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Sunak should lead ‘national mission for health improvement'
A government-commissioned review has suggested the share of local NHS budgets being spent on ‘prevention’ should be increased by at least one percentage point over the next five years.
The former Labour health secretary says the proposed funding uplift will be “challenging” for many systems but it is “essential if we are to avoid simply another round of rhetorical commitment to prevention”.
Ms Hewitt, who chairs Norfolk ICS, told HSJ: “Because prevention can mean different things to different people, I’m recommending a fast exercise… to agree a broad definition of prevention and a simple method of reporting so that every system, by next April, can report its baseline of investment in prevention and do that in a way which then enables you to benchmark across all systems and measure progress over the next five years.”
The report states: ”Many health systems in other parts of the world, including those that are entirely or largely taxpayer funded, are developing payment models that support and incentivise a focus on health. Meanwhile, NHS funding remains over-focused on treatment of illness or injury rather than prevention of them and ICS partners struggle to work around over-complex, uncoordinated funding systems and rules in order to shift resource to where it is most needed.”
It cites international examples of successful public health initiatives, such as the Medicare system in the US, which has a payment system geared at the overall needs of a population group, encouraging an “upstream approach” to screening and other programmes. It also cites the use of data in Australia which reports on the underlying health of the population.
The funding streams for public health and prevention services are complex, with the main funding stream for locally commissioned and delivered services being the public health grant, which the DHSC gives to local councils.
This has been cut by around 26 per cent in real terms since 2015-16, and is planned to be around £3.7bn next year. This represents around 3.5 per cent of the value of total ICS allocations, meaning a percentage point increase would take the share to 4.5 per cent. Children’s services, drug and alcohol, and sexual health services make up the largest elements of this.
Source: HSJ, 4 April 2023
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Man arrested following seizure of a million cigarettes in Pembroke Dock
AN ALLEGED tobacco smuggler has been arrested after almost one million cigarettes were seized at Pembroke Port last month.
His Majesty’s Revenue and Customs (HMRC) said officers seized more than 900,000 cigarettes from a lorry at the port. The cigarettes were worth around £350,000 in evaded duty, it was claimed.
A spokesman for HMRC told The Pembrokeshire Herald: “More than 900,000 cigarettes, worth over an estimated £350,000 in evaded duty, were seized from a lorry at Pembroke Port on March 27.
Source: Pembrokeshire Herald, 1 April 2023
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Disparities seen in declines in smoking prevalence
A study from researchers at the University of Southern California used a representative sample of 187,821 U.S. young adults (ages 21 to 25 years) from the National Survey on Drug Use and Health to examine racial, ethnic, and education-related differences in smoking prevalence and age of smoking initiation between 2002 and 2019.
The researchers found that the prevalence of ever and daily smoking declined significantly from 2002 to 2019 for all education and racial and ethnic groups, and was lowest among those with at least some college education and for Asian and Black young adults. Five-year decreases in the prevalence of ever and daily smoking were significantly slower for participants with less than high school or a high school education and for Black and Hispanic (versus White) young adults.
"Targeted marketing, availability of menthol cigarettes, economic inequalities, and racism and discrimination may have contributed to slower decreases in smoking prevalence and slower increases in the age of smoking initiation for minoritized racial and ethnic young adults as well as those with less education," the authors write.
Source: The Medical Xpress, 3 April 2023
See also: JAMA Network - Racial, Ethnic, and Education Differences in Age of Smoking Initiation Among Young Adults in the United States, 2002 to 2019
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