Shifting the paradigm from “disease care” to health care

Cat Oyler, vice president, global public health, tuberculosis at Johnson & Johnson, explains that by shifting focus to prevention, we can help to both reduce pressure on an increasingly stretched NHS and deliver the best possible patient care.

It’s been a landmark few years for the NHS, which celebrated its 70th anniversary in 2018, and released details of its long-awaited 10-year plan in January.

In September last year, I had the privilege of attending NHS Expo in Manchester where the achievements of this national institution were rightly applauded. However, the Expo also reignited the ongoing debate around the challenges faced by the service, and how, as an industry, we can provide much-needed support.

“These goals are not down to the NHS to achieve alone – industry has a responsibility to help tackle the challenge collectively.”

One of the biggest discussion points centred around the current structure of the service, which primarily focuses on treatment, as opposed to the prevention of ill health. The current funding split also highlights the differences between treatment and prevention – with the UK spending £97 billion of public money on treating disease, while only £8 billion on preventing it. If we then think about this beyond the system and the funding, there is a person needing care at the centre. Maintaining health, therefore, must be our collective focus.

Against this backdrop, it was encouraging to see that the NHS long-term plan includes giving more weight to preventative measures, alongside treatment and cure – focusing on relieving the pressures faced by UK hospitals and other front-line services.

At Johnson & Johnson, we have long advocated for a more preventative approach to healthcare – believing that it’s not only vital for the sustainability of services like the NHS, but also for improving the future of human health. By reaching individuals before they become patients and preventing and intercepting conditions before they take hold, we can collectively reduce the burden and cost faced by the NHS, all while drastically improving patient outcomes. We believe that by strengthening prevention, disease interception and cures, we can help to create a world where disease is a thing of the past.

The idea of a world without disease might sound like a dream, but we believe that it is fundamentally achievable, and a goal we should be aspiring to every day. Of course, it requires all stakeholders working together – with healthcare services, governments, payers, academia, patient organisations and private companies needing to combine forces to make this dream a reality.

The NHS has some ambitious targets, which go a long way to redressing the balance between prevention and treatment – including halving childhood obesity by 2030, and sequencing five million genomes in as many years. This is an enormous task, especially considering the NHS’s infrastructure was initially constructed to focus on treatment. However, it is worth noting that these goals are not down to the NHS to achieve alone – industry has a responsibility to help break down barriers and help tackle the challenge collectively.

Despite the enormity of this task, its potential impact shouldn’t be underestimated. A recent study by Queen Mary University found that whole-population genetic testing for women over 30 years of age could result in 64,000 fewer cases of breast cancers, and 17,500 fewer ovarian cancers. If that wasn’t compelling enough, the study also found this approach was more cost-effective than the current treatment focussed approach.

And these aren’t just statistics; at the very heart of this are real people who will potentially no longer suffer from disease because their health has been maintained.

Another example of how prevention can generate savings and improve patient outcomes is seen in the work we’re doing at Janssen, the pharmaceutical companies of Johnson & Johnson. In collaboration with the Oxford Academic Health Science Network (AHSN), Janssen is exploring specialist early intervention for young people who present the first instances of psychosis. This has shown that early intervention leads to better outcomes and brings estimated annual savings of up to £7,000 per year, per patient – the equivalent of up to £7 million per year across the Oxford AHSN region alone.

It’s encouraging to see this focus on preventative measures, and it feels as though there’s a genuine consensus among those in the service, and its partners, to make meaningful change happen. By continuing to work together, and implementing strategies for preventing and intercepting disease, not only can we help to future-proof the NHS – but I also believe we can help to create a world without disease.