Event
Designing prevention that reaches people
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The ecosystem in conversation with Neko Health
The NHS has talked about prevention for decades but today, only 5% of the health budget goes on preventing illness, while 40% is spent treating preventable diseases. That gap has created space that private companies, consumer health platforms and insurers are increasingly filling -raising urgent questions about who funds it, who delivers it, and who gets access.
On 28 April, SomX and Neko Health brought NHS leaders, clinicians, investors, academics and policymakers together at Hale House to explore what prevention looks like at scale. The evening featured a fireside chat with Hjalmar Nilsonne, co-founder and CEO of Neko Health, and Dr Nikita Kanani MBE, Global Medical Director at Neko Health, hosted by Dr James Somauroo of SomX.
The real debate isn’t clinical
Clinically, nobody disagrees that catching disease early beats treating it late. The disagreement is about cost, access, incentives and pace.
As Hjalmar put it: “It’s not something there is much debate about, other than the practicalities of what’s possible right now, what are the right steps, and who should pay for it.”
Access is about more than cost
The NHS Health Check demonstrates that even free prevention fails if people don’t engage,and fewer than half of eligible people do. The programme was designed around what clinicians know people should do, rather than how people actually behave. Trust, cultural context and lived experience of the system all matter.
Consumer health companies like Neko Health have approached this differently, starting with the experience. Hjalmar drew on co-founder Daniel Ek’s lesson from Spotify: people paid for music they’d been downloading for free once the experience was good enough.
The NHS understands this, and that’s shown in vast behavioural insights, social prescribing, the long push towards personalised care, but its challenge is delivery; as former Primary Care lead for NHS England, Nikita has felt this acutely.
The incentive problem
Some of the greatest barriers are structural. The NHS is still largely funded around activity, meaning incentives for prevention are often weaker than those for treatment. The benefits of prevention are also harder to realise, with savings often emerging years later in a different budget and sometimes under a different government. While insurers and employers may have more closely aligned incentives, neither can deliver the universal reach prevention requires, and relying too heavily on either risks widening existing inequalities.
Closing the gap will require the NHS and consumer health companies to share risk, share data, and agree on what success looks like. The intent in the room was clear. The hard work is in the doing.
It’s not something there is much debate about, other than the practicalities of what’s possible right now, what are the right steps, and who should pay for it.
