An alternative to the 'one-size-fits -all' approach to public engagement in preventive healthcare, leading to healthier ageing for all

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**We know preventive healthcare is crucial for managing the common complaints of ageing**To manage the common complaints of ageing is to understand them. For long-term and chronic conditions (a major source of the common complaints of ageing) this is best achieved by attending NHS prevention programmes. These programmes identify these conditions early, allowing preventive action to be taken, or help individuals to self-manage an existing condition.**High public engagement in prevention is a structural and behavioural challenge**The problem is that not everyone benefits from these programmes. Older adults are increasingly likely to live with one or more long term or chronic condition. This means that need for these programmes is increasing every year as our population ages. But the preventive healthcare programmes that manage or screen for these conditions are underperforming.The causes for underperformance are both behavioural (how do you get a high proportion of individuals to participate?) and structural (how do you get care providers to prioritise prevention?).These causes intersect in the 'call and recall' process, which NHS GP practices follow to engage the public in preventive programmes. This includes outbound letters, SMS or emails typically asking the recipient to 'please call the practice'.We have identified this process as the major blocker to effective preventive healthcare. It creates several barriers for patients accessing appointments:* "I don't understand what I'm being offered"* "I try to call the GP but can't get through"* "I never received the invitation"* "The times offered don't work for me"A one-size-fits-all approach is usually taken but, too often, that leaves people out.**Our innovation is a movement away from 'one-size-fits-all'**Appt-Health (Appt) is an established social enterprise with a track-record of successful innovation. Building on top of Appt's established patient engagement platform, we will prototype a 'targeting engine'. This will mean that different cohorts of patients will receive different appointment invitation workflows.This innovation serves two purposes. It allows us to:1. carry out controlled trials, to compare which invitation strategies work best.2. target separate demographic cohorts with an invitation strategy that is most suited to them.We will use this prototype targeting engine to carry out six controlled trials to evaluate different invitation strategies. These strategies will be informed by user needs, identified by research. By understanding which invitation strategies work best for which patient cohorts, we will revolutionise the way we think about patient engagement.