The prevention work streams
18 April 2023
Below are the ten workstreams the Committee will be exploring during its inquiry into prevention in health and social care, with some more information about the proposals that the Committee received relating to these workstreams.
The physical environment was a common theme in proposals received by the Committee: issues raised included housing (64 submissions), the workplace (25 submissions), and town planning (124 submissions). The Committee also received 33 proposals on air quality and air pollution, both outdoors and indoors (factors discussed included poorly ventilated buildings, mould and damp, and carbon monoxide). Proposals on town planning discussed the concept of healthy assets (e.g., leisure centres, open spaces) and hazards (e.g., fast food shops) which are unevenly distributed between the most and least deprived areas. Proposals referenced green and blue spaces (18 submissions) as producing benefits for individuals in terms of fitness and wellbeing, as well as broader community and environmental benefits. Similarly, active travel (16 submissions) – walking and cycling – was cited as having fitness, wellbeing, and environmental benefits, while public transport infrastructure (2 submissions) was mentioned as important for reducing air pollution from car travel.
The Committee received 14 proposals relating to vaccination. The Covid-19 pandemic has demonstrated the importance of vaccines to preventing ill health and to managing pressures on the health service. This workstream presents an opportunity for the Committee to consider what steps need to be taken for the UK to remain at the forefront of global vaccination policy.
Over a third of proposals received by the Committee (209 submissions) mentioned health inequalities in some form, including issues arising from deprivation (79 submissions) as well as disparities by ethnicity (34 submissions), gender (6 submissions), and region (14 submissions). Multiple proposals referred to the fact that a Health Disparities White Paper is no longer expected to be published and raised concerns about whether the Government is doing enough to combat health inequalities. Overall, inequalities and a “whole system” approach – whereby multiple Government departments and organisations play a role in prevention – were a recurring theme throughout submissions, even where they were not a focus.
Mental health and wellbeing
The Committee received 144 proposals on mental health. These covered a wide range of topics, from general wellbeing to specific mental health conditions, although there was not always a clear delineation between the two. Proposals highlighted that there are a wide range of factors that can affect mental health, including sleep, diet, exercise and physical activity and effectively managing stress. This workstream will consider how to promote good mental health and wellbeing, and whether and which interventions at these early stages can prevent mental health conditions from developing.
Healthy eating and obesity
The Committee received a high number of proposals about lifestyle issues (221 submissions), including food (70 submissions) and physical activity (93 submissions). Certain conditions, such as obesity (63 submissions) were noted as being linked to lifestyle factors. Throughout these proposals, there was an emphasis on the need to target interventions at a population-wide level. Many of the population-wide interventions that were suggested related to industry regulation, such as the marketing and advertising of products: for example, cost-related measures such as the Soft Drinks Industry Levy, or public awareness measures such as front-of-pack nutritional labelling on food. In the health service specifically, a number of submissions suggested that social prescribing could play a role in improving access to services and facilities that can play a role in supporting people to live a more healthy lifestyle, such as sports and physical activity facilities.
Alcohol, drugs, gambling and smoking
The Committee received multiple proposals about alcohol (49 submissions), smoking (67 submissions), gambling (18 submissions), and drugs (19 submissions). There was an emphasis in proposals on population-level interventions over those targeted at changing behaviour in individuals. Other issues include the balance between Government-led regulation and local initiatives to help prevent poor health caused by factors such as alcohol, drugs, gambling and smoking; the effectiveness of existing regulation and existing initiatives; and the role of the private sector in preventing harm caused by alcohol, drugs, gambling and smoking.
The Committee received 10 proposals on the role of sexual health services in preventative healthcare. Some made the point that sexual health services, which in many cases have regular engagement with service users, could be used to provide services such as screening for certain conditions, vaccinations, advice, and brief interventions, thereby reducing the pressure on other services.
Early years and childhood
The Committee received 103 proposals relating to children and young people, in addition to 39 proposals on pregnancy and maternity. Proposals advocated a “life course” approach to prevention and referred to childhood as a window for impacting health outcomes in adulthood. They made the point that there was a strong link between children’s health and inequalities, as health disparities often arise early in life and persist into adulthood.
This workstream will complement the Committee’s inquiry on Future Cancer. The Committee received 22 proposals relating to cancer prevention, some of which focused on the prevention of specific cancers, such as cervical cancer and bowel cancer. Screening and early detection were also discussed, as were measures to reduce smoking, obesity, and alcohol consumption.
Prevention of other major conditions
The Committee received 58 proposals that discussed the prevention of particular medical conditions (excluding cancer). The majority of these (15 submissions) discussed cardiovascular disease prevention. It was noted that cardiovascular disease was the leading cause of death globally, but screening, early diagnosis, and upstream interventions can improve outcomes. Other popular topics were diabetes prevention (12 submissions) and respiratory disease prevention (10 submissions).