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Time for a greater focus on prevention



From the Primary Care CVD Leadership Forum, including Dr Matt Kearney, Professor Ahmet Fuat, Dr Kathryn Griffith, Dr Chris Arden, Professor David Fitzmaurice, Dr Clare Hawley, Professor Mike Kirby, Professor Ruth Chambers, Dr John Robson, Dr Paul Wright, Dr Ivan Benett, Dr Matthew Fay, Dr George Kassianos and Professor Kamlesh Khunti (all GPs) and Jan Procter-King of the British Heart Foundation

Current performance in primary care in relation to prevention and early diagnosis is fairly patchy. Like the GPs quoted in your story last month, we agree that we are struggling to cope with a burgeoning workload.

But while the NHS of 1948 focused on treating the sick, in 2014 this model is no longer appropriate. 

A third of deaths in under-75s are due to preventable illness. As the obesity epidemic rolls on, the burden of non-communicable disease threatens to overwhelm us. This needs both a public health and an NHS response. We agree there is an urgent need to find ways of reducing our workload in GP practices. But closing our eyes to the need for prevention of risks is making the NHS unsustainable. 

At the very least, if our patients are at increased cardiovascular risk, they have a right be told and to be offered an informed discussion of the benefits and risks of treatment and lifestyle change.

While we accept that there is debate about whether the NHS Health Checks programme is the best delivery method for the evidence-based interventions it includes, and also about the lowering of the 10-year cardiovascular risk threshold to 10%, we would challenge the assertion that cure is more important than prevention, and we do not think the status quo is an evidence-based option.