Press release: New ROI tool shows best ways to prevent cardiovascular disease

Public Health England (PHE) has launched a new return on investment (ROI) tool to help local commissioners decide the best approach to preventing cardiovascular disease (CVD) within their populations.

CVD costs the NHS £7.4 billion each year and is one of the leading causes of death and disability in England, with deprived communities at greatest risk. Reducing the burden of CVD on local populations is an important step to helping people stay in work, boosting the local economy and lowering the future demand on health and social care settings.

The majority of CVD is preventable through identifying and managing risk earlier. The ROI tool shows the health and cost impacts of using different interventions to treat people at high risk of CVD, helping commissioners decide how their budget is best spent to improve local health outcomes. It also shows the effectiveness of different approaches to detecting and managing people with high risk conditions.

Professor Jamie Waterall, National Lead for Cardiovascular Disease Prevention at Public Health England, said:

We’re seeing the number of people with long-term conditions, such as diabetes, continue to rise which means prevention should be high on the agenda for the NHS. That is why this new tool is hugely useful in helping decision-makers make better choices about CVD prevention, based on the best evidence of what works. It will help commissioners plan effective CVD prevention strategies and make the most of their budgets to help more people live healthier, longer lives.

The ROI tool is the latest from PHE’s health economists underlining why investment in prevention is important to both the long term health of the population and the long term sustainability of the NHS. Assessments can be made at national, local authority, clinical commissioning group, or sustainability and transformation partnerships level.

Publication of the ROI tool coincides with a new Global Burden of Disease study highlighting the importance of national and local policies targeting prevention to tackle premature mortality. The study supports calls for renewed efforts to run systematic programmes to reduce chronic disease risk factors, including high blood pressure and high cholesterol.

The ROI tool lets users see predicted impacts of different interventions in terms of costs saved and the number of CVD events and premature deaths prevented. Analysis shows that optimising the use of statins and hypertensives could bring some of the most considerable cost-savings. The tool also highlights the importance of identifying risk earlier, with the earlier identification of diabetes predicted to provide the highest long-term benefits in terms of CVD events prevented and costs saved.

PHE commissioned the University of Sheffield to develop the tool, following an evidence review and in consultation with an expert steering group.

Dr. Matt Kearney, GP and National Clinical Director for Cardiovascular Disease Prevention at NHS England, said:

Heart attacks and strokes are life-changing events for sufferers and their families, and the NHS long term plan will set out a strategy for cardiovascular disease prevention and care. Thankfully these conditions are highly preventable and minimising their impact is not just good for patients but also benefits taxpayers who fund the NHS.

This return on investment tool will show health professionals in each part of the country how heart problems and strokes could be prevented, and how much health service resource could be freed up for reinvestment if we increase detection and treatment of high-risk conditions like atrial fibrillation, high blood pressure and high cholesterol.

Professor Brian Ferguson, Chief Economist at Public Health England, said:

This is a great addition to the suite of tools we’ve produced to support commissioners in local systems. It’s the first one that allows users to consider combinations of interventions, and so better reflects the reality of complex care needs. The results demonstrate that investing at scale in the most cost-effective preventative activities can deliver significant health benefits.

The tool and the accompanying report can be accessed online.

Commissioners can read further PHE advice on how to make the most of their budgets.

To find out more about the CVD ROI tool contact PHE’s Health Economics team.

Background

  1. Interventions were chosen for inclusion in the tool if they were recommended by NICE for individuals without pre-existing CVD and if there was high quality and recent effectiveness evidence available. Selected detection interventions included NHS Health Checks, annual review in people with a pre-existing condition, cascade testing for FH and opportunistic detection. Selected management interventions included pharmacological interventions (antihypertensives, lipid modification therapy, anticoagulants and blood glucose lowering), lifestyle interventions (NHS diabetes prevention programme (DPP), diabetes structured education, weight management, smoking cessation, nutritional advice for CKD) and interventions that improve adherence to pharmacological interventions (blood pressure self-monitoring, insulin pump and medicines use review). A series of additional reviews were carried out to inform other intervention parameters including costs and duration of effect.

  2. The tool was developed with input from a tool user group who provided information about local priorities for CVD and their requirements for a CVD prevention ROI tool. The tool design enables users to see the potential benefits of either improving detection and/or management of one or more high-risk conditions, or of improving the usage of one or more of the key interventions for people at risk of CVD. The tool is designed to include both the direct costs and benefits of implementing chosen scenarios and the indirect consequences, for example the increased cost of management that will occur as a response to increased diagnosis of high risk conditions.

