Introduction
Within the public sector, adopting a preventative approach is generally recognised as a sensible course of action – for both financial and non-financial reasons.
Financially, prevention offers the opportunity to reduce costs at a time when budgets are tight. Cashable savings or demand avoidance can create space to re-allocate resources to pressing challenges elsewhere, including rising pressures on social care (1). Beyond the financial, it improves outcomes for the public. A person referred onto a highly effective drugs misuse programme may reduce future spend on their healthcare, but it also supports their health, wellbeing and employment prospects and reduces stressors to loved ones and communities.
Despite all these well-recognised benefits, however, daily pressure to respond to service demands often crowds out funding for, and strategic focus on, prevention. Practical work of implementing preventative approaches is also highly complex. For many parts of the public sector – including local government – learning how to make prevention a reality has long proved challenging.
The Challenge
In 2021, the London Borough of Hounslow launched its ‘One Hounslow’ model. This transformation programme sought to re-focus the council’s activity onto community priorities, work increasingly with communities and partners and join up services. The One Hounslow approach also promised greater focus on prevention.
The London Borough of Hounslow commissioned Leapwise to help support this greater focus on prevention, using our experience helping public sector organisations implement new ways of working at speed, including New Zealand’s social investment approach.
Our Approach
The work involved two projects. In the first, we developed the operating principles of a new preventative approach. Following the success of this project, we were then re-commissioned to conduct further ‘sprints’ to assess the potential benefits of taking a preventative approach in five separate areas of business – such as reducing hospitalisation among dementia patients – and to produce a benefits appraisal toolkit for further use in Hounslow.
- Developing prevention principles and initial opportunities
Hounslow harnessed Leapwise support to engage closely with key stakeholders, build readiness and momentum for changes, and identify the overall most promising areas for quick action. Together, we:
- Developed five key prevention principles, identifying what a Hounslow-specific approach to prevention might look like. This involved a strategy workshop, close engagement and interviews with senior leaders, and the production of a concise prevention paper, articulating the five principles and providing an evaluation framework for preventative investments.
- Applied the new prevention framework across three key opportunity areas, running acceleration workshops to galvanise new ideas and assess opportunities in the areas of fly tipping, youth education, skills and employment, and children affected by domestic abuse (CADA).Delivered further key actions to embed prevention ‘quick wins’, such as facilitating open discussion of potential extra funding for CADA in year ahead.
2. Rapid ‘Prevention Sprints’
This phase involved rapidly quantifying prevention benefits across key areas of business and developing a toolkit for further use.
We
- Conducted sprints to dive deeper into the benefits of prevention across five areas of activity – dementia (preventing hospitalisations), falls prevention, youth skills and employment, household income, and CADA. This involved drawing on evidence from within and beyond the council to quantify the potential benefits of successful preventative interventions in each area, and further data-driven analysis of likely benefits realisation.
- Produced a benefits mapping model (or toolkit) for further use by the London Borough of Hounslow. This toolkit was underpinned by a robust financial model to help quantify benefits, including a ‘confidence scale’ to ensure greater weight was given to more trustworthy data.
Results
Across the two projects, Hounslow achieved remarkable success in embedding its prevention-first model and its overall ‘One Hounslow’ work earned the authority a Local Government Association Council of the Year award. By developing tools and principles that would support practical implementation, we helped them turn the positive rhetoric around prevention into a new approach to day-to-day business. This helped them lay the foundations for their new model, one that could deliver substantial financial and non-financial benefits in the future.
Our work across these two projects resulted in:
- Five defined principles to guide the council’s renewed emphasis on prevention, with a short paper setting these principles out alongside an evaluation framework for future preventative investments.
- Clearer understanding of the social and public sector financial benefits of existing and planned investments in health (falls prevention and dementia), environment (fly tipping), social investments (youth employment interventions) and other areas, including where there is financial benefit to agencies of government and over what time period. This helped support evidence-based conversations about funding and avoid under-investment in programmes that really work for residents
- A clear case for expanding investment in an effective, innovative early help programme for children affected by domestic abuse which ultimately led to further long-term funding and a doubling of resources
- Close engagement with critical stakeholders within the council, including a workshop with senior leaders to frame out the prevention principles and ‘test and accelerate’ workshops to explore how they could be practically implemented.
- A benefits mapping toolkit, developed through five ‘sprints’, providing a model that would enable quantification of benefits in other areas in future.
At all times, our work was focused on prevention that works and creating an evidence base that allowed for wise investment decisions by the local authority and partners on tough, systemic issues, in the context of real financial constraints.
“I was initially introduced to Leapwise through another piece of work they had been supporting Hounslow with. It was impressive how they had been able quickly establish a good understanding of Hounslow’s strategic intent and provide work which added value. After discussing the requirements of my own project, to accelerate documenting systematically the expected benefits of a range of proposed change activity. Feedback from senior officers across the projects was positive throughout, particularly Leapwise ability to limit the burden placed on existing resources through ensuring all engagement was focused on the core task. The outcome surpassed expectations as it has delivered a methodology Hounslow is now seeking to adopt across all relevant change activity.“
– Robert Meldrum – Director, Commercial and Projects
To find out more about steps that can help embed a preventative approach, please reach out to our team to discuss this in more detail
You can also read about our prevention work in policing here.
