Invest in early intervention and community capacity building

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In their sixth How-to guide for creating an asset-based area, Cliver Miller and Alex Fox look at prevention, ways of doing it and how to cost it.  

Investing in prevention, early intervention and community capacity building is a central feature of Asset-based Areas rather than a ’nice to have’ one.

It’s about tackling the causes of the causes early on and often away from an organisation’s ‘core business’, e.g. tackling poverty, to produce a long-term improvement in outcomes.  This contrasts with conventional commissioning’s focus on managing demand for services at a core business or sector level; an approach which aims to delay, reduce or channel demand, and invest in services and supports that have an immediate impact in the current financial year. The result is disinvestment in prevention and well-being that would produce greater and continuing outcomes well beyond the current financial year.  

The Lambeth and Southwark Early Action Commission, drawing on the work of the Early Action Task Force, provides an example of how an Asset-Based Area might approach prevention.

It uses a multi-level approach aimed at tackling issues when they are: ‘downstream’, i.e. acute, for example domestic violence; ‘midstream’ stopping problems getting worse; and ‘upstream’ tackling the causes of the causes. This model ties in well with the five key areas of transformation identified in Creating the five year forward view for social care:

Upstream

Helping all people and families to stay well connected to others and resilient when facing health or care needs.

Enabling people with support needs to do enjoyable and meaningful things during the day, or look for work.

Midstream

Supporting people and families who need help to carry on living well at home

Developing new models of care for adults and older people who need support and a home in their community

Downstream

Equipping people to regain independence following hospital or other forms of health care

Evaluating spend on prevention

Finding rapid and cheap ways of tracking and evaluating spend on prevention has always been a major challenge. Early Action Task Force used  a set of specially developed criteria.  In one and a half hours, a ‘bucketing’ methodology enabled a group of 10 assessors, to identify how much of the spend on each of 600 projects, was being invested in which of the three levels of prevention. 

Links to all of the above innovations and more can be found in:

Alex Fox. (2017)   The Asset-Based Area. Online: Coalition for Collaborative Care, Shared Lives Plus, and Think Local, Act Personal. Available at: https://lnkd.in/g2cfAbx

Richard Field and Clive Miller. (2017) Asset-based commissioning: better outcomes, better value. Bournemouth: Bournemouth University. Available as a free download, in both its full (215 pp) and digested versions (11pp), from http://www.ncpqsw.com/publications/asset-based-commissioning/ (opens new window)  

* This How-to guide is one of a series of 13 that put flesh on the bones of the vision of Asset-Based Areas and how they can be developed.