The Care Act definition of ‘triple wellbeing. The 5YFV makes little, if incorporated the continuum of prevention’: any, reference to tertiary prevention primary, secondary and tertiary PREVENT: primary and only limited reference to prevention, but all bar one of the prevention/promoting secondary; much of its emphasis is studied Strategies mentioned wellbeing on primary prevention with the initial prevention (Field, 2014). focus of delivered action being the Opportunities for Primary prevention is aimed at introduction of a nationwide diabetes people who have no particular prevention programme. It does, change health or care and support however, state the commitment that Local authorities and the NHS share needs. The intention is to help a the NHS is “getting serious about the priorities of meeting needs person avoid developing needs prevention” (NHS, 2014: 9). within the context of promoting for care and support, or help a individual wellbeing, integrating carer avoid developing support Despite little, if any, incorporation of services, and preventing, reducing needs. It includes universal tertiary prevention within the 5YFV, and delaying need in order to policies like health promotion, according to its Mandate, one of minimise the loss of independence. first aid learning and universal the responsibilities of the NHS is to The case studies in the next section services like community activities help people recover from episodes of this report demonstrate that that prevent social isolation. of ill-health. The Mandate goes on short-term wheelchair loans can REDUCE: secondary to explain that recovery is achieved promote individual wellbeing, with prevention/early intervention “through effective treatment but also some of those interviewed stating through on-going help in recovering that the loan was essential to their Secondary prevention is more quickly and regaining independence” wellbeing. The preventative value targeted. Interventions are aimed (DH, 2014b: 15). The combination of short-term wheelchair loans is at people who have an increased of the 5YFV’s recognition of primary also demonstrated within the report risk of developing health or and secondary preventative findings; not only with regard to care and support needs, or at approaches, plus the Mandate’s individuals and their families, but carers with an increased risk of recognition of tertiary preventative also with regard to associated cost developing support needs. The approaches, demonstrates that the savings. goal is to help slow down or NHS commitment to “get serious reduce any further deterioration, on prevention” is in parallel with the The current landscape is one of to prevent further needs from 2014 Care Act’s new duty on local health and social care planning, as developing, and to prevent a authorities to do the same. well as commissioning intentions crisis occurring. Secondary HWBs – in which local authorities being integrated through HWBs. prevention includes short-term and the NHS come together locally New integrated models of care, provision of wheelchairs, – recognise prevention as a key underpinned by single, integrated handyman services, “social driver for planning, commissioning budgets, are emerging through prescribing” services and and provision of services. Research initiatives such as the Greater telecare. conducted by the Red Cross in Manchester devolution. The DELAY: tertiary prevention 2014 showed that, among 138 integration ambition is increasingly HWBs studied, the majority of being realised, and this landscape Tertiary prevention is aimed at their Joint Health and Wellbeing affords us a new opportunity to minimising the effect of disability Strategies put an emphasis on ensure that everyone who needs or deterioration for people with prevention. There was variation as short-term use of a wheelchair can established or complex health to the extent to which the Strategies get one. conditions. The goal is to support people to regain confidence and skills, and to manage or reduce need, where possible. For people who have already reached the point of crisis, the goal is also to prevent this recurring. Tertiary prevention includes reablement, rehabilitation and bed-based intermediate care. (DH, 2014a: 7–12, bold added) 7