Prevention and the Care Act – A Chance to Shift the Curve? LCAS Care Act Event 25th November 2014 Kensington Town Hall Steven Falvey, Senior Commissioner, Adult Social Care Steve Shaffelburg, Strategic Public Health Adviser Public Health

The Challenge Away from crisis Intervene early Help individuals take more responsibility Create a system that is preventative, personalised and proactive

How do we get there? By working together By having a common language and definition of prevention Prevent Reduce Delay By sharing a vision Preventing needs for care and support (1) A local authority must provide or arrange for the provision of services, facilities or resources, or take other steps, which it considers will— (a) contribute towards preventing or delaying the development by adults in its area of needs for care and support; (b) contribute towards preventing or delaying the development by carers in its area of needs for support; (c) reduce the needs for care and support of adults in its area; (d) reduce the needs for support of carers in its area

What’s the Curve? # of People Frailty

(The Individual Approach) Crisis Intervention (The Individual Approach) # of Adults ££££ Individual Approach FRAILTY

Why is it not sustainable? # of Adults ££££££££ Individual Approach FRAILTY

We could shift the threshold… # of Adults ££££ Individual Approach FRAILTY

Or We Can Shift the Curve (Population Approach) Ageing Population Population Approach # of Adults FRAILTY

Tipping Points? Secondary Prevention # of Adults Individual Approach Tipping Points FRAILTY

People First/Making Every Contact Count Adults and Prevention A – Primary Prevention B – Secondary Prevention C – Tertiary Prevention # of Adults Primary Prevention involves individual and population health interventions to prevent or delay dementia, disability and frailty. It includes a range of interventions delivered across Public Health and other council services and summarised in NICE public health guidance on Dementia, disability and frailty in later life – mid-life approaches to prevention i.e. stop smoking, increase physical activity and everyday activity, reduce alcohol consumption, adopt healthy diets, healthy ageing, delaying dementia onset, reducing social isolation, mitigating visual/hearing loss. ASC has a supportive role in primary prevention focusing mainly on sign-posting to information and advice. This role can be considered within the context of Making Every Contact Count (MECC). MECC is an approach that would see all officers trained in the skills required to have a purposeful conversation with residents/clients/customers about issues that can support their health and well-being. ASC officers and providers would then be able to signpost clients and/or carers to primary care services using a wide range of information sources, notable People First. Conversely, officers from other departments would be able to signpost residents to secondary/tertiary prevention services as appropriate. Secondary prevention involves individual and population health interventions that target individuals/populations at high-risk of losing independence and focuses on risk factors that are amenable to prevention – malnutrition, falls, social isolation, medicine management, fuel poverty etc. ASC has a major role in providing/commissioning these services Tertiary Prevention aims to reduce the impact of established needs of people in receipt of care and improve quality of life. For some, but not all, of these individuals the aim will be to shift them to B or A. ASC has the lead role. Frailty A B C People First/Making Every Contact Count

Table Discussion Map your services along the curve What, if anything, can your service do to help shift the curve? What do you think the Councils should focus on to “support the shift”?