  3. The University of Sheffield developed the ROI tool based on a modification of an existing type 2 diabetes prevention model (The School for Public Health Research (SPHR) Diabetes Prevention Model), which has been previously used as the basis of a PHE tool to model the ROI of the NHS Diabetes Prevention Programme.

  4. The tool includes demographic information about local populations, so that the outcomes are area-specific. Users can select localities of interest from the full range of CCGs, STPs and local authorities in England, or for the whole of England.

  5. Primary prevention of CVD is not considered by the tool. However there is the functionality for users to assess the impact of additional interventions that are happening in their local area if they have information on effectiveness of the intervention.

  6. Uncertainty analysis is not included in the tool, but it is important to note that there will be some uncertainty around estimates.

  7. The tool lets users see the benefits of interventions around 6 CVD high risk conditions, identified by the NHS RightCare Optimal Pathway as currently underdiagnosed and insufficiently managed despite a range of available interventions, and therefore representing targets for improvement:

  • high blood pressure
  • atrial fibrillation (AF)
  • high cholesterol/high CVD risk including familial hypercholesterolemia (FH)
  • diabetes (type 2 and type 1)
  • non-diabetic hyperglycaemia
  • chronic kidney disease (CKD)

Public Health England press office



Press release: GOVE LAUNCHES FISHERIES BILL TO TAKE BACK CONTROL OF UK WATERS

Legislation creating the powers the UK needs to operate as an independent coastal state after leaving the EU is being introduced into Parliament today (25 October 2018).

For the first time since 1973, the Fisheries Bill will enable the UK to control who may fish in our waters and on what terms.

The Bill also gives the UK the power to implement new deals negotiated with the EU and with other coastal states and manage fisheries more effectively and sustainably in future.

At its heart the Bill delivers on the UK government’s commitment to sustainable fishing and marine conservation as set out in the 25-Year Environment Plan by:

• Controlling access – by ending current automatic rights for EU vessels to fish in UK waters. In future, access to fish in UK waters will be a matter for the UK to negotiate and we will decide on the terms – foreign vessels would have to follow our rules.

• Setting fishing opportunities – by proposing powers to ensure that the UK can set its own fishing quota and days at sea, which it will negotiate as an independent coastal State. As now, the UK government will consult the Devolved Administrations.

• Protecting the marine environment – by ensuring fisheries management decisions are taken strategically for the benefit of the whole marine environment. The Bill extends powers to the Marine Management Organisation and the Devolved Administrations to protect our seas.

We do not yet know the outcome of the UK’s negotiations to withdraw from the EU or on a future economic partnership, but we have been clear that market access for fisheries products is separate to the question of fishing opportunities and access to waters. The Bill will give us the powers to implement the result of those negotiations.

The new legislation also proposes ways in which the UK government and the Devolved Administrations will work together to adopt common approaches to fisheries management in certain areas – including preserving UK vessels’ right to fish across the four zones of UK waters and creating a consistent approach to managing access of foreign vessels.

The four fisheries Administrations will set out in a joint statement how they will work together to achieve the Bill’s sustainability objectives.

Environment Secretary Michael Gove said:

This new Fisheries Bill will allow us to create a sustainable, profitable fishing industry for all of the UK. It will regenerate coastal communities, take back control of our waters and, through better conservation measures, allow our precious marine environment to thrive.

The Common Fisheries Policy has damaged the UK’s fishing industry and our precious fish stocks. The Bill will deliver a sustainable fishing industry, with healthy seas and a fair deal for UK fishermen.

The Bill also provides powers to reform fisheries rules. To ensure legal continuity, the EU (Withdrawal) Act transferred Common Fisheries Policy (CFP) rules into UK law. This Bill allows government to amend fisheries legislation to respond to scientific advice and innovation quickly – something the CFP failed to do – and to meet our international obligations.

In addition, the Fisheries Bill introduces powers to create new schemes in England to help seize the opportunities of Brexit.

These include:

• a new scheme to help the fishing industry comply with the landing obligation to end the wasteful discarding of fish, and

• powers to tender additional English quota.



Press release: GOVE LAUNCHES FISHERIES BILL TO TAKE BACK CONTROL OF UK WATERS

Legislation creating the powers the UK needs to operate as an independent coastal state after leaving the EU is being introduced into Parliament today (25 October 2018).

For the first time since 1973, the Fisheries Bill will enable the UK to control who may fish in our waters and on what terms.

