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Establishing and mainstreaming prevention
Setting up for success in initial piloting
This practical checklist focuses on what local authorities have indicated are essential first steps to begin a targeted prevention pilot. Rather than covering everything needed for long-term success, these suggested actions represent the minimum viable preparation to get a prevention programme off the ground effectively.
- Identify a specific group of people to target first (e.g., older adults at risk of falls, carers at risk of breakdown)
- Outline the scale of the issue locally, using available data on current needs and costs, and by talking to and listening to people drawing on support and care as well as those in the at risk groups
- Articulate clearly what success would look like for this cohort (both for residents and the system), informed by what individuals themselves say they want and need
- Identify and brief a senior sponsor within adult social care leadership
- Engage the relevant portfolio holder/lead member to ensure political support
- Secure necessary sign-off for initial resource allocation (staff time and any funding)
- Map which organisations are essential for your chosen group of people (e.g., NHS, housing, VCFSE and others identified by individuals themselves)
- Have initial conversations about potential collaboration with these partners, and including local residents, potentially using a framework such as Working Together for Change
- Identify specific individuals within each organisation who will be your key contacts
- Assess what data you already hold that could help identify at-risk individuals
- Determine what additional data you might need and potential sources
- Draft initial data-sharing requests for essential partners
- Agree how you will identify people at risk of crisis at scale through data
- Create a simple governance structure with clear decision-making authority
- Schedule initial steering group meetings with key stakeholders and with representation from people at risk themselves
- Assign a project lead with dedicated time to coordinate activities
- Select 3-5 key metrics that will indicate whether your pilot is successful, informed by what individuals themselves say good looks like for them
- Establish a baseline for these metrics before intervention
- Create a simple process for tracking these metrics throughout the pilot, including a means by which individuals voices and experiences will be captured
- Plan check-in points to review progress and make adjustments
- Identify staff who will deliver the prevention activities
- Ensure these staff have ring-fenced time to participate
- Secure any necessary funding for the initial pilot period
- Consider what training might be needed before launching
- Set up a mechanism to capture learning throughout the pilot
- Schedule regular reflection sessions with the delivery team and with representatives of people from the ‘at risk’ group/s themselves
- Create a simple way to document what works and what doesn't
- Identify how you will share emerging insights with stakeholders
From pilot to an embedded preventative system
Successfully piloting a targeted prevention approach with a single cohort creates both the capability and evidence base to transform an organisation into a truly preventative system. The journey from isolated pilot to embedded practice typically follows a staged pathway of intentional growth.
Building from initial success
Once an authority has developed the technical and operational capability to support one cohort effectively, and has built a convincing evidence base that secures leadership buy-in, expanding to additional cohorts becomes significantly easier. The infrastructure, skills, and ways of working established during a pilot provide a foundation that can be adapted rather than rebuilt from scratch.
This first pilot often serves as a 'proof of concept' that prevention works - demonstrating tangible improvements in resident outcomes alongside measurable system benefits. This evidence creates the momentum needed for more ambitious expansion.
Expanding within adult social care
The first stage of growth typically occurs within adult social care, applying the targeted prevention model to additional cohorts who might otherwise require formal services. For example, a council that successfully piloted falls prevention for older adults might expand to support:
- Carers at risk of breakdown
- Adults with learning disabilities transitioning to greater independence
- People with early-stage dementia and their families
- Adults experiencing social isolation and deteriorating mental health
Each expansion reinforces the prevention infrastructure while building a more comprehensive evidence base across diverse needs. This growing body of evidence strengthens the strategic and financial case for prevention as a core function rather than a discretionary activity.
Towards whole-council and whole-system prevention
With established prevention capabilities and a robust evidence base, local authorities can pursue two complementary growth pathways:
Whole-council prevention extends the approach beyond adult social care to benefit other council departments. This might include:
- Working with housing teams to prevent homelessness
- Supporting children's services to reduce care entries
- Collaborating with environmental services to address property issues before they escalate
- Partnering with public health on preventative health initiatives
Whole-system prevention develops increasingly integrated approaches with NHS partners, voluntary organisations, and community groups. This aligns with the neighbourhood health vision by:
- Creating joint prevention teams working at locality level
- Developing shared financial models that reflect system-wide benefits
- Establishing unified assessment and intervention pathways
- Building community capacity through asset-based approaches
The choice between these pathways—or pursuing both simultaneously—often reflects a council's strategic priorities and local system relationships. What has found to be critical is maintaining intentionality about the desired end state, as this will shape how the organisation develops its capabilities from the outset.
Making the transition
Moving from pilot to embedded system requires deliberate attention to several key elements:
- Strategic alignment: Explicitly connecting prevention work to corporate priorities and system-wide transformation programmes, positioning it as an enabler of broader goals rather than a standalone initiative.
- Governance evolution: Transitioning from project-based governance to established structures that embed prevention within core business. This might include creating dedicated prevention boards or integrating prevention metrics into existing performance frameworks.
- Cultural development: Fostering a prevention mindset and coproduction approach across the organisation through consistent leadership messaging, staff development, and celebrating prevention successes. This cultural shift is often the most challenging but essential element of sustainable change.
- Partnership maturity: Moving from informal collaboration to more structured partnership arrangements with shared accountability, integrated workflows, and possibly pooled resources. This may begin with bilateral relationships before expanding to more complex multi-agency arrangements.
- Technical infrastructure growth: Scaling data systems, analytics capabilities, and intervention pathways to handle increasing volumes and complexity while maintaining quality. This requires ongoing investment in both technology and the skills to use it effectively.
By deliberately planning this transition from the outset, rather than treating a pilot as a standalone project, authorities can create the conditions for prevention to become embedded as a core function across the local authority and across the wider system.
