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Prevention in Care Services
Prevention work in social care is usually considered in three forms: preventing problems arising in the first place, dealing with the effects of a problem in the second stage, and finally working to prevent a worsening of a problematic situation which has occurred.
There are many signs in our present care systems that prevention work needs to be improved, or perhaps simply needs to be done.
NHS funding crisis
The NHS funding crisis is one sign: treatment of our individual health needs seems to create a mushrooming effect of ever increasing demand and over-stretched budgets. Medical care seems, shockingly, not to meet still less prevent our health needs arising and increasing. Witness the spread of obesity, and the wide range of illnesses which accompany it.
Another indicator is the apparent large scale failures of our child protection systems. There is apparent increasing evidence that child abuse has been somewhat tolerated by organisations which should be working in partnership against it. The government is, with great difficulty it appears, setting up an inquiry into why this has occurred. Protective prevention has in many cases seemed to be ineffective, and tragically harmful to many young people.
H Gilbert Welch, a Professor in medicine has written a book called “Over-diagnosed: Making People Sick in the Pursuit of Health.” This points to the weaknesses of preventive health screening: looking for wrong things is not a good way to promote health, he suggests. Instead it promotes disease.
So how can preventive services be promoted to genuinely avoid or at least reduce these social wide issues?
There are good examples of how this can be done. In Cornwall, for example, a Living Well pioneer project devised by Age UK, is changing the lives of many of its older people.
The scheme is reported to have reduced significantly emergency hospital admissions, reduced admissions to long term care, and shown improvements in older people's measured wellbeing. It involves social care services, health commissioners, voluntary organisations and community resources, with proposed merging of budgets.
This model brings agencies together, effectively and at lower cost providing the individual with sustained increase in quality of life. We could do well in all our services to consider this model, and other pointers to genuine prevention and genuine improvement in social welfare.
Tony Clarke – QCS Expert Scottish Care Contributor