The Bill also gives the UK the power to implement new deals negotiated with the EU and with other coastal states and manage fisheries more effectively and sustainably in future.

At its heart the Bill delivers on the UK government’s commitment to sustainable fishing and marine conservation as set out in the 25-Year Environment Plan by:

• Controlling access – by ending current automatic rights for EU vessels to fish in UK waters. In future, access to fish in UK waters will be a matter for the UK to negotiate and we will decide on the terms – foreign vessels would have to follow our rules.

• Setting fishing opportunities – by proposing powers to ensure that the UK can set its own fishing quota and days at sea, which it will negotiate as an independent coastal State. As now, the UK government will consult the Devolved Administrations.

• Protecting the marine environment – by ensuring fisheries management decisions are taken strategically for the benefit of the whole marine environment. The Bill extends powers to the Marine Management Organisation and the Devolved Administrations to protect our seas.

We do not yet know the outcome of the UK’s negotiations to withdraw from the EU or on a future economic partnership, but we have been clear that market access for fisheries products is separate to the question of fishing opportunities and access to waters. The Bill will give us the powers to implement the result of those negotiations.

The new legislation also proposes ways in which the UK government and the Devolved Administrations will work together to adopt common approaches to fisheries management in certain areas – including preserving UK vessels’ right to fish across the four zones of UK waters and creating a consistent approach to managing access of foreign vessels.

The four fisheries Administrations will set out in a joint statement how they will work together to achieve the Bill’s sustainability objectives.

Environment Secretary Michael Gove said:

This new Fisheries Bill will allow us to create a sustainable, profitable fishing industry for all of the UK. It will regenerate coastal communities, take back control of our waters and, through better conservation measures, allow our precious marine environment to thrive.

The Common Fisheries Policy has damaged the UK’s fishing industry and our precious fish stocks. The Bill will deliver a sustainable fishing industry, with healthy seas and a fair deal for UK fishermen.

The Bill also provides powers to reform fisheries rules. To ensure legal continuity, the EU (Withdrawal) Act transferred Common Fisheries Policy (CFP) rules into UK law. This Bill allows government to amend fisheries legislation to respond to scientific advice and innovation quickly – something the CFP failed to do – and to meet our international obligations.

In addition, the Fisheries Bill introduces powers to create new schemes in England to help seize the opportunities of Brexit.

These include:

• a new scheme to help the fishing industry comply with the landing obligation to end the wasteful discarding of fish, and

• powers to tender additional English quota.



Press release: Alun Cairns: “Wales can lead the way in our engineering revolution”

Welsh engineering has the ability to revolutionise the economy and provide young people with the skills to succeed in a modern world, the Secretary of State for Wales will say today as he meets representatives from Miskin-based engineering company Renishaw (Thursday 25 October).

The global company, which has 80 offices in 36 countries, specialises in precision measurement and healthcare, supplying products and services used in applications as diverse as jet engine and wind turbine manufacture, through to dentistry and brain surgery.

The Miskin site employs over 400 staff, including apprentices studying towards STEM qualifications. Mr Cairns will tour the facility, which specialises in precision manufacturing and metal 3D printing, as well as Renishaw’s Healthcare Centre of Excellence, which includes the production of dental structures and implants for facial reconstruction.

The Welsh Secretary will also hear first-hand how Renishaw is preparing young people for a career in engineering when he meets Stephen Pickles, Process Development Technician and Apprentice of the Year for Wales at the Apprenticeship Awards Cymru in 2017.

The visit comes during the UK Government’s Year of Engineering campaign, celebrating the world and wonder of engineering with the aim of boosting engineering in every part of the UK, ensuring everyone has the skills needed to thrive in a modern economy.

Secretary of State for Wales Alun Cairns said:

Building on Wales’ strengths, the UK Government wants to work closely with businesses and industry to support and grow our engineering capabilities and ensure we have the skills in place to secure a strong, resilient economy that is fit for the future.

That is why we’re investing in the skills, industries and infrastructure of the future via the Industrial Strategy. This will build on the foundations of productivity, including encouraging innovation, securing good jobs, driving major upgrades in the UK’s infrastructure and attracting investment by making the UK the best place to start and grow a business.

All of this has the capacity to create prosperous communities in every part of the country, and companies like Renishaw are helping us achieve that ambition, training hundreds of people in south Wales to realise their potential and make a valuable contribution to our economy.

William Lee, Chief Executive of Renishaw said:

Renishaw has invested over £45 million in our facility near Cardiff since 2011 as part of a long-term commitment to developing our presence in Wales.

