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Proactive healthcare

There’s nothing new about the phrase ‘prevention is better than cure,’ particularly when it comes to healthcare. First coined in its current form by Erasmus in the 1500s, the origin of the phrase can be traced back to early an early Chinese proverb from some two thousand years ago. That proverb runs to the effect that: ‘The superior doctor prevents sickness; The mediocre doctor attends to impending sickness; The inferior doctor treats actual sickness.’

Irrespective of its origin, the idea of proactive healthcare is one which is very much in evident within today’s health services. Take the ‘Healthier you’ programme being run in England which has seen over one million people sign up since its launch in 2016. Or what about the fitness scheme run by the Welsh Government as part of its ‘Healthy weight: healthy Wales’ programme which has delivered more than ten thousand weight and fitness sessions to over 60s over the past five years.

Both have been successful in helping people to live more healthy lifestyles, thereby preventing or delaying the onset of life limiting conditions such as diabetes. This has led Colette Marshall, Chief Executive at Diabetes UK, to say: “The NHS Healthier You Diabetes Prevention Programme has a pivotal role to play in tackling the rising number of people developing type 2 diabetes.” She went on to comment that those completing the programme could: “reduce their risk of developing type 2 diabetes by more than a third, in turn helping people avoid the serious complications associated with the condition.”

Whilst some proactive healthcare measures can be delivered and practiced on a day-to-day basis, from time to time other circumstances crop up which may require more short-term targeted interventions. Take the amber cold health alert which, at the time of writing, runs from the 2nd to the 9th January 2026. Issued by the UK Health Security Agency, the alert is designed to highlight the possible impacts of the current spell of cold weather on health and social care.

These include the potential impact of staffing issues due to factors such as travel delays as well as possible knock-on impacts across a wide range of sectors including transport and energy. Lower outside temperatures can also cast a spotlight on heating issues across both healthcare settings and private homes. This potentially could result in a greater health risk, in particular for vulnerable individuals.

Adding to the mix is, according to the UK Health Security Agency, a likely increase in demand for health services. Some will arise as existing conditions are exacerbated by the cold weather. Indeed, the Health Security Agency warns that cold weather brings an increase in deaths for those aged 65 and over with existing health conditions; another reason which proactive healthcare measures are so important.   But the increased risk of slips, falls, and accidents which cold weather, and particularly ice and snow, brings can also lead to an increase in demand for specialised health services. As a result, not only might hospitals see an increased demand from those with broken bones, for example, so too might the demand for associated healthcare services such as those provided by physiotherapists or osteopaths. That’s when services such as those provided by Clinic Appointments can come in handy, relieving some of the pressure by helping with services such as phone answering and booking  appointments.

Coughs, Colds, and Hiccups

When is a health emergency not a health emergency? That’s the question which NHS England is trying to make us all think about this winter. They’ve issued a short film which is designed to highlight the various treatment pathways available including visiting your local pharmacist, re-ordering prescriptions via the NHS App, sending online messages to GP services, or calling 111.

The underlying message is that whilst there are some conditions which will still need a 999 call or urgent visit to A&E, there are also a range of more common conditions which can be treated elsewhere. In particular, NHS England wants to draw attention to some of the more than two hundred thousand visits to A&E last winter which could have been avoided had other avenues been considered. These included 384 visits for hiccups, 83,705 visits for earache, and over ninety-five thousand visits for sore throats.

Now it is true that some of these conditions could have underlying factors which point to a more serious health issue. However, by skipping the interim steps and going straight to A&E patients may not only have to sit for hours in crowded waiting rooms as they look for treatment which they could have received quicker elsewhere, they also prevent or delay treatment for those with more serious conditions.

Commenting on the campaign GP Dr Ellie Cannon said “Every winter, NHS services face a surge in demand, and this year is no different. Knowing where to get the care you need can make all the difference.”

