Both nationally and locally the recent focus has been on the integration of health and social care and on prevention. The Care Act has introduced a wider duty to consider physical, mental and emotional wellbeing of individuals needing care and a duty to provide preventative services to prevent reduce and delay needs. The Better Care Fund allows further pooling of health and social care funding and the ability to integrate services further. The NHS and Public Health England publication ‘A Call to Action: Commissioning for Prevention’ (http://www.england.nhs.uk/wp-content/uploads/2013/11/call-to-action-com-prev.pdf) was launched in 2013 and provides a case for prevention and a framework for local action.
The aim of this prevention work is for an upstream shift to preventive action to reduce health inequalities and reduce premature morbidity and mortality, and for preventative work streams align and form a cohesive whole. Work around prevention and the integration of health and social care will involve the work of local authorities and clinical commissioning groups, acute NHS trusts, mental health trusts and voluntary and community sector organisations.
Any prevention approach will need to consider the life-course following the principles of starting well, living well and ageing well. To impact on prevention, programmes need to support successful aging from middle age onwards rather than simply aiming to support elderly people to prevent worsening of chronic conditions. Successful aging enables people to have the knowledge to develop the behaviours and acquire the skills as they grow older to avoid the development of disease and stay active and positively healthy until a short time before death. Successful ageing will include; survival to an advanced age whilst maintaining physical and cognitive function, maintaining functional independence and living a full and active life. It means morbidity and disability are compressed into a relatively short period before death in line with the ‘compression of morbidity’ theory(http://www.ageing.ox.ac.uk/files/workingpaper_206.pdf).
A prevention strategy covering social care and health within Devon is currently in development.