The Secretary of State will see how this investment is benefitting people across South Wales, including an extensive education outreach programme centred on a dedicated facility at the site for primary and secondary schools. This is all part of ensuring that young people have the necessary skills to help develop our business over the coming years, allowing us to sustain the company’s growth for the future.

Find out more about the UK Government’s Year of Engineering campaign and sign up to be a partner



Press release: An STI is diagnosed in a young person every 4 minutes in England

Latest statistics from Public Health England (PHE) show that a case of chlamydia or gonorrhoea is diagnosed in a young person every 4 minutes in England. There were over 144,000 diagnoses of these sexually transmitted infections (STIs) in people aged 15 to 24 in 2017.

PHE’s ‘Protect Against STIs’ campaign highlights the increased likelihood of contracting a life-changing STI if people have sex without a condom. The impact of having an STI is significant, particularly if left untreated as they can cause major health issues, including pelvic inflammatory disease, infertility, swollen or painful testicles, and reactive arthritis. In pregnant women, STIs can lead to higher risk of miscarriage or stillbirth.

The majority of STIs (like chlamydia) are symptomless, and gonorrhoea is becoming increasingly resistant to antibiotics and at risk of becoming untreatable in the future. PHE’s campaign, therefore, encourages condom use, as prevention is better than cure.

Rates of STIs in England remain high across England, and there has been a significant year-on-year increase in certain cases like gonorrhoea (22% increase from 2016 to 2017).

In 2017, there were approximately 420,000 diagnoses of STIs in England and of those, chlamydia accounted for nearly half of them (200,000 diagnosis of chlamydia and over 44,000 diagnoses of gonorrhoea).

A large proportion of these STI diagnoses are amongst young people aged 15 to 24, who account for 63% of chlamydia diagnoses and 37% of gonorrhoea diagnoses.

In a bid to get the nation’s young adults talking about and having safe sex, TV personality Sam Thompson (who appears in Made in Chelsea and Celebs Go Dating) hits the streets to find out young people’s attitudes to sexual health and condom use.

In the first of 2 new films, Sam Thompson and Dr Sara Kayat visit a Further Education College to speak to young people about how much they know about sexual health.

Sam then heads to Warwick with Dr Joe Peterson Camp, to meet a number of students to talk to them about their own experiences of sexual health and uncover their attitude towards condoms.

Dr Hamish Mohammed, Consultant STI Scientist at Public Health England, said:

Young people are more likely to be diagnosed with an STI than people aged 25 and older. STIs present a real threat to young people, and without using condoms, young people are putting themselves and their partners at risk of getting an STI.

Sam Thompson said:

I’m on a mission to encourage young people across the country to use condoms, with the help of Dr Sara and Dr Joe. We’re not talking about safe sex or normalising the use of condoms enough, and finding out all the facts about STIs has taught me so much, which I want to let everyone know about too, so we can limit the spread of STIs.

The most shocking thing I’ve learned is that some STIs are symptomless and that some are actually becoming harder to treat – that’s scary. The best thing I’ve learned is that if you’re under the age of 25, you can get condoms for free by just looking online for a free condom finder; I’m spreading that message far and wide.

There’s really no excuse for people not to use condoms and we should all feel empowered to use them and to see condoms as a normal part of a healthy sex life.

TV Doctor and GP, Dr Sara Kayat, said:

Rates of STIs remain high in young people, and we want to make sure people know that the best way to protect themselves from getting an STI, is to use a condom.

Often STIs don’t have any symptoms, with 4 in 10 cases of chlamydia in women and around half of the cases in men symptomless, and they can have serious consequences.

You can easily contract an STI or pass one on without even knowing it, so – as I tell my patients – make sure you use a condom.

The campaign launches on 25 October with a nationwide social media, digital audio, Out of Home advertising & PR campaign targeted at 16 to 24 year olds. It is being supported by a range of partners, including the Family Planning Association (FPA) and British Association for Sexual Health and HIV (BASHH).

  1. The films created by Sam Thompson, along with campaign advertising and images can be downloaded here.
  2. Dr Joe Peterson Camp is a doctor at Homerton Hospital in its Sexual Health and HIV Service.
  3. Dr Sara Kayat is a GP at Grays Inn Road Medical Practice. Her main areas of expertise are Sexual and Reproductive Health, as well as surgical specialties like ENT and Orthopaedics.
  4. The FPA is supporting the ‘Protect against STIs’ campaign by helping to deliver sexual health information and support to key audiences via their Sexwise website.