In his October Budget, the Chancellor announced a significant change in how government will approach prevention, committing to ringfence spending that reduces future costs at the next Spending Review.
This is an important step towards tackling one of the longstanding challenges facing public services, namely how to invest in preventing problems when budgets are dominated by the pressures of responding to immediate needs and primary intervention – whether that be health, welfare or other interventions delivered in our communities.
Setting and protecting prevention budgets at a departmental level is a welcome step forward, but it is only part of the answer. Effective prevention often requires investment across different public services, with the costs and benefits falling to different organisations and emerging over different timescales. With greater devolution of powers and funding to local areas within England, more of these decisions will sit with regional and local leaders. This raises important questions about how funding is allocated, how costs and benefits can be shared, and how national, regional and local government can work together to support more preventative approaches.
Our new report with The Health Foundation, ‘Power to Prevent: International Lessons on Regional Funding Models for Prevention’, draws on international experience to explore these challenges and identify practical lessons for funding prevention in the UK’s evolving system of devolution.
Learning from international experience
Drawing on international experience, the research examines for the first time how different prevention funding mechanisms can enable prevention at a regional and local level.
Drawing on 11 case studies from Australia, the United States, Germany, Spain, the Netherlands and Scotland, we explore how different governments and organisations have developed innovative approaches to funding prevention.
In Victoria, Australia, an Early Intervention Investment Framework embeds prevention directly into the state's annual budget process, linking investment to anticipated reductions in future demand.
In New York, financial incentives encouraged healthcare providers to redesign services around prevention. Meanwhile, Catalonia's Neighbourhoods Law demonstrates how regional and municipal governments can co-invest in improvements to disadvantaged communities.
Closer to home, Edinburgh's Regenerative Futures Fund shows how long-term public and philanthropic funding can empower communities to tackle the underlying causes of poor outcomes.
These examples offer valuable lessons, although the research also highlights the importance of robust evaluation and understanding whether anticipated savings are realised.
Seven recommendations for making prevention work
Across the case studies, a consistent message emerges: funding prevention requires more than additional resources. It requires changes to how public money is allocated, managed and accounted for, including giving local and regional leaders greater flexibility to invest across services and share the benefits of prevention
Our report identifies seven priorities for action:
