Population Health Gain in Primary Care Dr Hilary Guite FFPH MRCGP Consultant Public Health Medicine Public Health England

How good is the NHS at population health gain compared to other economically developed countries? 2Presentation title - edit in Header and Footer UK 19/33

The fantastic opportunity of the NHS: Universal access and patient registration UK Fantastic opportunity of primary care- 90% of all NHS contacts carried out in primary care

The session INTRODUCTION Shifting the population health outcome curve in primary care. Dr Hilary Guite Consultant Public Health Medicine Public Health England CASE STUDIES Diabetes identification and management improving life expectancy Dr Junaid Bajwa Conway Practice Plumstead, London Hypertension management and reductions in CHD emergencies and the role of an academic network in realising population health gains Dr John Robson Chrisp Street health centre. Tower Hamlets London. Physical activity and reducing obesity Dr William Bird. Intelligent Health SUMMARY How general practice can work with the generally well to become optimally well and the nearly sick to become generally well. Ms Shakti Dookeran. Population Health Services Manager. 4Presentation title - edit in Header and Footer

Source WHO/WHF/WSO Global atlas on CVD prevention and control The ideal prevention strategy- shifting the population health outcome curve

Source WHO/WHF/WSO Global atlas on CVD prevention and control The ideal prevention strategy Identify and actively manage people with disease Early diagnosis; management of risk factors; BP; raised HBA1C etc Shift whole population mean by reducing population risk factors

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Spare slide Rank order of effective interventions resulting in reduction in CHD mortality UK 1. (E) Fall in BP in the general population not on medication 29%: 11,160 DPP (deaths prevented or postponed) Consistent with salt ↓ 2. (A) Lipid reduction with statin treatment 14% 5,300 DPP 3. (G) Improved management of stable CAD in the community 13% 4. (H) Improved secondary prevention post MI or revascularisation 11% 5. (I) Improved management of heart failure 9% 6. (B) Reductions in Total Cholesterol in the general population not on statins 6% 7. (F) Hypertension medication 5% 8. (D) Changes in hospital based patient groups NSTEACS 0.8% 9. (C) Changes in hospital based patient groups – STEMI – 0.3%