Background/ Why Is This Important?
Improving the health of the British Columbia population through health promotion and prevention has gained increased importance, which means shifting focus on preventing disease as opposed to treating disease. While there is more focus being placed on prevention, there was no clear, specific provincial policy on clinical prevention, the Lifetime Prevention Schedule (LPS) provides guidance on the recommended clinical prevention interventions applicable to the general (low-risk) population of BC. The interventions included in the LPS are clinically effective, have significant population health impact and are cost-effective in the BC context.
What Actions Have Already Been Taken?
Where did this work start? In December 2009, A Lifetime of Prevention was published by the Clinical Prevention Policy Review Committee (CPPRC). A key goal of the CPPRC was to determine which clinical prevention services are worth doing in British Columbia, culminating in a proposed Lifetime Prevention Schedule (LPS). Clinical prevention services (CPS) were included on the LPS if they were considered to be effective had a significant impact on population health and were cost-effective.
Clinical prevention services (CPS) are defined as:
Manoeuvres pertaining to primary and early secondary prevention (i.e. immunization, screening, counselling and preventive medication) offered to the general population (asymptomatic) based on age, sex, and risk factors for disease, and delivered on a one-provider-to-one-client basis, with two qualifications:
- The provider could work as a member of a care team, or as part of a system tasked with providing, for instance, a screening service; and
- The client could belong to a small group (e.g. a family, a group of smokers) that is jointly benefiting from the service
Where Are We Now?
The Lifetime Prevention Schedule provides recommendations to government to support and fund clinical prevention services that are clinically effective, cost effective and have a substantial population health impact. The Lifetime Prevention Schedule process is currently being discussed as a basis for clinical prevention policy and screening policy at the Ministry.
Child Health BC funded and participated in the update to the Lifetime Prevention Schedule in 2014/15. Of interest to Child Health BC: fluoride varnish for children 0-5, dental sealants for children 6-7 and 12-13, vision screening for amblyopia in children 3-5, the well child visit, prevention of tobacco use in children/ youth and breastfeeding promotion were assessed. As fluoride varnish and dental sealants for children and youth were found (1) to have substantial population health impacts, (2) to be highly cost effective, and (3) to not be universally accessible for children in BC, the LPS Expert Advisory Committee developed a business case to provide options to government to implement these services.
Child Health BC participates on the LPS Expert Advisory Committee. This Committee is creating the priority list of services to be assessed in the next update to the LPS. The highest priorities are the assessment of the obesity in children service and the developmental delay/ autism/ speech language delay screenings services.
See Government of BC Lifetime Prevention Schedule: https://www2.gov.bc.ca/gov/content/health/about-bc-s-health-care-system/health-priorities/lifetime-prevention