The Local Government Association’s prevention Yet, while the triple definition of prevention has been spending model concluded that handyperson adopted by adult social care through the Care Act’s services have a return of £1.13 for every £1 invested statutory guidance, it was notably not mentioned in and telehealth care has a return of £2.68 for every the NHS Five Year Forward View. This is despite the 19 £1 invested. two documents being launched on the same day. Similarly, the Department of Health’s Mental Health The Red Cross is pleased that both recognise the Strategy 2011 estimated that its plans to expand need to shift from reaction to prevention. However, the provision of talking therapies services would ‘be unless we share a common language, we cannot strongly cost saving to the overall public purse, with be confident that we are all talking about the same a net saving of an estimated £302m’, representing a thing. With the Chancellor’s plans to integrate 20 23 public sector saving of £1.75 for every £1 spent. health and social care by 2020 , sharing the same definition will prove ever more important in effectively Yet, while local authorities see prevention as a key working together to make prevention a reality. source of savings for the future, spend on prevention only forms 6.6 per cent of local authorities’ budgets in 2015/2016 (a reduction in cash terms of 6 per 21 cent from the previous year) . As ADASS explains: ‘Many [local authorities] are struggling to balance investment in reducing future demand and costs at a time when budgets to meet existing statutory duties 8. NHS (October 2014), Five Year Forward View: england.nhs.uk/wp-content/ uploads/2014/10/5yfv-web.pdf 9. LGA & ADASS (October 2014), Adult social care funding: 2014 to provide care and support to state of the nation report: local.gov.uk/documents/10180/5854661/ Adult+social+care+funding+2014+state+of+the+nation+report/e32866fa-d512-4e77-9961- those most in need are under 8861d2d93238 10. ONS (October 2015), National population projections, 2014-based Statistical Bulletin: ons. 22 gov.uk/ons/dcp171778_420462.pdf such pressure.’ 11. ADASS (June 2015), ADASS Budget Survey 2015: adass.org.uk/uploadedFiles/adass_ content/policy_networks/resources/Key_documents/ADASS%20Budget%20Survey%20 2015%20Report%20FINAL.pdf A shared language 12. The King’s Fund (October 2015), Quarterly Monitoring Report: qmr.kingsfund.org. uk/2015/17/ 13. Chancellor George Osborne’s Spending Review and Autumn Statement 2015 speech (25 The Care Act clearly recognises that prevention November) is about more than just stopping something 14. The King’s Fund (25 November), The King’s Fund’s response to the Spending Review: kingsfund.org.uk/press/press-releases/kings-funds-response-spending-review arising. It is about preventing, reducing and 15. Simon Stevens (18 January 2015) delaying needs and associated costs. 16. Joint letter for the Chancellor and Secretaries of State, from Care and Support Alliance, Association of Directors of Adult Social Services, Care Provider Alliance, NHS Confederation (December 2015): careandsupportalliance.com/social-care-sector-response-to-the-spending- While public health interventions and reablement review/#sthash.eS0VEpiv.dpuf 17. ADASS (June 2015, ADASS Budget Survey 2015: adass.org.uk/uploadedFiles/adass_ services are generally recognised as preventative, content/policy_networks/resources/Key_documents/ADASS%20Budget%20Survey%20 there is much more to prevention than these 2015%20Report%20FINAL.pdf 18. Personal Social Services Research Unit, LSE & Research, Evaluation and Impact team, alone. And while public health initiatives – such British Red Cross (January 2014), An Analysis of the Economic Impacts of the British Red Cross as diabetes and obesity prevention – are gathering Support at Home Service: pssru.ac.uk/archive/pdf/dp2869.pdf pace, not enough attention is being paid to other 19. LGA (September 2015), Prevention: A Shared Commitment: local.gov.uk/ documents/10180/6869714/Prevention+-+A+Shared+Commitment+(1).pdf/06530655-1a4e- preventative measures. 495b-b512-c3cbef5654a6 20. The Department of Health (February 2011), Talking therapy services – impact assessment: gov.uk/government/publications/talking-therapies-impact-assessment It is not possible to prevent everything 21. ADASS (June 2015), ADASS Budget Survey 2015: adass.org.uk/uploadedFiles/adass_ entirely, so it’s important that preventative content/policy_networks/resources/Key_documents/ADASS%20Budget%20Survey%20 2015%20Report%20FINAL.pdf approaches and interventions are adopted 22. ADASS (15 May 2015), Budget Survey 2015: Key Messages: adass.org.uk/full-report- across the life course and pathology of a adass-budget-survey-2015/ 23. HM Treasury (25 November 2015), Spending review and autumn statement 2015: gov.uk/ condition or illness. The triple definition of government/publications/spending-review-and-autumn-statement-2015-documents/spending- prevention helps us do this. review-and-autumn-statement-2015#a-sustainable-health-and-social-care-system-1 British Red Cross Prevention in action [email protected] l l 9