NIHR School for Social Care Research: Local evidence of prevention investments, outcomes and sustainability

The objective of this study was to study the evidence used by English Local Authorities to make investment decisions in prevention services for older people and to gather practice-based evidence of the impact of these interventions. Directors of Adult Social Services identified their ‘top three’ prevention interventions and nominated local contacts who could provide further detail through semi-structured interviews. Due to the lack of a coherent and complete evidence base Local Authorities had to patch together the findings and/or guidance from a range of information sources, including that provided by central government, the limited number of formal research studies and third sector organisations. Local evidence was generated through pilot projects and learning from the experience of other Local Authorities. Other major influences on investment decisions were the professional opinions of Directors and political commitment to retain an element of in-house provision or funding for a third sector provider.

Reablement was commonly seen as one of their top three prevention interventions, and telecare and information and advice services were also mentioned by more than one area. The other interventions were all mentioned by only one Local Authority indicating considerable localism in their decision making. Clear outcomes were rarely set for the interventions, and gathering evidence of their effectiveness was generally limited to combining referral and process data with feedback from service users regarding their experience of receiving the support.

This study supports the case for improving the evidence base for prevention services and highlights Local Authorities need support to set and gather evidence on service and user outcomes.