There is also another reason why the NHS has launched its campaign at this time. This flu season is proving to have hit harder than in recent years. With no signs of the current wave of flu abating, figures released on 4th December reveal that on average 1,717 patients were hospitalised in the previous week due to flu. That’s more than 50% up on the same time the previous year and more than ten times higher than in 2023. This despite the fact that nearly seventeen million individuals have taken up the flu jab, up 350,000 on the previous year.

As National Medical Director for Urgent and Emergency Care, Prof Julian Redhead said: “Today’s numbers confirm our deepest concerns: the health service is bracing for an unprecedented flu wave this winter. Cases are incredibly high for this time of year and there is no peak in sight yet.”

Despite all of the patient pathway options there are going to be times when an individual just wants to pick up the phone to their health provider, perhaps to book an appointment or to ask a simple question. There may well be times when that health practice is, for one reason or another, unable to answer the phone in as speedy a manner as they would like. That’s where a service such as that provided by Clinic Appointments comes into play. Answering the phone in the name of the relevant health practice, our trained receptionists can book appointments, answer pre-agreed queries or take messages. Calls are recorded and with over 97% of calls being answered in three rings patients can receive a swift and reassuring response; starting them on the pathway towards treatment for their health conditions.

Keep Britain Working

One in five UK adults of working age are currently out of the workforce due to health reasons. That stark headline statistic from the Keep Britain Working review which was released in November 2025 underlines the challenge facing individuals, employers, and the country.

The review, headed by Sir Charlie Mayfield, could not be clearer in setting out the challenges and consequences which arise from long term sickness. With unemployment due to ill health up by 800,000 since 2019, the impact is felt across society. For example:

  • A 22 year old individual who falls out of work due to ill health could lose up to £1million over their lifetime, impacting not only their health but also their mental wellbeing.
  • UK employers lose £85billion each year due to employee sickness impacting turnover and lost productivity.
  • For the country as a whole the cost of ill health that prevents work equates to 7% of GDP or the equivalent of nearly 70% of income-tax receipts.

The rate of long term sickness seen in the UK is higher than comparable countries. So much so that an additional two million individuals would need to be returned to long term work just to bring the UK in line with the OECD average. Why is this? Well, partly the review’s authors identified three key barriers to managing health and disability in the workplace. They are:

  • A culture of fear which prevents employees and line managers from feeling that they are able to discuss and address challenges at an early stage.
  • A lack of effective or consistent support, compounded by a ‘fit note’ system which the report’s authors believe is not working as intended.
  • Structural challenges for disabled individuals which leave them disproportionately excluded from the workplace.

In the light of the report, Sir Charlie Mayfield has been asked to lead a three-year initiative which is designed to identify changes within the workplace which could both prevent those with health issues from falling out of work and to help those already out of the workplace to return to employment. The Vanguard Taskforce will bring together employers, the disabled, work representatives and health experts. Commenting on the initiative Sir Charlie Mayfield said: “Employers are uniquely placed to make a difference, preventing health issues where possible, supporting people when they arise, and helping them return to work. If we keep Britain working, everyone wins – people, employers, and the state.”

More than sixty employers ranging from global brands such as British Airways to smaller SME organisations have already signed up to the initiative. Organisations across the health sector have also signalled their support. For example, the Chartered Society of Physiotherapy, which itself contributed, to the report commented: “This is a huge opportunity for employers and healthcare systems to recognise the power of rehabilitation in keeping people well and working. A significant part of that success depends on employers playing their part by harnessing the full expertise, experience and capacity of the independent physiotherapy sector, alongside NHS services, to create healthier, more supportive workplaces.”

Integrating healthcare

Healthcare management has come a long way since the days of paper and manual processes. This writer well remembers a parent being handed their X-Rays to be carried from one health provider to another in order to speed up diagnosis and the development of a treatment plan. Nowadays, those X-Rays and associated patient records can be digitised; available to be transferred or retrieved at the touch of a button.

With digitised data comes the opportunity to deliver something more than a simple linear treatment plan. Quite simply, moving patient information online opens up the pathway to integrated healthcare delivered by multi-disciplinary teams; in the process potentially transforming health management in particular for those with multiple or lifelong conditions.

