to increase engagement with the NDPP but don’t know how to do it.
To that end, we supported our client, Meddbase, to communicate the results of a pilot study that showed how their clinical software increased engagement in the NDPP.
The campaign was a a huge success, generating widespread media coverage from the likes of Digital Health, National Health Executive, Pulse and GP online, securing a big spike in website visitors and triggering more than 100 organic sign-ups to an educational webinar. Most importantly, new NHS Integrated Care Board customers were secured, with ICBs wanting to follow a similar approach to the pilot in order to increase engagement with this proven programme in their region.
If there is indeed a capacity problem, then of course a different approach will be needed. The Government Communications Service says that when there isn’t the ‘opportunity’ for people to enact the desired behaviour, communicators have two choices - shift the target behaviour or shift the target audience.
Different organisations might select different options here to tackle the access challenge, for example health charities and campaigning groups might reduce attempts to engage the public and instead focus on communicating with the Government, with the goal of securing more investment into the service. Alternatively, a change to the target behaviour might be to encourage people to sign-up to a preventative health-focused app that has evidence that it drives similar behaviour changes to those achieved by the NDPP.
3. Investment is focused on short term goals
This identifies that, sadly, the political system encourages ‘chronic short-term-ism’, which inhibits our ability to make long-term changes.
In re-imagining prevention, OHA calls for prevention to be elevated above short-term political cycles to a position where all parties accept that programmes initiated now may reap benefits under successive governments. It also suggests the idea of social impact bonds, which could be purchased by financial institutions or charities to fund proven interventions.
These are noble suggestions but, in the meantime, the points made highlight the huge importance of health charities and purpose-driven healthcare organisations in continuing to invest in public health campaigns that provide high-quality evidence-based advice to the general public.
By demonstrating their meaningful social contribution and how they are plugging ‘a gap’ with their public health campaigns, cash-strapped charities may be more likely to secure much needed partnerships and investments that enable them to continue and expand their great work.
4. Prevention is underfunded
This final point identifies the substantial gap between the stated importance of prevention and the reality of the funding it receives.
It is several years since the Government published its ‘prevention in the 2020s’ report, but the reality is that the public health grant has been cut by more than a quarter in real-terms since 2015/16.
One of our clients, the Personalised Care Institute, does great work in supporting the prevention agenda by educating health and care professionals on how to provide personalised care that gives individuals more choice and control over their health. Thanks to their training of tens of thousands of health and care professionals, more and more patients are learning to manage their own health. We have found that campaigns that connect to real issues, such as our recent Money Talk activity, attract and convert the highest number of learners.
To solve the problem though, it is clear that we do need greater investment in public health campaigns. Perhaps additional funds could be secured from Government through continued campaigns and evidence reports like this one from OHA - or like the Tinnitus Manifesto campaign we delivered for Tinnitus UK, which led to the Government recognising the need to invest more money into tinnitus research. Certainly this would increase awareness of its importance. Campaigns could come from a range of stakeholders, including cause-led charities and tech-based lifestyle interventions that have data to prove the positive impact that can be achieved by engaging people in prevention. In the meantime, these stakeholders might perhaps partner to pool resources and influence for mutual benefit.
As the report states, there is “substantial scope for stakeholder groups to take meaningful steps to advance the prevention agenda”. Here at Evergreen PR, we’d be delighted to support organisations who want to make a meaningful contribution to this debate, with the goal of driving tangible change.
Do you represent a health charity, NHS Trust or lifestyle-based preventative health product? Do you want to increase the focus on prevention in order to transform health outcomes for the better? If so, we’d love to help! Contact me (Leigh) on 0114 437 2487 or email leigh@evergreenpr.co.uk for a free consultation.
Leigh Greenwood Chart.PR is the founder and managing director of Evergreen PR, the healthcare PR agency that drives tangible outcomes.