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The most common are conditions of musculoskeletal pain, such as osteoarthritis or back and neck pain. Women are more likely to be affected than men. Her muscles and ts had become stiffer and more painful, making it harder to enjoy interests like jam-making, gardening and art classes.

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The most common are conditions of musculoskeletal pain, such as osteoarthritis or back and neck pain. Women are more likely to be affected than men. Her muscles and ts had become stiffer and more painful, making it harder to enjoy interests like jam-making, gardening and art classes. Nora decided it was time to make markket changes to push back against the negative impact arthritis was having on her life.

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After taking advice from healthcare professionals and doing online research, Nora started an exercise routine that worked for her, incorporating Pilates, low-impact exercise on a cross-trainer or a bike and swimming. That means the world to me. After speaking to colleagues at work, Helen now receives the help and support she needs to continue in her role. I was feeling sick, not wanting to go into work.

This is sometimes called multimorbidity. She had to stop work in when she got fibroids, and was bedridden for 2 weeks at a time. Since stopping work, Susan has been diagnosed with osteoarthritis, COPDhypothyroidism, angina, high blood pressure and high cholesterol, depression and diabetes. She takes 14 different medications every day and her illnesses can feel as though they consume her life. Some health conditions we are born with and cannot avoid. Where this is the case, the priority is supporting people to enjoy a good quality of life and to live well.

But they will help us towards achieving this mission. Further details on this will be provided later in the year, through a government response to the green paper. Markett that disability-free life expectancy has remained stable in recent years, [footnote 29] this onoine likely to be extremely difficult, and will require bold action. Much has been written on the factors that shape our health. Nevertheless, most people agree that the choices we make, shaped by the conditions in which we live, have the biggest impact.

The focus of this green paper is on services, choices and conditions. If we are to achieve our mission, we need to take bold action in all areas: making the most of the opportunities in front of us and being open to innovations ahead. This includes: bringing in a new wave of onlne public health, which is more proactive, predictive and personalised, while also taking tough action on our biggest challenges: smoking, obesity and mental ill-health [footnote 32] taking a behavioural science approach to some of our biggest challenges on prevention.

This means making healthy choices as easy as onlime for people, and, in some cases, making all options healthier viewing health as our most precious asset, and not just a problem to fix when it goes wrong. Good health is the foundation of happy families, caht communities, and a strong onllne. When our health eex good, we take it for granted. When our health is bad, we karket the NHS to do their best to fix it.

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The future is even greater personalisation and a closer fit with individual needs. But it can be less intrusive and better value for money to offer people more personalised and tailored support. Many are already opting in to this kind of approach. In the next decade, intelligent public health will mean: focused support and advice omline those who need it and choose to participate precision medicine tackling current and future threats Predictive prevention Starting this year, PHE will work together with NHSX and other partners across the public health system, academia, industry and the voluntary sector to build a portfolio of new innovative projects that will help us ssex and model Predictive Prevention at scale.

We can tailor our diet to meet our coonado, we can for air pollution in our exercise plans, and we can take action to prevent painful diseases decades before they would begin. And we know this is only the beginning. Finding insights in this data is an ongoing challenge, one that can be met on our phones and tablets, in the GP surgery or nationally, at a population level. We are entering a new era of evidence-based self-care, driven by us as patients in partnership with the NHS.

PHE and the NHS use data and insights to create these algorithms and models, and the public can have a role in this if we choose to help by either allowing our phones and devices to send data, or by allowing PHE and the NHS to access our anonymised clinical data. To date, there have been over 7. The UK Biobank has also been able to build a record of the data of over half a million volunteers.

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They will also explore developing models of dynamic, informed consent, so we can choose how and when we want to share our personal data for this purpose. The impact achieved will be constantly evaluated in the open, with regular and transparent engagement with the health sector and the public — ensuring that individual interventions are having a positive impact overall, and that we are narrowing the gap between richest and poorest.

Some of the most exciting opportunities for intelligent prevention are those that can be developed locally, including as part of devolution areas that have a broad focus on economic development alongside a commitment to improve health. The learning from these experiences can be shared more widely to enable other areas to benefit. This will involve a programme of work to explore, test and learn from new opportunities to prevent ill-health using the latest technology — stimulating innovation in ways that can support both health and wealth.

The digital version gives the same advice on healthy eating, exercise and weight management as the face-to-face programme, but through wearable technologies, apps and websites. It is deed for those at risk of type 2 diabetes who find it difficult to attend sessions because of work or family commitments. Early analysis from pilots involving over 4, people shows the digital programme is reaching more people of working age.

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Andrew, a year-old farmer from North Yorkshire, took part in the pilot. This helped him lose weight and reduce his blood sugar levels out of the pre-diabetic range. I get a video message from my personal health coach a couple of times a week with diet recommendations and fitness techniques personalised to me and my lifestyle plan.

I send a text back and we keep up the conversation digitally. I also like reading the comments and conversations on the online community. Focused support and advice In the future, the support and advice we provide to people will become much more focused and tailored. We will start this transformation with 2 of our largest existing programmes — screening and NHS Health Checks.

Intelligent screening Screening programmes have long been used to identify those at risk of or already living with health problems.

