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Let’s put an end to One Size Fits All

By George Ames

23 June 2015

We are a very different country since the launch of the NHS in 1948. Yes we are living longer lives, but not always healthier or happier ones. Health inequalities are widening, with proactive ‘expert patients’ leaping ahead of increasingly disengaged individuals with a fatalistic attitude towards their health. Patients come in all shapes and sizes, so “one size fits all” communications won’t cut it.

While mass prevention campaigns can raise awareness, their ability to encourage action and change behaviour can only ever be limited. Healthcare communications need to be as tailored and specific as possible, particularly around chronic or long term conditions. Conversely, getting through to disengaged audiences requires a much broader scope in terms of communications, reaching beyond health itself and engaging on cause rather than symptom.

We know from our work with the Health Foundation that self-management of long term conditions can save the NHS £1,800 per patient per year which, with 15.8 million people in the UK living with long term conditions, is not an inconsiderable saving.

Across the country, there are great examples of partnerships emerging between healthcare professionals and patients, using a person-centred approach to put the individual in control of their condition. It requires a new conversation to take place, where choices are discussed and presented, and accurate support materials are available to help patients and carers at home. The increasing use of wearable tech and simple phone apps to help monitor and manage their condition makes this area all the more exciting.

In a converse situation, many people do not believe – or are not in a state of mind to consider – that they are responsible for their own health. The gap between higher and lower socioeconomic groups, in terms of smoking and other health-related behaviours and associated diseases, is getting bigger.

Recent work by Public Health England, with the UCL Institute of Health Equality, has shown just how many variables affect the health of people in lower socioeconomic groups. The Centre has produced evidence papers looking at the effects of parenting styles, resilience in schools, access to the living wage, green spaces and the environment, and fuel poverty. They make fascinating reading.

Fragmented communities and overall feelings of disempowerment lead to unhealthy behaviours, and one cannot be tackled without the other. People get used to things being done for them or to them, not with them. Here, the starting point is not health itself but the development of aspiration and opportunity for individuals, with families and across entire communities.

This needs to come long before trying to get buy-in to smoking cessation services and means that healthcare responsibility steps beyond traditional boundaries to work across the care, housing, education, community and many other sectors, combining public, not-for-profit and increasingly corporate partners.

The People’s Health Trust, Groundwork and Local Trust are amongst some of the charities leading exciting projects in this area, alongside every employer who has joined the Living Wage Campaign or provided Apprenticeships. This ultra-local approach, where each individual is accounted for, needs to be complemented by increased healthcare support through community pharmacies alongside GPs and community nurses where personal conversations can take place in an unthreatening environment. The biggest communications challenge out of all of this is to bring all the disparate elements together from across sectors, so they recognise their role and value in working together to tackle health issues. As ever, everything is connected, and communications can help ensure those connections are clearer and acted upon.