One of the new secretary of state’s key priorities for the NHS is increasing investment in prevention, thereby delivering crucial cost savings and improving our national health. Yet with an NHS already seemingly lurching from one crisis to another, any change in focus towards prevention creates significant financial challenges, especially in the current cash-strapped environment.

The ‘National Emergency Service’

The crisis in the NHS has become particularly acute over the last decade. Real-term funding cuts have been compounded by the effects of an ageing baby boomer generation, while staff have felt additional pressure with staff shortages and the cap on public sector pay.

Our NHS has become more of a National Emergency Service than a National Health Service, often only dealing with health concerns where they become acute: we all know people who’ve had ‘non-urgent’ operations cancelled or delayed for months on end, often resulting in further complications as a result.

The reaction from NHS bosses to a shift towards prevention will rightly be: “well, you find the money because we are already struggling to do the basics.” There is, however, a solution: what if the NHS didn’t have to pay for the up-front cost of prevention?

Buy Now Pay Later

We’re all aware of the principle of repayment schemes – you get the benefit straight away while paying the cost back in manageable sums. This is how most people buy new cars, even new furniture. It works because you’re paying for a long-term benefit without having to bankrupt yourself right at the start, and the company selling the product has a secured source of revenue over several years. With these schemes it can cost more in the long run, but as consumers we accept this because we get the immediate benefit without having to worry about getting into debt. It’s seen as an investment with an attractive cost/benefit ratio.

So what if the NHS could get the preventative medicines now, enabling it to deliver long-term savings through prevention, while spreading the cost over several years? This would enable the NHS to deliver long-term savings without the correspondingly massive upfront investment. It could even be operated in such a way as to be effectively cost-neutral over five years.

Coincidentally, the current Pharmaceutical Price Regulation Scheme (PPRS) – a five year scheme in operation since 2014 – is up for renewal this year. This scheme is designed to give certainty to pharmaceutical companies and the NHS alike, and has kept the NHS spend on medicines flat – delivering real-terms savings over the last five years. One of the proposals which could be being considered is precisely this: a ‘Buy Now Pay Later’ scheme.

This kind of scheme could be used to finance medicines relating to the treatment of Hepatitis C, for example, but equally for revolutionary gene therapies or cell-based therapies. Many of these are currently under development and over the coming years look set to transform the treatment of a host of conditions, ranging from sickle cell disease to the most aggressive forms of cancer.

With negotiations on a new PPRS almost complete, it may be too late to ensure this scheme is a part of it, but that doesn’t mean it couldn’t be adopted by policymakers further down the line. For our NHS to be truly focussed on improving our national health, the focus should rightly be on prevention. We need a National Health Service, not just a National Emergency Service, and a ‘Buy Now Pay Later’ scheme, partnering with industry, could be the key to unlocking it.

Our public affairs team regularly comments on events that intersect the political sphere. To find out more about our work, email Sarah Jones