This week, the iHV has submitted a written response to the Department of Health and Social Care’s Major Conditions Strategy consultation (read the call for evidence here).

The consultation was seeking views and ideas on how to prevent, diagnose, treat and manage the 6 major groups of health conditions that most affect the population in England. These are:

  • cancers
  • cardiovascular disease, including stroke and diabetes
  • chronic respiratory diseases
  • dementia
  • mental ill health
  • musculoskeletal disorders

The views and ideas gathered will inform the priorities and actions in the major conditions strategy.

Our submission focused on the massive untapped potential in the health visiting service, when adequately resourced, to improve short, medium and long-term health outcomes across three critical life stages:

  • Building healthy people– reducing risk factors in preconception, pregnancy and early childhood. Health visitors have a key role to play in harm reduction through their universal work with all families – benefits can be realised in the short-term (for example, by improving preconception support for healthy weight, increasing uptake of folic acid and reducing smoking in pregnancy, providing support for perinatal mental health problems, and reducing the incidence of foetal alcohol spectrum disorders through targeted support). They also provide guidance on immunisations, contraception and pregnancy spacing and will be central to the national plans to improve health through genomics.
  • Being a child – for babies/children to be seen as citizens in their own right, in line with the WHO Nurturing Care Framework. Preventing, identifying and treating problems in childhood can avoid them escalating. Health visitors work with families to promote health in childhood and also play a key role in the identification of babies and young children with underlying health conditions, developmental delay and disabilities. They support parents to navigate the complex system of health, education and social care support to ensure that families receive the help that they need. Improved outcomes can be seen in the short-term/medium-term in areas like infant feeding, immunisation uptake, accident prevention, oral health, childhood obesity and child development.
  • Becoming healthy adults, with the absence of disease. The WHO states that non-communicable diseases pose the greatest threat to our nation’s health and are the single biggest cause of preventable illness, disability and lives cut short. Tackling this requires a shift away from selecting interventions in childhood based on quick ‘cashable savings’, to also include investment in long-term outcomes. There is strong evidence that the strategy must address both the wider determinants of health and provide personalised support for individuals, that takes account of the context in which they live, to improve health and reduce risk factors. Evidence driven interventions should include proximal outcome measures linked to reductions in the four main risk factors for non-communicable diseases like cardiovascular disease (smoking, alcohol, physical inactivity and unhealthy diets). The evidence is clear that early action leads to cumulative savings across the life course and across the health and care system – this avoids or delays more costly late interventions that will incur, due to increasing numbers of people spending more years in poor health in adulthood.