How has the idea of prevention been conceptualised and progressed in adult social care in England?

Abstract

Over recent years, a preventative approach has been promoted within adult social care policy and practice in England. However, progress has been somewhat inconsistent, in part due to issues around conceptualising what exactly prevention means within this context. Particularly since the financial crisis, there have emerged tensions between seeing prevention as a positive strategy to build assets and capability; as part of a neo-liberal project to roll back expectations for state support; or simply as a technocratic strategy to increase efficiency by deploying resources ‘upstream’ where they might have greater impact. This paper provides a critical perspective on how policy has unfolded over the last 15 years, which provides the context for an analysis of findings from a national survey of English local authorities and interviews with key stakeholders. These findings demonstrate a substantial commitment to preventative activity, but also some serious confusions and contradictions in how this agenda may be taken forward in the current policy environment.