Prevention

Definitions and duties

Primary prevention: Taking action to reduce the incidence of disease and health problems within the population, either through universal measures that reduce lifestyle risks and their causes or by targeting high-risk groups.

Secondary prevention: Systematically detecting the early stages of disease and intervening before full symptoms develop – for example, prescribing statins to reduce cholesterol and taking measures to reduce high blood pressure.

Tertiary prevention: Softening the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy.

Wider determinants of health: These are the social, economic or environmental factors affecting health, such as housing, employment, education, or parks and green spaces

The King's Fund: Broader determinants of health

Councils and public health: Local authorities were given renewed responsibility for public health as part of the 2012 health and social care reforms.

• Department of Health: The new public health role of local authorities  sets out the main statutory duties for public health that were conferred on local authorities by the Health and Social Care Act 2012
• LGA: Wellbeing and prevention breakdown of the statutory duties and legislation 

CCGs: Commissioning for prevention is one potentially transformative change that Clinical Commissioning Groups (CCGs) can make, together with Health and Wellbeing Boards and other local partners

• NHS Commissioning Board: the range of core CCG functions as set out in legislation

The Care Act: Under the Care Act, local authorities make sure that people who live in their areas:

• receive services that prevent their care needs from becoming more serious, or delay the impact of their needs
• can get the information and advice they need to make good decisions about care and support
• have a range of provision of high quality, appropriate services to choose
• .gov.uk: Care Act factsheets: information on the Care Act.

Frequently asked questions

What is the evidence base

• The evidence base for prevention and public health is growing; Public Health England and others have wide range of tools to demonstrate return on investment (see below)
• Collecting data from local services to show what is effective and what produces cost savings in the short term and upstream
• Regional, national and international evidence can also support investment cases

Case studies and examples

• LGA: Public health's role in local government and NHS integration: cases studies from areas in which public health is one of the local leaders of integration
• The Marmot Review (Fair Society, Healthy Lives): the definitive review of the most effective evidence-based strategies for reducing health inequalities in England
• Bristol Ageing Better: Bristol – A brilliant place to grow old: Bristol's partnership, working to reduce social isolation and loneliness among older people and help them live fulfilling lives
• NHS Clinical Commissioners: Delivering a healthier future: a series of case studies highlighting CCG leadership on prevention and early diagnosis
• Croydon CCG – Prevention, self-care and shared decision making strategy: the CCG's strategy to enable residents and patients to take greater responsibility for their own health
• PHE: Health and Care Integration: Making the case from a public health perspective includes case studies of local interventions
• North East Commission for Health and Social Care Integration: Health and Wealth - Closing the Gap in the North East sets out a vision for transforming the health and wellbeing of North East residents.

LGA support and resources

• Public health programme: a wide range of resources including briefings, publications and events
• Prevention: A shared commitment making the case that investing £1bn in 11 evaluated interventions could yield a return in savings of £1.90 for every £1 spent over a five year period
• Health in All Policies: a manual for local government: a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas
• Public health's role in local government and NHS integration: a resource to promote public health's involvement in integrating care, health and wider public services.

Selected tools and resources from our partners

• PHE: Data and analysis tools: a single point of access to data and analysis tools from across Public Health England
• PHE: Spend and Outcome tool (SPOT): an overview of spend and outcomes across key areas of local government business and for public health and its sub-programmes
• National voices: promoting prevention: a summary of the evidence: what works in prevention and health promotion
• Social Care Institute for Excellence's prevention hub has case studies, research and tools
• NHS England: CCG outcomes tools: NHS outcomes tool providing interactive access to key data.
• Local health and care planning: menu of preventative interventions outlines public health interventions that can improve the health of the population and reduce health and care service demand.