Dr Joan Madia

England records around 30,000 excess deaths every winter: 30% more people die daily in January than August. Respiratory disease, cardiovascular conditions, and dementia drive the seasonal surge, amplified by cold homes and an ageing population. The pattern is strikingly consistent across a decade of ONS data, and largely preventable.

Prevention programs deliver remarkable returns: childhood vaccinations save $11 for every dollar invested, preventing millions of illnesses and deaths. Evidence-based interventions like tobacco taxation and sodium reduction cost under $100 per quality-adjusted life year, far more efficient than treatment. Yet prevention receives only 3% of healthcare spending, despite addressing most disease burden.

Socioeconomic deprivation influences how people access emergency departments, with differing referral routes linked to varied ED experiences. Improving access to primary and urgent care may reduce inequalities and support more efficient emergency care use.