Co-creating preventative healthcare

Co-creating preventative healthcare: who's responsible for keeping Britain healthy?

“The decade of proactive, predictive, and personalised prevention” – that’s the bold headline of a new government consultation setting out a vision for British healthcare in the 2020s.

Covering everything from smart models that calculate risk based on genomics to the idea of being ‘co-creators’ in our own healthcare, it’s an innovative vision that has the potential to make a real difference to population health.

It goes far beyond treating physical illness, encompassing mental health prevention and choosing to proactively monitor national health through a regular index alongside more traditional measures like GDP.

It’s inspirational stuff, but it leaves you with one fundamental question: how?

How can an NHS already burdened with treating chronic conditions and supporting an ageing population possibly have the capacity to deliver ‘intelligent public health’ that’s focused on prevention? How can it deliver this blue-sky strategy alongside an already stretching long-term plan for prevention?

The short answer is it can’t do it alone. Just as the report looks to patients to be ‘co-creators’ in their own care, it’s also an opportunity for employers to step up.

For many, the idea of your employer being involved in your health is an uncomfortable one. We’re used to a transactional relationship centred on illness: employers only know when something goes wrong in the form of sick days and absence notes.

But if we challenge that perspective and start to look at healthcare from a preventative angle, it becomes obvious that employers not only could, but should be involved in improving our health as a nation.

After all, we spend a significant portion of our lives at work - over 82,000 hours in a lifetime. For office workers, much of that time is sat sedentary at a desk, leading to musculoskeletal, heart, weight and overall health issues.

From the physical infrastructure of an office to organisational culture, companies not only have a responsibility, but the means and motivation to get involved with creating a healthier nation. It makes good business sense.

A recent report by John Lewis Partnership and the Centre for Economics and Business Research (Cebr) forecasts that by 2025, the cost in lost productivity and absenteeism will rise to £2,605 per employee, per year.

It affects some businesses more than others, particularly when it comes to location. Research by the Northern Health Science Alliance found that there’s a staggering £4 gap in productivity per-person per-hour in the North compared to the rest of England; £1.20 of this is attributable to poor health.

It’s clear that there’s a real cost to ignoring healthcare at work. But if the link between health and productivity is so clear, why don’t more businesses invest in wellbeing?

There are some practical barriers. On top of the upfront costs, under current legislation employer-provided health services are a taxable benefit, subject to Income Tax and National Insurance.

Beyond removing this tax disincentive, why not take it one step further? For other initiatives that help improve employee health, like the cycle to work scheme, or boost the economy, like R&D credits, companies can offset these costs against their corporation tax.

It may seem unusual to talk about R&D credits and wellbeing in the same sentence, but when it comes to economic impact we can’t underestimate how much ignoring employee health is costing us.

As a country, sick days cost us £77.5 billion each year. To put that in context, the direct Gross Value Added (GVA) of life sciences, aerospace and clean energy – some of the most R&D intense sectors - to the UK economy stood at £30bn in 2017, projected to grow to £44bn by 2025.

It’s a serious problem that fundamentally affects businesses of all sizes. With SMEs accounting for 99.9% of all businesses and providing 60% of all private sector employment in the UK, minimising financial barriers and even providing an incentive to invest in preventative healthcare opens up the opportunity for the majority of businesses across the UK to play a role, rather than a select few.

There are often internal company barriers too. Business leaders have a major role to play in making the case for investing in proactive healthcare interventions, in challenging the stereotype of wellbeing as a ‘nice to have’.

A look at the evidence shows the numbers do add up when it comes to wellbeing. In many cases, initiatives even pay for themselves: research by Deloitte found that the average ROI of workplace mental health intervention is £4.20 for every £1 spent. Wellbeing pays.

Proactively investing in a healthier workforce creates a more productive nation – something we’re in dire need of; not only is the UK lagging behind, but our productivity as a nation is in decline.

To stay competitive at both a business level and a national level, we have to acknowledge the link between productivity and health and start thinking differently about the roles we all play.

This government consultation recognises that it’s not a change in system we need, it’s a change in mindset. It’s a proactive approach with a shared sense of responsibility so that we all feel invested in and empowered to take control of our own health.

It’s an ambitious vision, but it’s not an impossible one. Beyond calling on the general public to become ‘co-creators’, inviting and allowing businesses to play a role in preventative healthcare allows us to reach more people, increasing the chances of this vision becoming a reality with the promise of very real benefits for the economy and society.

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