How local authority and Health and Wellbeing Board strategies overlap Local authorities are engaging with the triple regard to the importance of prevention through definition of prevention terminology more than Clause 1(3). Accordingly, there is a clear duty on local Health and Wellbeing Boards. Over half of the authorities and their relevant partners to co-operate local approaches to prevention that have already with one another in preventing, delaying and reducing been developed and over a quarter of local authority needs for care and support and carer’s support. commissioning strategies specify all three types These duties, coupled with the return of public health of prevention compared to just 12 (eight per cent) responsibilities to local authorities as a result of the of the joint health and wellbeing strategies. This is 2012 Act and the new prevention duty, present a perhaps to be expected, as the legislation’s duties unique opportunity for aligning prevention services 73 pertain to local authorities. However, the Care Act across health and care and support.’ statutory guidance is clear that a local authority’s commissioning strategy should be ‘integrated with As the place where key partners come together, the Joint Strategic Needs Assessment and Joint Health and Wellbeing Boards are well-placed to 71 Health and Wellbeing Strategy’. The statutory enable this sort of co-operation. The Care Act’s guidance recognises: statutory guidance also identifies joint health and wellbeing strategies as the ‘key means by which local ‘Preventative services, facilities or resources are authorities work with Clinical Commissioning Groups often most effective when brought about through to identify and plan to meet the care and support 74 partnerships between different parts of the local needs of the local population, including carers.’ It authority and between other agencies and the is therefore vital they continue to update their community such as those people who are likely to use strategies and prioritise prevention accordingly. 72 and benefit from these services’. However, as also seen in the joint health Recommendation: and wellbeing strategies, local authority FOI responses sometimes demonstrated confusion > All health and social care decision makers as to what constitutes primary, secondary or should adopt the triple definition of tertiary prevention. They also cited more prevention terminology – unless we share primary and secondary preventative the same language, we can’t be sure we interventions than tertiary. share the same ambition. As we move to increased integration and joint-working Finally, a number of local authorities referred to joint this will become ever more important health and wellbeing strategies in their responses to one or more of the questions asked in the FOI request. While – as noted above – this connection is welcome, it is particularly concerning that only around a third of the joint health and wellbeing strategies have been updated since 2014 and fewer than a quarter mention the Care Act (or Care Bill). Under Sections 6 and 7 of the Care Act, local authorities and their relevant partners must ‘co- operate’ in order to carry out their various functions. 68. Department of Health (October 2014), Care and Support Statutory Guidance, Chapter 2 Earl Howe noted how this relates to prevention: (“Developing a local approach to preventative support”), Section 2.23 69. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 2 (2.5) 70. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 2 (2.24) ‘Such co-operation is to be performed for the 71. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 4 (4.51) 72. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 2 (2.30) purposes of, among other things, promoting an 73. Earl Howe, The Parliamentary Under-Secretary of State at the Department of Health (3 July individual’s well-being, which in turn includes having 2013): publications.parliament.uk/pa/ld201314/ldhansrd/text/130703-0003.htm 74. Department of Health (October 2015), Care and Support Statutory Guidance, Chapter 15 (15.9) British Red Cross Prevention in action [email protected] l l 23