
Innovative financing mechanisms can attract non-traditional sources of capital into community-level preventative care, protecting the NHS for the long term
27 January 2024 (London, UK)—With a shift towards preventative healthcare needed by both the National Health Service (NHS) and the new United Kingdom (UK) government, innovative financing solutions are critical to ensuring the sustainability of the health system. The Reinvention of Prevention: How to Fund and Finance a Pivot to a Prevention-First Healthcare System, a new report by the Milken Institute, a global, nonprofit, nonpartisan think tank, responds to the challenge posed by the need to simultaneously invest in national health prevention infrastructure while also funding existing spending priorities around tackling the NHS waiting lists and meeting recruitment and workforce challenges within the health system. The report proposes innovative financing mechanisms to channel additional capital into community-level preventative services: a blended finance fund to attract Local Government Pension Scheme funding, using the Business Relief (a form of tax relief) to attract additional private capital, and a social impact bond to provide an initial proof of concept. These financing mechanisms are starting points to inform policy conversations on how we can ensure the long-term sustainability of the NHS, while preserving the founding principles that healthcare should be comprehensive, universal, and free at the point of access.
“Investing in prevention improves individual health and makes economic sense,” said Simon Radford, PhD, director of policy and programming at the Milken Institute and one of the report authors. “Preventing, stopping, and delaying disease can reduce healthcare costs and enhance the nation's productivity. The Local Government Pension Scheme already invests in investments that are also policy priorities, from affordable housing and nature-based solutions to the climate crisis. Our pension pools should be able to invest in long-term, UK-based health prevention infrastructure too, which can raise our growth rate through a healthier population.”
“As the NHS attempts a major strategic shift from treatment to prevention, this timely report provides fresh and creative ideas that are worthy of serious consideration,” said Tom Kibasi, chairman of NHS Mental Health and Community Providers, NW London.
The report examines the challenges of this historic underinvestment in preventative care and offers actionable recommendations to bridge the funding gap. If enacted, its recommendations will mobilise additional capital into community-level infrastructure, such as local vaccine clinics, community health screening stations, mobile health units, and wellness centres.
The report outlines the creation of new financing models, based on interviews and insights from experts in health, finance, and policy.
The establishment of a Prevention Fund, structured as a Blended Finance Fund, would leverage government resources and philanthropic capital to attract additional investment from local government pension pools seeking both financial returns and positive social impact. By mobilising local government pension money, the government would be solving multiple ambitions at the same time: firstly, meeting the challenge outlined in the chancellor’s recent Mansion House speech for pension money to invest more both in the UK and into infrastructure; secondly, to help stem the flow of patients into the NHS; and thirdly, to potentially arrest the growing social care bill that is pushing local council finances to the brink, all the while providing returns for local government pension fund beneficiaries.
“While this report focuses on the UK context, we hope that this pathbreaking work will hold lessons for health systems globally,” added Esther Krofah, executive vice president of Milken Institute Health. “Health systems around the world are wrestling with how to fund both the treatment of a growing incidence of chronic disease while also finding ways to finance effective, long-term investment in prevention to reverse this trend. The Milken Institute’s Project Prevent initiative is all about finding solutions to meet this challenge.”
The report was informed by interviews with leaders in politics, health policy, and innovative finance and with asset owners. A full list of interviewees is listed at the end of the report.
Read the full report: The Reinvention of Prevention: How to Fund and Finance a Pivot to a Prevention-First Healthcare System.
About the Milken Institute
Milken Institute is a nonprofit, nonpartisan think tank focused on accelerating measurable progress on the path to a meaningful life. With a focus on financial, physical, mental, and environmental health, we bring together the best ideas and innovative resourcing to develop blueprints for tackling some of our most critical global issues through the lens of what’s pressing now and what’s coming next. For more information, visit https://milkeninstitute.org/.
About Milken Institute Health
Milken Institute Health bridges innovation gaps across the health and health-care continuum to advance whole-person health throughout the life span by improving healthy aging, public health, biomedical science, and food systems.
About Project Prevent
Project Prevent is a programme of Milken Institute Health sparked by our long-standing advocacy on preventive health. It aims to bring together leaders and experts across sectors—including health, finance, technology, and government—to create a scalable and sustainable blueprint for pivoting towards a prevention-first health system. GSK, a founding partner of Project Prevent, provided financial support for this initiative.
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