Too many people have to reach a crisis point before they receive the health and social care support they need.
That’s why we support the Care Act’s duties on councils to ensure that preventative services are available in their area and that access to these services is broadened.
We also support ambitions to shift towards health and social care integration. We believe this could result in fewer people falling through the gaps and also help encourage a real move towards prevention.
However, there is no consistent understanding of exactly what ‘prevention’ and ‘integration’ are and how to put them into action.
Putting prevention in action
We want decision makers across health and social care to recognise that prevention is about more than just stopping something arising; it is about preventing, reducing and delaying needs and associated costs.
However, our annual research, which looks at how local authorities in England have implemented their prevention duties under the Care Act, suggests much more needs to be done to make the prevention vision a reality.
While prevention is present in local authorities’ strategies and plans, our report shows the term itself remains misunderstood. This is despite the Care Act’s attempt to provide a clear triple-definition of prevention.
The Red Cross advocated strongly for prevention to be included in the Care Act and for it to be defined.
We were successful, with three equally-important forms of prevention being written into the statutory guidance. Read the triple definition of prevention in our report, Prevention in Action.
While our research also shows there is a clear progression from the situation last year, with more prevention programmes moving from the planning stage to reality, innovative examples are still far and few between.
More than two years since it came into force, we are disappointed the Care Act’s vision for prevention is still not being fully realised.
Integrating health and social care
Local authorities and Sustainability Transformation Partnerships also demonstrate an inconsistent level of understanding of what health and social care integration is, while the level of ambition also differs from place to place. This is despite government plans for full integration by 2020.
Health and social care is being integrated in a range of ways, from pooling budgets to integrating services and management structures.
Yet, it seems few actions have been done at scale. And, in some cases it seems local authorities are ‘cooperating’ rather than ‘integrating’ with health services.
The duties to co-operate (under Sections 6 and 7 of the Care Act) and the duty to integrate (under Section 3 of the Care Act) are distinct.
This lack of progress has its roots in a number of factors, including a lack of sufficient resources.
Despite financial restraints, more can be done at a local level. Our report intends to help decision makers make the transition to a preventative and integrated health and social care system.
It provides a national picture of local developments and highlights areas of good practice.
Read our report to see the extent to which prevention and integration is being prioritised and implemented locally.
A step-by-step guide to tracking your preventative spend
We recognise that councils and other local decision makers have tough decisions to take about their local priorities and resource allocation.
To help councils manage and track their preventative spend, we worked with the LGiU, Mears and Camden Council to develop a toolkit.
The toolkit can also be used by health and well-being boards, clinical commissioning groups, and other local statutory bodies.