Two examples of the way in which online access can open up integrated healthcare hit the headlines in September 2025. The first, saw the launch of neighbourhood health services in forty-three areas of the country. The areas chosen to benefit from the first wave of these services are those which have traditionally seen the lowest life expectancy and longest treatment waiting times in the country.

By linking healthcare, the voluntary sector, and the wider community the new programme aims to move services such as diagnostics, mental health, outpatients, rehab, nursing and social care away from specialist centres and closer to home. Trials in one area in London saw a lowering of A&E admissions by 7% and hospital admissions by 10%.  In Cornwall another trial lowered unplanned GP appointments by 7% whilst increasing vaccinations by 47% and cancer screening and NHS health checks by 82%. As Rachel Power, Chief Executive of the Patients Association, said: “Locating services in more convenient places for patients can mean earlier support, quicker diagnosis and fewer barriers to accessing vital treatment.”

The second example, announced at the end of September, comes in the form of an ‘online hospital’ to be known as NHS Online. This service is not expected to be rolled out until 2027 and with a gradual introduction may not be fully operational until some time after that. However, the new scheme is expected to deliver the equivalent of up to 8.5 million appointments and assessments in its first three years.

The idea behind the NHS Online offering is to digitally connect patients to clinicians who may be based anywhere in England. Using the NHS App as the focal point of contact, the service will enable integrated healthcare; with patients being able to book not just GP appointments but also follow-up scans or hospital appointments at a time and place which best suits them. Not only that, depending on the nature of the condition, it is expected that patients will also be able to have an online consultation with their chosen specialist from the comfort of their own home.

Commenting on the new scheme Dr Jeanette Dickson, Chair of the Academy of Medical Royal Colleges said: “This is a novel and potentially game changing way of improving equity and speed of access to NHS services, which would reduce health inequalities.”

Emergency alerts

On Sunday 7th September 2025 mobile phones across the UK will leap into life as a second nationwide test of the Government’s emergency alert system gets underway. The alert is due to go out at 3pm and be received simultaneously on all compatible 4G and 5G phones and tablets across the UK.

The last nationwide test was not an unqualified success; with some phones and indeed areas of the country not receiving an alert at all, whilst other phones delivered the alert several hours late. Since then, some tweaks have been made which it is hoped will deliver a more universal alert service. In fact, since that initial test, the alert service has already been deployed on a number of occasions. For example, in February 2024 an alert was sent across the city of Plymouth, containing information about the transportation of a World War II bomb from where it was found to a nearby ferry terminal. And in January 2025 red alerts about the potential dangers of strong winds were issued in Scotland and Northern Ireland.

In the future it is envisaged that the emergency alert system will be used for genuine life-threatening emergencies such as flooding, extreme storms, and wild fires; all of which could constitute a danger to life. The Government is at pains to point out that such alerts will only be sent out by the emergency services or by authorised government departments, agencies and public bodies so they won’t be used or available for more mundane matters.

Using mobile phones to deliver emergency alerts in this way shows just how far our acceptance of this type of technology has come. When the first mobile network was launched in January 1985, who would have envisaged that forty years later we would be using mobiles not just for voice communications but also as recording devices, calendars and diaries, as conduits to a world wide web of information, and now as potential life savers.

Whilst it is hoped that emergency alerts appearing on our phones will be few and far between, mobile phones can also act as delivery points for other alerts which may be less important in the overall scheme of things but equally of importance to the individual.

The health sector, for example, has been successfully delivering appointment reminders via SMS text for a number of years. Delivered automatically as part of an online booking system, SMS text messages can be a simple way of helping to improve attendance rates for health and other appointments. Not only do SMS texts act as a visible reminder of the appointment, the receipt of the reminder can also act as a prompt for individuals to cancel if they are no longer able to attend. This in turn enables the health practice to fill vacant appointment slots rather than have them go to waste.

Optimising appointment scheduling in this way could help health practices to run more efficiently; making the best use of available resources for the benefit of both patients and the practice.

