Transforming prevention: ASH’s response to the NHS 10-year Health plan consultation
In November, the Government launched a new consultation as part of their 10-year plan to reform the UK’s health service. ‘Change NHS: help build a health service fit for the future’ asked organisations, NHS staff and the public for their input into they would want the 10 year health plan to include, what changes should be made and how they should be implemented.
ASH has responded, emphasising the urgent need for comprehensive measures to reduce smoking rates through a sustained focus on primary and secondary prevention both through population level interventions and individual treatment. The cost of smoking to our nation is staggering. Each year, smoking claims 64,000 lives, creates 408,700 hospital admissions, and is responsible for half the difference in life expectancy between the most and least deprived in society. Smoking is a risk factor for all six of the conditions identified as contributing 60% of total Disability Adjusted Life Years in England. Best known are smoking and cancer, CVD and COPD (smoking is responsible for 27%, 13% and 90% of deaths from these causes). In 2023 alone, smoking drained public finances in England by over £11.3 billion, with the NHS bearing a £2.6 billion annual burden. It's clear that prevention isn't just a strategy – it's an urgent necessity.
The benefits of quitting smoking are such that investment in smoking cessation and tobacco control measures provide a net benefit to public finances from year one onwards, as well as supporting economic growth and reducing pressure on our NHS and social care services. Reducing smoking prevalence has a significant impact on the population’s healthy life expectancy, particularly in our most disadvantaged communities with the highest rates of smoking. ASH found that the impact of one year of a fully established tobacco dependency treatment service across England would result in an additional 523 bed spaces created per day.
ASH’s consultation response to the NHS’s 10-Year Health Plan focused on six critical recommendations that can help make the shift from sickness to prevention:
1. Leverage population-level measures
The upcoming Tobacco and Vapes Bill presents a pivotal moment for systemic change. While the legislation alone will make only a minor difference to current smoking rates, how we build upon it will be decisive. A comprehensive, system-wide communications plan that unifies hospital trusts in enforcing smoke-free environments and accelerating quit attempts is essential.
2. Build on proven evidence-based programmes
The NHS has already made significant strides in establishing in-hospital treatment services for smokers. The maternity sector offers a compelling success story, with smoking at delivery rates dropping at their fastest-ever rate. However, these programmes are currently underfunded by £15 million. ASH recommends maintaining and expanding these evidence-backed interventions, particularly in acute and mental health services.
3. Empower Integrated Care Board (ICB) leadership
ASH proposes a collaborative approach that extends prevention efforts beyond NHS boundaries. By fostering partnerships between local government and NHS services, we can create more aligned, population-level interventions. Success stories from regions like North East and North Cumbria demonstrate the potential of this integrated strategy.
4. Secure dedicated prevention funding
A commitment to dedicated NHS prevention funding – protected from being diverted to address treatment emergencies. Aligned with the Hewitt recommendation of 1% of the NHS budget, this would enable scaling up proven support models in lung health checks, Talking Therapies, A&E, and outpatient clinics.
5. Preserve local government's critical role
Local government holds immense expertise in smoking cessation and tobacco control. Ensuring a well-funded Public Health Grant and local government's active involvement in ICB plans to support all populations effectively are vital.
6. Develop a national roadmap
A comprehensive "Roadmap to Smokefree Britain" would provide strategic coherence, clearly defining responsibilities, setting targets, and outlining a vision for change. This would include renewed funding for mass media campaigns, "swap to stop" initiatives, financial incentives for pregnant women, and robust enforcement mechanisms.
Claire Wells, Policy Officer (NHS Lead) at ASH