Prevention and early intervention

Scoping study for the Big Lottery Fund

Everyone seems to agree with the principle that prevention is better than cure: that a little effort now prevents a big problem later. And yet in practice there remains a culture of late intervention and fire fighting throughout public services.

Whether it’s long-term health problems, offending, or isolation among older people, we seem to wait until problems reach a crisis and then seek expensive, institutional responses from hospitals, prisons and care homes.

Across a range of policy issues, there is broad agreement that more should be done earlier, but when it comes to the detail, there is little clarity or consensus about how to fund prevention: about what works, where cashable savings exist and how interventions should be targeted. In this context there is a key role for independent funders—and the Big Lottery Fund (BIG) in particular—in helping to advance the debate on prevention: providing leadership, coordinating disparate efforts, taking risks, providing long-term commitment, and demonstrating what works with concrete, well-evidenced examples.

This report is intended to provide BIG with an overview of the policy landscape on prevention and early intervention in the UK, and help BIG identify opportunities where it could make a difference. NPC conducted research for this report between April and June 2012, including a literature review, and 30 interviews with BIG staff and external experts.

 Cultural issues are perhaps the greatest obstacle to prevention. They reach our core values. We’re inclined to support those already in most need, rather than trying to stop future harm.

Dawn Plimmer, report author