This is a really interesting question Lawrence. Completely agree with the idea that lifestyle changes should be pushed forward and promoted to the nation as a whole before we might become a patient, however I’m not sure who’s responsibility this should be and the best way to go about it. It is quite rare to see government campaigns in partnership with the NHS which promotes making “healthier” lifestyle choices, but I suspect this is down to the lack of resource and the fact it is not being prioritised currently

Hi Lawrence, This is a very valid and interesting question. I recently attended a session on Population Health Management (PHM) and I feel that there is some cross over here as they consider the wider determinants of people’s health, rather than just a diagnosis / specific illness. https://www.england.nhs.uk/integratedcare/what-is-integrated-care/phm/#:~:text=Population%20Health%20Management%20focuses%20on,of%20communities%20and%20local%20people. Population health has now been listed as a core strategic aim for integrated care systems across the NHS, but of course some ICS’s are acting on this better / faster than others as is always the way.

Also, the question could be challenged / answered best if the person asking it had a greater understanding of the implications of not looking after themselves in the best possible way- from a whole person/holistic approach. I feel some of this comes down to population education and empowerment- and this ties in with a lot of work we do at Surgery Hero. It’s not enough to simply tell a patient to do XYZ to benefit their health- this may seem like a task or chore, they should be educated in an appropriate way to truly understand *why* XYZ is critical to their treatment and further quality of life. Hopefully then it wouldn’t seem like another ‘thing’ we are asking patients to do but rather a natural way of life to maintain ones health as best as possible.

Kind regards, Chloe

Great question Lawrence. For me it feels important as looking after ourselves can really give us control when things in our life feel out of control, empowerment and resilience through what can be a physical and emotional rollercoaster. Small changes really matter, at or shortly after diagnosis we know can be a teachable moment for very brief advice which may just someone in the right direction/give them permission to take control….

Agree with June. The questions is framed as if ‘wow, this is another thing I need to contend with’ rather could consider reframing the conversation around lifestyle interventions being a way to aid in coping with their diagnosis (as well as preparing for treatment).

The wider question is more tricky as it needs a wider range of collaborators, personal choice and political will. Smoking shows us that it is possible to make some changes over time e.g. association with the changes to the law and reduced smoking rates. There are ways to take this further e.g. New Zealand are gradually raising their smoking age so that adults can continue to choose to smoke but if you are a child born today that you will never be legally able to smoke in New Zealand. However, there will may always be new challenges / unknowns e.g. vaping.