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Our vision for future screening in the NHS is for: uptake to be maximised, including by making screening easier for people to access, and tackling unjustified variations in take-up existing national screening programmes coronwdo become more personalised and stratified by risk, so we focus interventions where they are most needed. For example, reviewing the case for increasing cervical screening intervals for lower-risk groups, such as women vaccinated against human papillomavirus.

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We also know that the predictive power of a screening test is cuat if marlet identify high-risk groups, rather than screening everybody focused screening within high-risk populations to be offered for a greater range corobado conditions. For example, considering introducing lung cancer screening to high-risk individuals, such as smokers, together with more marker ongoing support better use of technology, including an expansion of our offer on genomics, better use of data and embedding the use of artificial intelligence.

This includes incorporating genetic testing into screening and diagnostics. For example, using next generation sequencing to confirm cases of cystic fibrosis in children currently being tested in the newborn bloodspot programmeor screening for genes associated with Lynch syndrome, which le to an increased risk of onlinee cancer recommendations to be developed in a co-ordinated way across different kinds of screening opportunity, while continuing to be based on the best evidence and advice.

For example, by reviewing how the different sources of expert advice on screening, in particular the National Institute for Health and Care Excellence NICE and the UK National Screening Committee UK NSCnarket to one another faster implementation of recommended interventions and programmes, with clear ability for delivery and investment in supporting IT Professor Sir Mike Richards is currently carrying out a review of cancer screening.

The report is due to be published in September This provides a good opportunity to update and modernise our approach to screening. We recognise that there are challenges in the existing screening arrangements, and that reform is needed to achieve our vision for the future. Recommendations from the review will help shape our plans for change, markey by a strategic review of IT required corobado enable our vision for future screening. NHSX will lead on this element of the screening strategy.

We also recognise that there remains variation in screening outcomes across the country, and by deprivation and ethnicity. As part of our response to Public s Committee PAC recommendations, we will set out our understanding of the variation in performance and a plan for reducing these inequalities. We are due to respond to these recommendations in Marekt. Health Checks offer people aged 40 to 74 a free check-up of their overall health, every 5 years.

The can tell people whether they are at higher risk of developing certain health problems, such as heart disease, diabetes, stroke and dementia. People who had already been offered an NHS Health Check, but had not responded, were sent a text message inviting them to access the digital check.

A third of the people accessed the digital check. Half of these completed it to find out their chance of having a heart attack or stroke in the next 10 years. More than 1 in 10 of those using the digital check were found to be at high risk of having a heart attack or stroke and so went on to complete a face-to-face NHS Health Check.

These important checks focus on the leading causes of premature death and ill-health such as obesity, smoking, high blood pressure and type 2 diabetes, therefore offering people the chance to lower or manage their risk. But uptake varies across the country, [footnote 33] the risks identified in a check could be followed up more consistently by the NHS, and evidence is emerging that people could benefit from a more tailored service. Building on the gains made over the last 10 years, we believe the time is right to take a step back and consider whether changes to the programme could help it deliver even greater benefits.

The government will commission an evidence-based review of the NHS Health Checks programme to maximise the benefits it delivers in the next decade.

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Details will be confirmed later this year, but the scope is likely to include: ways of increasing uptake, particularly among high-risk groups options for making it more focused, for example identifying people on the basis of information about their likely risks, rather than making the same offer to everyone. Precision medicine Genomics is changing the future of health and medicine.

From providing more tailored cancer marker to helping diagnose unknown conditions, it will underpin a new era of precision medicine. Over the next decade, we want to build on our position as a world leader in genomics and make the UK the one destination to research and develop the latest scientific advances in genomic healthcare. It coroonado the unique blueprint that makes every person different from every other, and tiny variations in the genome can have ificant impacts on our life and health.

Sequencing these variations can help doctors identify people at risk of developing treatable diseases, speed up diagnoses and find effective personalised treatments that deliver better with fewer side effects. For the last 70 years, the UK has been at the forefront of the use of genetics to improve healthcare.

We have led the way globally with initiatives like theGenomes Projectwhich was led by Genomics England and is the largest national sequencing project anywhere in the world. This project is already making a real difference for patients. Early show 1 in 4 rare disease patients ly without a diagnosis now receive one, and up to half of cancer patients could be provided with findings that put them and family members on a better care pathway.

Later this year, Genomics England and the NHS will start returning of additional findings related to preventable conditions to participants who have sx to receive them.

These may be available based upon follow-up analysis of their samples. The Genomic Medicine Service in the NHS is the first of its kind in the world to integrate whole genome sequencing into the healthcare system. It aims to deliver equitable access to genomic testing to help more accurately diagnose disease and personalise treatments and interventions.

Our partnerships with researchers, industry and governments, domestically and internationally, all contribute to advancing this area. Genomic approaches will be transformative for early detection of many of the common diseases and cancers. Opportunities to understand how best to realise these benefits will be explored as part of plans to sequence 5 million genomes by tothrough a unique collaboration between the NHS, UK scientists and industry.

Genetic risk in healthy populations We know genetic cyat play a role in human health and disease, including most major chronic diseases. For some diseases, many thousands of genetic variations across our genomes esx have a small impact on the chance that we will develop some common diseases. It is now possible to combine this genetic information from many people into polygenic risk scores PRSwhich identify those at highest risk of particular diseases.

This could allow individuals to make lifestyle changes that will help prevent disease or reduce its impact, lead to more effective prescription medicines and improve other public health interventions.

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