Being tick aware

According to the UK Health Security Agency (UKHSA), in 2024 there were 1,581 laboratory confirmed cases of tick borne Lyme disease in England. That’s a slight fall on 2023; but as the UKHSA say, as some cases go unreported or untested, laboratory confirmed cases are known to be an underestimate of the true total.

Awareness of Lyme disease has risen in recent times, partly thanks to a number of high profile individuals who have revealed that they were suffering from the condition. For example, in an Instagram post at the end of July 2025 the pop star Justin Timberlake commented that following his diagnosis: “at least I could understand why I would be onstage and in a massive amount of nerve pain or, just feeling crazy fatigue or sickness.”

In the UK, ticks are more prevalent across the south, south east, and south west of England. The recent mild winters have meant that ticks have not died off as they might usually do. As a result, and as any dog walker in a tick-prevalent area will readily testify, there has been a growth in tick numbers. And whilst larger ticks are easier to spot, young ones can be as small as 1mm, making them hard to identify.

It is important to note that the majority of ticks don’t carry Lyme disease. However, any individual who has been bitten is encouraged to monitor their health and contact their GP if they develop any symptoms. These, according to NHS Inform, can include:

  • a pink or red rash
  • a temperature of 38°C (100.4°F) or above
  • other flu-like symptoms, like a headache or joint pain
  • swollen lymph nodes

And don’t be misled if the “traditional” marker of a bullseye around the bite wound doesn’t appear. It won’t do so in about a third of cases but if other symptoms arise and are suspected to have been caused by a tick bite then the sooner antibiotic treatment starts the better.

Left untreated, Lyme disease can lead to the development of long-term symptoms including chronic fatigue syndrome, fibromyalgia, heart problems, brain fog, nerve problems and ongoing joint pain.  

Little wonder then that the UKHSA has launched a campaign to be more tick aware. That awareness message is as important for health providers as it is for those who are venturing outdoors into wooded areas or areas of long grass. If individuals present with a collection of vague symptoms including exhaustion and/or joint pain then Lyme disease is one option which should be considered in tandem with other potential causes.

Commenting on the tick and Lyme disease awareness campaign Christina Petridou, Consultant Microbiologist at UKHSA, said:

“It’s really important that people continue to be tick aware this summer to protect themselves against Lyme disease. The disease is usually acquired when spending time outdoors in green spaces, which people do more of in the summer months. After spending time in nature, people should take precautions such as checking for ticks and promptly and safely removing them which will reduce chances of infection.”

Ten years to reform healthcare

The choice for the NHS is stark: reform or die.”

Those words from the introduction to the new ten-year plan for the NHS in England clearly set out the challenge facing healthcare today. Warning that demographic changes and an aging population are putting unsustainable pressures on already stretched systems, the introduction highlights the need for a fundamental change in health delivery.

In drawing up the new ten-year health delivery plan the team has consulted widely, speaking to health staff and members of the public and considering the quarter of a million ideas submitted to the Change NHS website. This research led to the inescapable conclusion that “staff and patients are crying out for change.”

That change, according to the new plan, requires the harnessing of science and technology in order to deliver a patient-controlled system, supported by frontline staff who are empowered to reshape services. This, the plan’s authors envisage will deliver change in three fundamental areas:

Hospital to community. The review comments that the current health service is hospital-centric with care broken down into fragmented silos. The ten-year plan looks to shift the balance away from hospitals to a more integrated model which delivers continuous accessible care primarily in homes or neighbourhood health centres. Agreed care plans should also be available for 95% of those with complex needs by 2027.

We have already reported on some of the measures to be implemented including ending the 8am scramble for GP appointments and boosting community pharmacies. Other measures will see the development of neighbourhood health centres offering a one-stop shop for care delivered by multi-disciplinary teams. The personal health budget scheme will also be rolled out to more individuals to ensure it is available to all who may benefit from it by 2035.

