Some practices seem to get more out of prevention work than others, even when they are operating under similar pressure and constraints. From the outside this can look like motivation or leadership. From inside a practice, it shows up in smaller, practical ways: fewer repeat calls about the same issue, fewer “while I’m here” conversations, and fewer patients returning because they were unsure what they were meant to do last time.
The difference is rarely effort. It usually comes down to a small number of deliberate choices about where attention is focused, how patients are supported to act, and what the practice is realistically trying to change over time.
In primary care, prevention is about acting earlier and more intentionally, rather than waiting for problems to resurface. That might mean identifying risk sooner, supporting people to manage conditions more confidently day to day, or helping patients handle issues that do not always need an appointment.
When it works, prevention creates space. Patients get support earlier and in ways that make sense to them, and practices spend less time dealing with avoidable repeat contact and more time where clinical input adds most value. This approach aligns closely with population health management thinking, but it lives or dies on what happens in everyday practice.
In reality, prevention work is always competing with full appointment lists, stretched admin teams, and patients who understandably prioritise today’s problem over tomorrow’s risk. If prevention activity does not fit that reality, it quietly falls away — not through lack of belief, but through lack of time.
Practices that get more value from prevention tend to be proactive by design rather than reactive by default. Turning that intent into something that holds up in routine work is harder. Based on delivery experience, a few patterns consistently separate prevention activity that delivers from activity that quietly stalls.
1. Be explicit about who prevention is for, and who it isn’t
Practices that see more impact are clear about who they are prioritising at any given point. Rather than defaulting to broad eligibility lists, they make conscious choices, such as:
- focusing on frequent attenders where contacts are largely reassurance-driven
- prioritising patients at early or emerging risk rather than those already well controlled
- targeting activity that is likely to reduce future demand, rather than work that is unlikely to change anything meaningful
This approach treats prevention as sequenced rather than universal. Some groups are deliberately deprioritised, not because they are unimportant, but because spreading effort too thin rarely leads to meaningful change.
Where practices try to do everything at once, prevention often becomes an invisible extra. Lists are generated and messages are sent, but ownership is unclear and attention quickly shifts to the next urgent issue.
Practices that are comfortable being explicit about their focus find that this clarity simplifies engagement, stabilises workload, and makes it easier to judge whether the work is actually helping.
2. Treat prevention as something you repeat, not something you finish
Prevention rarely works as a one-off push. Practices tend to struggle when they try to work through an entire cohort in one go, creating spikes in administrative work, pressure on clinical capacity, and frustration when uptake falls short of expectations.
You can usually tell when prevention has been treated as a one-off because staff describe it as something “we did last quarter” rather than something “we do”. That shift in language often reflects how sustainable the work actually is. Practices that see better results tend to:
- work in smaller, controlled batches
- review what happens after each round
- adjust both targeting and approach before the next cycle
This approach moves prevention away from being a disruptive campaign and into routine work. The aim is not to clear a list, but to establish activity that can be repeated without destabilising the system.
3. Put more effort into engagement than into generating lists
Once the right group has been chosen, engagement quickly becomes the limiting factor. Practices that see better uptake focus less on message volume and more on whether communications clearly answer a few basic questions:
- why am I being contacted now?
- what am I expected to do?
- what happens if I do nothing?
Plain language consistently outperforms formal or generic wording. Explaining why someone has been selected and making the next step explicit both reduce hesitation and drop-off.
Most prevention activity does not fail because patients are disinterested, but because they are uncertain.
4. Reduce friction before increasing follow-up
When uptake is lower than expected, the instinct is often to add reminders or increase messaging. Practices that get better results usually look first at friction:
- how many steps a patient needs to take to act
- how clear the route is from message to action
- how much back-and-forth is required
In everyday practice, friction shows up as follow-up calls that start with “I got a message but…” or appointments booked simply to check whether anything needs to be done. These are not disengaged patients, but cautious ones.
Removing a single unnecessary step often has more impact than adding multiple follow-ups. Clear routes, fewer hand-offs, and obvious next actions such as direct booking links, make prevention easier for patients and reduce avoidable work for reception and admin teams.
5. Support self-care in ways clinicians are confident standing behind
Encouraging self-care is straightforward; supporting it consistently is not. Where practices struggle, advice often varies between staff or clinicians are unsure whether what they are recommending is appropriate or defensible. That uncertainty frequently leads to a default safety net of “book an appointment just in case”.
Practices that do this better prioritise consistency over choice. They reduce reliance on individual memory or preference and make it easier for staff to recommend the same options with confidence, knowing what patients will see and what advice they’ll receive.
Some practices and PCNs support this through structured digital navigation. Tools such as CareNav, developed by ORCHA, provide a reviewed set of digital options that clinicians are comfortable recommending and that patients can trust. Used this way, digital tools support self-care alongside clinical care rather than attempting to replace it.
6. Look for consistency throughout the practice
One of the less visible differences between stronger and weaker prevention approaches is consistency across roles. Where prevention is inconsistent, patients quickly learn that answers vary depending on who they speak to, reinforcing the idea that persistence rather than prevention is the safest route to help. Where prevention works better:
- reception, care navigation, and clinical staff reinforce the same messages
- patients receive similar advice regardless of who they speak to
- next steps feel predictable rather than variable
This consistency builds confidence for both patients and staff and reduces the sense that prevention is optional or dependent on who happens to be on duty.
Pulling it together
Effective prevention in primary care is rarely about ambition. It comes down to deliberate choices: engaging patients clearly, removing unnecessary friction, and supporting self-care in ways clinicians trust.
Together, these choices create a more structured and intentional approach to prevention, without turning it into a rigid process or an added layer of bureaucracy. From inside a practice, prevention rarely feels transformational in the moment. Its value shows up gradually in fewer repeat contacts, calmer workflows, and patients who feel more confident managing everyday issues. Gains that are easy to overlook but, over time, make prevention feel worth the effort.
These are the themes that Redmoor Health and ORCHA will explore further in a joint webinar focused on practical approaches to prevention and self-care that hold up in everyday primary care.
