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Optimising return on investment: spending your budget and generating the best value for money ... funding for public health falling, making the economic case for investment in prevention is more important than ever . All the studies showed public health is worth doing, and for most of them that is because of the large health gain they lead to. Section 6 responds to this. 1 Public health has traditionally been regarded as an economic good with mostly preventive attributes. changes will affect how local authorities are able to raise funds and meet the needs of their populations. As a starting point for this, RoI studies – and the tools and commentary that refer to them – could routinely and transparently distinguish between three sorts of returns: ‘cashable savings’ that provide public budget holders with a direct financial saving; ‘utilisation reduction’ that reduces the demand pressure on public services but which is not directly cashable as financial savings; and the monetised value of other outputs including health. What a surprise! The problem is patients want treatments, so a new system of social prescribing of social interventions and talking therapies should be commissioned whereby complementary therapists are paid for providing these interventions as pharmacists are paid for drugs. Because, as a society, we place a high value on health when estimates of health gain are included in RoI estimates of effective public health interventions, results tend to be very favourable, demonstrating why such interventions can be a wise use of resources. We don’t know how that £14 breaks down into cash saving (and if it did, whether savings would fall to the NHS or other sectors) or health or other outcomes of value since the authors didn’t report this information. Our first effort has, in many ways, raised more questions for us than it has answered, but that is part of the learning process in understanding how to best 'evidence' value and worth and to communicate that message. NICE and PHE are clear about the strengths, weaknesses and caveats in the use of each. In brief, it’s a methodology that comes from the economics literature of project appraisal, and is closely related to cost-benefit analysis. Everyone, but especially those with control over what gets funded and prioritised locally and nationally, needs to stop conflating RoI and cost savings. In the public health debate, and particularly when public health interventions are proposed, the ‘return on investment of public health’ is increasingly seen as a synonym for ‘cost-saving’ (either as directly cashable savings or through demand reduction), often, but not exclusively, to the NHS. It’s a good sign that Public Health England are increasingly aware of this as a problem. Information and resources on assessing return on investment (ROI) and results An Integrated Framework for Assessing the Value of Community-Based Prevention IOM’s report that proposes a framework to assess the value of community-based, non-clinical prevention policies and wellness strategies Those of us who advocate for public health also need to be wary: it’s understandable and tempting to take headline RoI figures without looking into what they truly imply and use them to lobby for public health. What is the return on investment (ROI) for participating in a health information exchange (HIE)? This content relates to the following topics: The increasingly common misunderstanding and misuse of the term ‘return on investment’ and its conflation with ‘cost saving’ to public services – usually the NHS – are a cause for concern. A 2018 study assessing the cumulative impacts of all health-related spending Which programmes, that we invest in, have the best return for our population? written submission to the House of Commons Health and Social Care Select Committee, Successful implementation of the NHS long-term plan depends on adequate funding for social care and public health, NHS. This shouldn’t be a surprise, since the purpose of RoI is to value the overall return, and the purpose of public health interventions is health gain. Making local government finance even more local, How might prospective changes to local government finance impact on health and wellbeing? Great summary. But their decisions also depend on the level of certainty around the point estimate of the ICER. Examples of community health enterprises include a corner store that sells fresh produce, a community health ... designed to generate both a health benefit and a financial return… In this video, find out why public health is a great investment for all. That’s the bar for NHS treatment and drugs, it should be the same for public health interventions. This paper summarises and personalises some of that information. What does the autumn 2020 Spending Review mean for health and care? It will be interesting to see how these challenges change as we move towards the new "Dorset Integrated Care System". public health grant contrasts with the long term certainly it has given the NHS, writes Sally Warren. 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