Analogue to digital. Key to success in this area will be the expansion of the NHS App. This, it is envisaged with eventually enable patients not only to book GP appointments and manage repeat prescriptions but also to carry out functions such as receiving automated advice, booking specialist tests, or choosing a provider to deliver health treatments. It is also envisaged that the App will eventually help patients to manage long term conditions through the use of digital tools including data uploads and reporting.

Sickness to prevention. This plank of the plan requires a step outside of the health service, drawing on the expertise of a multitude of agencies and bringing forward legislation in order to improve health levels. Goals include the halving of the gap in healthy life expectancy between the richest and poorest regions whilst simultaneously improving health outcomes for all. Legislative measures look towards areas such as the tackling of obesity, the reduction of problem drinking and cutting down on smoking. Other measures aim to draw in employers, schools, industry partners and the community to promote healthy eating, exercise and good mental health.

Whilst the new plan has been widely welcomed, various bodies including the BMA, the Royal College of Nursing and the NHS Confederation have raised concerns about the staffing and funding changes required in order to bring about its successful delivery.

Securing patient information

The potential health delivery benefits arising from the digital revolution cannot be underestimated. In the past we have reported on the way in which virtual wards have enabled at-home monitoring and treatment programmes; in the process freeing up vital space in hospitals whilst also helping to ensure that more patients can be treated by existing teams of clinicians. We have also explored the way in which the availability of digital patient information can help to speed up communications between health providers whilst also reducing administration time. And we’ve also looked at the way in which that administration and treatment time can be further reduced by deploying online patient booking systems or outsourcing telephone answering to specialist clinical call handling providers.

Whilst these benefits are clear to those working within health services, more may need to be done to ensure that patients are fully aware of the way in which their data is being collected and stored. For example, a report earlier this year by ‘Understanding Patient Data’ revealed that patients tended to see the NHS as a single organisation. As a result, 61% of those surveyed thought that there already was one single record held nationally which contained all of their data. Rather confusingly the same percentage said they would prefer a nationally controlled record rather than a GP led record whilst at the same time seeing GPs as the most trusted when it comes to making decisions about patient data. And whilst 81% thought it was very or somewhat important that they be given access to their own GP record, just 56% had accessed their data.

These findings and others led the report’s authors to make a number of recommendations about the storage and management of patient data. The need for clear and consistent messaging on how patient data was managed came through strongly as did the need for messaging to “focus on what matters most to people—how to access records, who can see their data, and how it is protected.”

The importance of that last message was thrown into the spotlight at the beginning of June 2025 when NHS England opted to pause a project which was using GP data to train an artificial intelligence programme which was being designed to predict future health needs. The decision came after GPs and others became aware that data originally collected for Covid 19 research was being used to train the programme. Whilst researchers commented that the information used was de-identified data, GP leaders questioned whether correct processes were followed and whether data was being shared in line with good governance practices and patient expectations. In the light of this query the programme has been paused whilst a data protection review takes place.

Commenting on the project an NHS England spokesperson told Digital Health News that: “Maintaining patient privacy is central to this project and we are grateful to the joint GP IT committee for raising its concerns and meeting with us to discuss the strict governance and controls in place to ensure patients’ data remains secure.”

Calling for a health appointment

Is the increased availability of online patient access allied to upgraded telephone systems ushering in the end of the 8am health appointment rush? It certainly seems so if the experience of one Leeds surgery is anything to go by. According to NHS England, the Lingwell Croft surgery deploys a mix of online contact forms, phone requests and walk-in options in order to provide an appointment service which best fits the needs of their patients.

The practice says that this has resulted in the receipt of some 350 e-consult requests each day, albeit it says mainly from younger patients. Those who still prefer to telephone in order to book an appointment have the option to either speak to someone or to leave a voicemail which is transcribed using voice recognition software. All requests, no matter how received, are triaged by two GPs and two care navigators with patients directed to the most appropriate member of the practice team, whether that be doctors, nurses, paramedics or physiotherapists.

NHS England says that thanks to GP practices making best use of technologies such as improved phone systems and digital records they have been able to offer 31.4 million GP appointments in March 2025. That’s an increase of 6.1% on the previous March and nearly 20% higher than in pre-pandemic times.

