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07th November 2014

Prevention in Care Services

?????????????????????????????????????In my student days I wrote a dissertation on preventive social work. I think now that this was a misguided focus. Preventive work which is effective must, I think, be always interdisciplinary.

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?

Good examples

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.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Tony Clarke

Scottish Care Inspectorate Specialist

Tony began care work as a care assistant in care of the elderly here in Scotland in the 1970s. He very much enjoyed promoting activities, interests and good basic care. After a gap to gain a social work qualification, he worked in management of care services, latterly as a peripatetic manager which gave him experience of a wide range of services.

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