From evidence to impact: making prevention stick

Spending on health as a share of GDP has tripled since the 1950s, and projections suggest it could double again over the next 50 years. We cannot afford to spend £1 in every £7 of our national wealth on health if it is not delivering much better health. A genuine pivot to prevention is not a ‘nice to have’, it is central to the sustainability of the system. This opening keynote will explore:

• where prevention has delivered real progress

• why success has been uneven and fragile

• what this tells us about leadership, power and persistence.

Despite renewed ambition through the government’s health mission and the 10 Year Health Plan, progress on prevention remains slow and uneven. Hear from those involved in this work about how they have made change happen and what they have learnt:

• what has worked, where progress has stalled and upcoming challenges

• what past successes reveal about how change really happens

• how to keep people and lived experience visible when systems come under pressure

• how to build on what has been accomplished.

Across the health and care system, there is growing enthusiasm for working differently at neighbourhood level to improve health and reduce demand on services. But moving from a system that largely does things ‘to’ people, to one that genuinely works ‘with’ people and communities, represents a profound shift, and one that is central to delivering effective prevention and improving population health.

This session will explore why a ‘do with’ approach is critical to prevention, and what it means in practice for systems under pressure to move upstream, reduce avoidable demand and support healthier lives.

The discussion will focus on:

• why prevention struggles in a ‘do to’ system, and how a ‘do with’ approach enables earlier action, trust and sustained behaviour change

• how communities are already making a difference to prevention and population health, and what the system can learn from this

• what doing with looks like in practice

  how leaders can create the conditions for authentic community power

• what neighbourhood‑based approaches are teaching us about delivering prevention at scale and reducing long‑term demand on health and care services.

This session focuses on the fragility of prevention gains, and how easily progress can be stalled or reversed. We will consider the impact of external forces, as we ask are genuinely prioritising prevention as a sector, or is it still too easy to sideline?

• why prevention gains are easier to undo than to build

• accountability gaps: who benefits when prevention fails?

• policy retreat, deregulation and short political cycles

• what failure in prevention reveals about incentives and power

A practical, case‑study‑led session exploring which system levers have genuinely sustained prevention over time. Drawing on real examples where prevention has been embedded at scale, it will explore what distinguishes approaches that last from those that fade when pressure mounts. This session will build on the opening plenary session and explore practical examples and discussions:

• what we can learn from areas where prevention has been sustained over time and what this looks like in practice

• how to measure the impact of prevention

• opportunities to co-create solutions

This session explicitly confronts poverty as the most powerful determinant of health and asks what prevention can realistically achieve without addressing income, security and power.

This plenary will focus explicitly on:

• how poverty and the cost‑of‑living crisis shape health outcomes across the life course

• why prevention cannot succeed without addressing income, security and power

• what past progress shows is possible when poverty is tackled directly

• what this means for national and local leadership

Prevention is widely recognised as essential to the long‑term sustainability of health and care, yet in day‑to‑day leadership roles it is often one of the first things to slip when operational pressures mount. This session will explore how leaders can make space for prevention when everything feels urgent, and how they can make prevention visible, legitimate and defensible in real‑world decision‑making. This interactive session will focus on:

• prioritisation and trade‑offs in crisis‑driven systems

• making prevention visible and defensible in day‑to‑day leadership

• what this means for me, in my role

• what has to stop, as well as start

This session will explore what the rapid emergence of GLP‑1 weight‑loss drugs and similar preventive interventions means for the NHS and for health inequalities.

It will consider the potential benefits of these treatments alongside the challenges they raise for access, affordability and prioritisation. The discussion will examine how decisions about if, when and how such interventions are scaled could shape who benefits from prevention, and what this means for efforts to tackle health inequalities. This facilitated discussion will use policy examples and challenge questions around:

• how access to new preventive treatments is being shaped by cost, capacity and eligibility - within and beyond the NHS

• the implications of a growing private market for prevention, and what this means for equity in a universal system

• how leaders can navigate innovation, cost pressures and fairness when deciding whether and how prevention is delivered at scale.

Using the principle that two things can be true at the same time, the session will examine how staff are already supporting prevention, while operating in systems that often make this difficult or unsustainable. It will draw on recent research and frontline experience to understand what it would take to make prevention part of everyday practice, not an add‑on.

The session will explore:

• why staff are not the barrier to prevention, and what they are already doing

• how system structures, incentives and pressures unintentionally crowd prevention out

• what the workforce is telling us would make prevention easier to deliver in practice

• what can change now to help prevention stick at scale

What can we learn from different regional, and national approaches to prevention and what does this tell us about what needs to change next? Drawing on recent examples from national policy and local delivery, this session will challenge participants to think more honestly about the conditions required for prevention to endure, and what needs to change if prevention is to survive periods of pressure rather than be quietly deprioritised.

The session will explore:

• what are national/regional/local leaders doing differently?

• how do we make progress on prevention during sustained economic and social pressure?

• what should leaders prioritise over the next 12–24 months? And what can wait?

• what does success on prevention actually look like?