THE CARE ACT: one step closer to putting prevention in action In 2014 the ambition to shift towards a truly During the passage of the Care Bill, the British preventative system was enshrined in law. Red Cross argued that this wasn’t sufficiently Section 2 of the Care Act places a new duty preventative. We wanted preventative services to on local authorities to ensure the provision of be available to everyone who may benefit from services that prevent, reduce or delay the need them, so that fewer people reach the point of crisis. 1 for care and support. Prevention is also a key Under Section 9(6)(b) of the Care Act, local component of the NHS Five Year Forward View, a authorities now have to consider whether shared vision for the NHS that notably calls for ‘a people could benefit from preventative services 2 radical upgrade in prevention and public health’. when carrying out a needs assessment, before 4 a determination is made as to their eligibility. Earl Howe, the then Parliamentary Under-Secretary And, as noted in the statutory guidance: of State at the Department of Health emphasised the importance of the Care Act’s prevention duty: ‘Where the local authority judges ‘Clause 2 creates a clear legal that the person may benefit from duty on local authorities to ensure such types of support [services the provision of preventative that prevent, reduce or delay the services… we believe that need for support], it should take preventative care can increase steps to support the person to 5 quality of life for individuals, while access those services.’ having the potential to provide The Red Cross also advocated strongly for longer-term financial savings to prevention to be clearly defined. We were concerned that because the term is understood differently the public purse. It is only with this across the country, there was a need to be explicit greater focus on prevention and about what ‘prevention’ entails, in order to support integration that both the NHS and local authorities to fulfil their new duty effectively. care and support can respond We were pleased that three equally important to the financial pressures of an forms of prevention were written into the statutory guidance: 3 ageing population.’ Historically, preventative services were only available to people with needs that met council eligibility thresholds. This meant that in the large majority of areas, people were required to have ‘substantial’ or ‘critical’ needs before they could access preventative services like reablement. 1.Care Act 2014, Section 2: legislation.gov.uk/ukpga/2014/23/section/2/enacted 2. NHS (October 2014), NHS Five Year Forward View: england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf 3. Earl Howe, The Parliamentary Under-Secretary of State at the Department of Health (29 July 2013): publications.parliament.uk/pa/ld201314/ldhansrd/text/130729-0001.htm 4. Care Act 2014, Section 9(6)(b): legislation.gov.uk/ukpga/2014/23/section/9/enacted 5. Department of Health (October 2014), Care and Support Statutory Guidance, Chapter 6 (6.62) British Red Cross Prevention in action [email protected] 4 l l