1. 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

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

3. 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

4. What’s the Curve?
# of People
Frailty

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

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

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

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

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

10. 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

11. 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”?