What is a preventative service?

There is a real need to understand prevention just now.

Social care services are facing increasing demand and expectations, alongside reducing resources. The draft Care and Support Bill makes it a statutory duty for local authorities to provide services or take other steps to prevent, reduce or delay needs for care and support. The growing integration agenda focuses on the need for proactive, joined-up services, and funding for integration is likely to be linked to services being able to show that they are effective in prevention.

For these reasons and, more importantly, because of the ethical imperative to be transparent about how public money is used and the effectiveness of public services, it is essential that preventative services can demonstrate their impact.

However, you can’t measure what you can’t define.

In order to understand what works in prevention and what impact preventative services have, you first need to define what prevention is.

The Social Care Evidence in Practice project, funded by the NIHR School for Social Care Research and Personal Social Services Research Unit at LSE, is working with researchers and people in social care to develop a framework for prevention. I have been involved in a mini project, on behalf of Research in Practice for Adults, which has drawn on this work to develop an approach to proving prevention in one local authority area.

From the mini project, and the wider prevention work, I have gathered some evidence-formed ideas of how prevention can be defined.

The definition should:

  • Be from the point of view of service users
  • Be positive rather than negative in aspiration
  • Include something about partnership
  • Include a focus on networks and communities as well as individuals
  • Be about assets not just needs
  • Not just be about services
  • Include something about reducing the need for interventions but from the point of view of service users.

My suggested definition is:

Prevention services are actions taken in partnership with citizens and their support network that:

Sustain or enhance quality of life (compared to what it would otherwise have been)

And reduce or delay the need for more intrusive services (that may be more costly)

For the benefit of an individual, their network and their community.

The process of thinking through what is meant by prevention has been invaluable in laying the foundation for future work on how to demonstrate impact.


Social Care Evidence in Practice project

Research in Practice for Adults (2013) Preventing need and maximising independence: Literature review