1. Increasing Investment in Prevention in Wales, The Journey So Far
Dr Chrissie Pickin, Executive Director of Health and Wellbeing
27 September 2018

2. Context
Well-being of Future Generations Act requires all public bodies in Wales to think prevention. Future Generations Commissioner requesting evidence of this from Welsh Government
Socialising the concept of this also providing a social return on investment through Making a Difference report
Burden of Disease study highlighted the case for change
A Healthier Wales made a commitment to prevention
Our new Long Term Strategy reflects how we will contribute to delivering this commitment
Increasing Investment in Prevention, The Journey So Far

3. Challenges in the prevention of long term conditions in Wales
Better problem definition
More systems thinking
More understanding and utilisation of the evidence base around effective prevention of non communicable diseases
More coherent or co-ordinated implementation of prevention programmes – currently piecemeal, fragmented with risks of duplication and gaps
More recurrent investment – shortfall of the order of £20m - £90m per annum compared to England
Increasing Investment in Prevention, The Journey So Far

4. Priorities for increased NHS investment in prevention
Combine a population health approach with appropriate focus to maximise impact ‘equity sensitive/proportionate universalism’
Based on key principles including
Best available evidence and experience in Wales/UK
Most significant risk and protective factors covered
Work across the life course (but focus on early life interventions to maximise impact)
Realistic and don’t overpromise. Ready to go in 2019/20
Evaluation and sharing learning is embedded
Builds on WAO work and is advice from the public health system not just Public Health Wales
Increasing Investment in Prevention, The Journey So Far

5. Population Health Triangle
Increasing Investment in Prevention, The Journey So Far

6. Proposed Priority Areas for Investment
Tobacco Control
Smoking in pregnancy, increased social marketing, smoking cessation in those with enduring mental illness, effective cessation prescribing
Obesity Prevention
Rapid implementation of 10 steps programme, maternal obesity intervention, intensive family support, primary care based weight management
Promoting Physical Activity
Active travel, Getting Wales Moving campaign
Mental Wellbeing and Resilience in Children and Young People
Whole school approach, positive adolescence, parenting support
Increasing Investment in Prevention, The Journey So Far

7. Proposed Priority Areas for Investment
Primary Care Prevention and Wellbeing
NERS+, clinical risk reduction programmes
Health Related Behaviour Change and Public Information Unit for Wales
Behavioural analysis team, behavioural interventions team, MECC+
Alcohol Misuse Prevention
Improving Housing Quality in Wales
Develop Population Health Standards and a peer review mechanism across LHBs
Increasing Investment in Prevention, The Journey So Far

8. Next Steps Developing our advice to Welsh Government
Agreeing with all Directors of Public Health so that it is a system view
Providing a direction for Public Health Wales in our journey towards A Healthier Future for Wales
Focus is only on non communicable diseases – another agenda around prevention of communicable diseases
Increasing Investment in Prevention, The Journey So Far