Digital prevention

Transcript

Introduction

Welcome back to Neighbourhood Health Conversations, the space where we explore how health and care can feel more human, more connected, and more grounded in the realities of people’s lives.

Today I want to share a question that’s been niggling away at me recently. I found myself wondering how is it that as a society we’re healthier and wealthier than ever, yet so many of us feel unwell, overwhelmed, and in need of ever increasing amounts of healthcare.

Somewhere along the line, I think we’ve slipped into equating health with the absence of disease. But what if health isn’t just a gap between one diagnosis and the next? What if it’s something we can experience even in the presence of disease? Because it’s rooted in what matters to us, how we sleep, how we move, our sense of belonging, and how we eat. And if that’s true, what might help move us from an unhealthy obsession with managing illness to creating health? Could digital, of all things, be the opportunity we’ve never really had before?

Why Digital Health Still Focuses on Illness

Now, whenever we refer to digital in an NHS context, perhaps we picture apps, dashboards, remote monitoring, virtual triage, and in many ways, these tools have already shaped how people interact with the system.

But when you look closely, almost all of it still revolves around illness. Digital is helping us detect diabetes earlier, monitor heart failure more efficiently, triage demand more quickly, all of which is absolutely helpful, but not really transformational, because it still frames the goal as avoiding deterioration and illness and not creating health.

A Different Kind of Digital: David’s Story

Meet David. David is 52, he works long hours, sleeps poorly, and tells himself he’ll get back into exercise next month. He’s not unwell exactly. He’s just flat, stuck, losing confidence. One day he downloads a digital health app after a bit of a scare with his blood pressure.

At first it does what most apps do. It counts steps, logs weight, reminds him to drink water, arguably all perfectly sensible, but none of it really changes anything. Because it’s trying to manage risk, not create meaning. But then something shifts. His local neighbourhood team invites him to try a pilot programme. It’s around digital metabolic health coaching and linked to community activities.

Still an app, yep. But this time the purpose is different. Every morning it checks in gently about sleep, not as a metric, but as part of a conversation. It nudges him toward a lunchtime walking group and somewhere to meet with others and play pool, a great passion of his, real people in his real neighbourhood.

It explores what matters to him, not what’s wrong with him. It helps him notice the small wins before the big changes. And slowly David begins to feel more alive. Not because the app is clever, but because digital finally becomes a connector to his community, to better habits, to himself.

From Disease Management to Health Creation

This is the kind of digital prevention we almost never talk about. Not digitised disease management, but digital health creation. If we want digital to create health at scale, then there are probably at least four things that need to happen.

First, we need to reframe the goal from efficient, productive healthcare to creating health. If digital prevention is going to matter in this space, it has to sit within a much broader ecosystem than simply healthcare alone. This means connecting people not just to services, but to everyday things that shape health in real life. Walking groups, community food projects, places to meet, talk and belong, even something as simple as a regular game of pool.

When digital tools help people find and connect with those assets, they stop being about efficiency and start being about life. And when digital points outward into communities rather than inward towards services and systems, it becomes a genuine catalyst for health creation, not just a more efficient way of managing illness.

Making Digital Prevention Personal

The second thing is to ensure that prevention is personal and accessible. We already have the technology to offer coaching, gentle nudges and day-to-day support, often through tools people already use like the NHS app or other platforms. But making prevention personal means starting with what matters to people, not what’s the matter with them. It means tailoring support around how someone sleeps, eats, moves, and connects to the world.

And doing that in small, achievable steps that fit real lives, not ideal ones. It means tailoring support around how people sleep, eat, move, and connect to their world, and doing that in small, achievable steps that fit real lives, not ideal ones or average ones. And making it accessible means recognising that digital should widen the circle, not narrow it. So every digital offer should have a human root alongside it. Community workers, neighbourhood teams, trusted local support, so that no one is left behind. And when digital and human support work together, prevention becomes something people can actually engage with rather than something that’s simply offered.

Funding Prevention for Long‑Term Impact

The third thing is we need to reimagine the funding and acknowledge that perhaps prevention pays back faster than people think. The real barrier isn’t that prevention takes too long to show results, it’s that our financial system is designed around treating illness, not around recognising or realising the benefits of prevention. Digital prevention often starts to pay back within a year even, sometimes sooner. But very few people in the system hold budgets in a way that allows them to notice that return, let alone invest in it or act on it.

Instead, budgets tend to be held in short cycles. They’re reset annually. Priorities shift, pressures mount, and the system moves on before the benefit has time to show up. If we’re serious about prevention, we need multi-year investment frameworks, not annual resets, long enough for good ideas to bed in, demonstrate impact, and build confidence.

Short‑term Budgets vs Long‑term Prevention

And the fourth area is ensuring that perhaps we start small and certainly designed to align. Because this is where so many good ideas still fall over. I recently read a LinkedIn post by Catherine Ward from Oxford Science Enterprises that really caught my eye because it put into words something I’ve seen repeatedly over the years. We often talk about the delay between research and routine practice, but as Catherine points out, and certainly my experience has borne out over the years, it’s rarely the science that slows us down. What slows us down is misalignment.

The successful implementation of health tech tends to move at the speed of alignment, not innovation. Brilliant ideas can stall because the evidence, the workflow and the funding don’t line up. So when we talk about starting small, this isn’t about being cautious, it’s about being deliberate, designing for real world use from the start, measuring outcomes that matter, being clear about where the value shows up and where the money flows, which with prevention and health creation can be really challenging. When evidence, workflow and funding align, the gap doesn’t just shrink, it collapses. And that’s exactly the mindset we need if digital prevention is going to move from interesting pilots to everyday health creation.

Creating Health Where People Live

Let me pose a question. What if the future of a sustainable NHS requires it to widen its perspective from treating disease to one that’s more about helping people build health every day in ways that matter to them? What is the role of digital in that?

Whilst I don’t think that digital can do this on its own, it can give us something we’ve never really had before. A way to reach people earlier, before problems escalate. A way to stay better connected between appointments rather than starting again each time. A way to better support behaviour change and a sense of belonging at scale, not just for those already engaged. And when that happens, the whole conversation begins to shift away from avoiding illness as the goal and toward creating health as something people can experience and build day by day in the places where they live their lives.

Conclusion

Thanks for listening to Neighbourhood Health Conversations. If today’s episode has sparked ideas, especially about how technology could help people stay well in their everyday lives, please share this thinking with your colleagues, your teams and your communities. And join us next time as we continue to explore how health and care can feel more human, more connected and more grounded in the realities of people’s lives.