If you live in Scotland, you may have recently received a letter inviting you to book your appointment at an Our Future Health clinic. Look at the bottom right-hand corner, and you’ll see Professor Dame Anna Dominiczak’s signature.

“I was honoured to be asked to do this,” she says. But really, the honour is all ours. Dame Anna is not only the Scottish Government’s Chief Scientist (Health), but also Regius Chair of Medicine, University of Glasgow and one of the world’s leading cardiovascular experts. In 2016, she was awarded her damehood for services to cardiovascular and medical science. During the pandemic, Dame Anna led a laboratory that processed 200,000 Covid tests a day.

Today, she says her mission is to use innovation and research to get NHS Scotland into sustainable shape. And Our Future Health is very much part of that plan.

“Our Future Health is very innovative,” she says. “With its ambition to recruit 5 million people, this study will have huge power to answer questions on public health. It will be used by researchers from all over the world.

“In Scotland, our public health doctors, researchers, statisticians and analytical teams will be able to look at Scottish data. Research using Our Future Health’s resource can be used by our NHS, by our social care organisations and by the Scottish Government.

“This health research programme is important for the entire population of Scotland.”

From small beginnings, big things

Dame Anna has had a seat on our Implementation board since 2022.  But her interest stretches back to 2018, when she first heard about the idea for a population-level research programme that brings together millions of volunteers. “I thought that recruiting 5 million people was extremely ambitious. But with appropriate funding and leadership, I saw that it was possible. My ambition was for Scotland to be the first of the devolved nations to open clinics. It’s fantastic that this has happened.”

Now it’s all up to the Scottish people, she says. “If Our Future Health can recruit half a million of the Scottish population, about 10 per cent, it will help us develop our public health strategies for Scotland.”

Her words go to the heart of why Our Future Health was created. The research that comes out of it “will drive innovation in healthcare, social care and help create a sustainable NHS for the future,” says Dame Anna.

Precision medicine for everyone

“The best way to describe Our Future Health is ‘precision public health’,” she says. The term comes from precision medicine, where medical decisions are designed with specific patient groups in mind. It’s the opposite of a ‘one-drug-fits-all’ approach.

For Dame Anna, the idea of precision public health offers a new way of thinking about how to make healthcare sustainable. She explains how it evolved.

“Traditionally, a good doctor always asked about family history, because your health is shaped by your parents’ health, your siblings’ health, your grandparents’ health. You could say that was the very beginning of precision medicine.”

Today, precision medicine uses the discoveries of the past 20 years to diagnose, treat and prevent diseases. That means using genomics, new scans, and biomarkers in the blood to tailor treatment for patients.

“Cancer is a good example,” says Dame Anna. “A blood test for cancer DNA could give you an early warning, allowing earlier and more successful treatment.And rather than treating ‘breast cancer’ as one type of cancer, we now treat it as subtypes. It allows doctors to give the right drug for that subtype.”

So, what is precision public health? “It’s using the same understanding of genomics and genetic makeup and proteins and biomarkers to look at disease – but at the population level,” she says. “This is what Our Future Health does.”

Moving from fixing to prevention

Dame Anna says that current healthcare is like a “repair shop”, where ill patients go to be fixed. But with precision public health, she says, “you can focus on prevention”. That means identifying people at risk of certain common diseases, then helping them to avoid ever needing to go to the repair shop.

It also means “diagnosing and treating a condition almost before symptoms begin”. She points to the patients she saw as a specialist in cardiovascular medicine at the Queen Elizabeth University Hospital in Glasgow: “They often had high blood pressure and a very sick heart, which led to heart failure. For many years in later life or even in middle age, they would be unable to go to work, and their life would be very limited. 

“If we can detect and treat these people earlier, they can avoid these complications. It would significantly reduce this long period of unhappy and unhealthy later life.”

“I look forward to the day when precision public health is simply regarded as ‘medicine’. Our Future Health is going to help us get there.”

Volunteering for a healthier Scotland

Dame Anna says that our research programme will shine a light on the specific health issues that affect people in Scotland. She gives the example of type 2 diabetes.

“It’s been growing for decade after decade, so it now affects a really large percentage of the population. We’re also seeing people getting diabetes earlier in life – young people who wouldn’t normally think they’re vulnerable.”

 By collecting health data from all types of people in Scotland, Our Future Health will offer health researchers the tools they need to better identify who is at risk of developing diseases like type 2 diabetes.

“Hopefully Our Future Health will include people who normally don’t join these kinds of studies, such as young men,” says Dame Anna. “If Our Future Health reaches young men who never usually think about their health, could we have a next generation who are healthier as they age? I believe the answer is ‘yes’.

“My message to the people of Scotland is: Come and join in! By volunteering, you’re becoming part of innovation in healthcare. Do it for yourself, but also for your children, your grandchildren and for Scotland.