Conclusion We will not sufficiently improve outcomes for people and their carers, nor will we release the associated It is widely accepted that prevention should sit cost efficiencies and savings. at the heart of the sector’s plans to innovate, FOI responses and joint health and wellbeing integrate and adapt to new challenges, strategies also emphasise the practical difficulties including financial. As previous British of shifting resources away from crisis intervention Red Cross studies have shown, there is no to prevention, especially in the current economic consistent understanding of exactly what climate. We hope this report supports this transition. ‘prevention’ is and how to put it into action. We also encourage local decision makers to The Freedom of Information (FOI) responses continue to explore ways of overcoming these indicate that local authorities are engaging with the challenges and to share useful learning. Care Act’s triple definition of prevention, but this terminology has yet to be embraced by Health and Recommendations Wellbeing Boards. We believe the triple definition of prevention is just as useful for the NHS, public health Decision makers across health and voluntary and community sector as it is for adult and social care: social care. > All health and social care decision makers It’s vital to ensuring preventative services are made should recognise that prevention is about more available across the life course and pathology of a than just stopping a condition or illness arising. condition or illness. Sharing the same language will It is about preventing, reducing and delaying become increasingly important as we move towards needs and associated costs. increased integration and joint working. > All health and social care decision makers should adopt the triple definition of prevention Both the FOI responses and joint health and terminology – unless we share the same wellbeing strategy review indicate that prevention is a language, we can’t be sure we share the key consideration in local decision making, including same ambition. As we move to increased commissioning. integration and joint-working this will become ever more important. However, while the review of joint health and Government and Whitehall: wellbeing strategies indicates an improved > The Government should look again at how understanding of prevention, tertiary types of to best enable local authorities to implement prevention are still not being emphasised as much the Care Act’s new duties in a meaningful way. as primary and secondary prevention. In some > The Department of Health should do more cases, they are forgotten altogether. Many Health and Wellbeing Boards are yet to place importance to distinguish between the older and on preventative measures that could stop the current versions of the Care and Support deterioration or reoccurrence of a health or social Statutory Guidance. care-related crisis by providing lower-level support. > The Department of Health should focus its Care Act implementation work on Local authorities are generally working to meet their understanding the legislation’s impact on new responsibilities under the Care Act. However, people. We hope this research serves as a there is so far little evidence of the innovative useful foundation with regard to solutions to preventing, reducing and delaying the implementation of the prevention duties. need for care and support that were the ambition of > The Care and Support Programme the legislation. Given the huge financial pressures on Management Office (Department of Health, local authorities, this is perhaps not so surprising. Local Government Association and the We are concerned that some local authorities are Association of Directors of Adult Social conflating their duty to provide information and Services) should review ‘opportunities for advice with their duty to prevent needs for care and shared learning’ to help local authorities be support. We will not achieve a truly preventative ‘truly innovative in the services offered in system by providing information and advice alone. their area’. British Red Cross Prevention in action [email protected] l l 25