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Instead of adding the preventive programme into existing primary care services provided by
GPs, NHS chose to purchase the services from four provider organisations, three of which
are privately run. There are 41 geographically-defined sites in total and each site can select
the most suitable provider for their requirements through a local competitive process.
Consequently, the implementation of DPP varies across different sites. The DPP also
provides a range of incentives and support services for GPs to encourage the identification
and referral of relevant patients to the programme.

NHS England invested GBP 42 millions as of 2017/18 for CCGs to improve the capacity for
care and treatment of diabetes in their localities (NHS England, n.d.-a). Technical leads who
focus on the monitoring and evaluation of CCG Diabetes Assessments is essential to
maintaining long-term sustainability. Annual CCG Diabetes Assessments are conducted to
document the overall proportion of people reaching treatment targets and specific
biomarkers for diabetic, hypertensive, and hyperlipidemic patients. These assessments build
year-on-year illustrations of the progress towards greater gains in chronic disease prevention,
management, and treatment.

Canada: Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic
Disease
UHC is an achievable goal in Canada through the public funding system, through which the
medically necessary hospital, diagnostic, and physician services are financed through
general tax revenue and provided for free. Unlike the United Kingdom where the internal
market through a purchaser-provider split is promoted, Canadian health authorities
emphasise more on integration than competition through strategic purchasing. Hospitals are
both owned and operated by health authorities in Canada. Most payments to hospitals are
generally made on the basis of the previous year’s allocation adjusted for inflation and budget
growth, in the form of global budgets. As the Canada Medicare (the name of its publicly-
funded health system) mainly focuses on hospital-based essential health services, closing
the gap in community-based prevention and management of chronic diseases shifted to the
top of the government agenda in light of the escalating burden of chronic conditions. One of
the efforts made by government is primary prevention of chronic disease through multiple
partnership projects. The public health agency of Canada’s Centre for Chronic Disease
Prevention (CCDP) launched the Multi-sectoral Partnerships to Promote Healthy Living and
Prevent Chronic Disease initiative in 2013. This initiative involves both public and private
organisations to advance the use of evidence-based intervention that address common risk
factors for chronic disease.

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