However, Dr Amanda Doyle, National Director for Primary Care and Community Services urged healthcare practices not to become complacent, commenting that: “there’s still more to do to make it easier for patients to contact and see their local GP, which includes making even better use of new technology to improve patient care”.

That caveat was born out by a British Social Attitudes survey published in April 2025 which revealed that just 31% of people in the UK were satisfied with their GP service, compared with 68% in 2019. Over the same period the percentage of individuals who saw their GP had fallen from 80% to 66%. However, what the survey didn’t show is whether that fall in GP visits was matched by a targeted increase in the use of other health professionals such as physiotherapists or mental care specialists.

The move towards prevention rather than post-condition treatment allied to more targeted health delivery may also impact these numbers and therefore patient satisfaction levels going forward. Interestingly, a report published by the UK Health Security Agency on 2 May 2025 highlighted the correlation between deprivation and health needs. For example, the report showed that those living in deprived communities are twice as likely to be hospitalised for invasive infections or respiratory diseases and 1.7 times as likely to be hospitalised for gastrointestinal diseases. This led to the findings that inequalities in emergency infectious disease hospital admissions cost the NHS between £970m and £1.5b in 2022-23 as well as accounting for some 20% of hospital bed use.

Commenting on the report Dr Leonora Weil, Deputy Director for Health Equity and Inclusion at UKHSA said: “These health protection inequalities – where there are poorer health outcomes based on where you live, your socio-economic status or ethnicity are avoidable, pervasive, and preventable. That is why it is so important to shine a light on these findings to increase action to support communities to live longer and in better health.”

Predicting health needs

The idea that prevention is better than cure has long been one of the central planks of health provision in the UK. And it’s certainly an idea which has gained traction in recent times. Put simply, the earlier that health problems, or the likelihood of problems developing, can be identified; the greater the chance of a cost-effective and efficient solution.

Now there is nothing new about some of the solutions; such as vaccinations to prevent certain diseases, or public information campaigns to highlight areas of concern. Where we have seen a development of these approaches is in the use of more targeted campaigns allied to a greater effectiveness in measuring outcomes. For example, a breast cancer screening campaign in February 2025 saw 32,432 visits to breast screening advice pages in the first week, an increase of 145% over the previous weekly average. Similarly, a Covid immunisation information campaign in March 2025 resulted in over half a million booster jab appointments being made in the first week.

These more targeted and measured campaigns can have a beneficial effect across the broad population stream, but new approaches are also having an impact on the health of individuals. We have previously reported on the deployment of ‘at home’ monitoring in order to avoid the necessity for regular hospital visits for long term conditions. This approach has now been taken one step further with the development of an artificial intelligence tool which can help to predict the likelihood of a patient suffering a fall.

The tool, which is said to be 97% accurate, requires patients, carers, health visitors and family members to input a range of data on an app which also is able to monitor vital signs such as blood pressure and heart rate in real time. This enables the AI tool to identify those at high risk of a fall, enabling preventative measures to be taken and preventing an estimated 2,000 falls leading to hospitalisation each day. The AI tool’s functionality is also planned be expanded in due course in order to identify illnesses such as Covid or norovirus; enabling early intervention to reduce recovery time.

With falls and fractures in those aged over 65 accounting for four million bed days and a cost of £2billion each year, it is hardly surprising that AI technology such as this is being hailed as a game changer. Commenting on the app, Dr Vin Diwakar, National Director of Transformation at NHS England said: “This AI tool is a perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital.”

Less technical but no less preventative, the idea of expanding the role of peripheral healthcare workers in order to undertake regular home visits is being evaluated. An early pilot scheme in Westminster saw a 10% drop in hospitalisations and a 7% drop in visits to A&E.

Adding these new initiatives into an existing mix of technological initiatives such as the use of digital patient records or the ability to outsource patient appointment bookings can further help to free up resources and streamline a healthcare delivery focused on prevention first.

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