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Prevention in action: How are prevention and integration being implemented?

A new British Red Cross report has found that local authorities in England must do more in their areas to provide services that prevent, reduce or delay the need for care and support.

The report also identified shortcomings in plans for integrating health and social care.

It has long been recognised that ‘prevention is better than cure’. But the UK’s health and social care system has historically focused on reacting to crises rather than preventing them.

The introduction of the Care Act in April 2015 sought to change this. It placed a new duty on English councils to make sure preventative services were available locally.

However, our research suggests that the Care Act’s vision for prevention is not being fully realised.

While local authorities across England have made efforts to implement preventative services and demonstrate better examples of innovation, integration and good practice since our last report (2016), there are still many barriers.

These include a lack of clarity on what is meant by prevention and integration, resistance to cultural change, and stretched budgets and resources.

This lack of progress has its roots in a number of factors. Our report aims to help decision makers make the transition to a better and integrated, preventative care system.

The report provides a national picture of local developments and highlights areas of good practice.

Key recommendations

  • Local authorities should implement the full ambition of the Care Act’s prevention duties.
  • The Government should look again at what resources are required to enable local authorities to implement their prevention duties in a meaningful way.
  • The Government should also ensure that sustainability and transformation plans are equipped with the necessary funds to truly invest in transformation.  
  • The proposed upcoming green paper on social care should explore whether the Care Act’s prevention duty, in its current form, goes far enough in realising the prevention vision. 
  • The Government should better define what is meant by health and social care integration at a local level, so that local decision makers understand the scale and pace to which they should aspire.
  • As part of its proposed green paper on social care, the Government should explore what is needed to make integration work in practice, at both a local and national level. This should involve an exploration of the resources needed to achieve the full ambition of integration, as well as whether a legislative framework, as implemented in Scotland, is needed to aid the process. 

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