Delivering prevention in a complex reform landscape: what needs to change? 

Written by Ruth Luscombe & Gaby Sims

“We have reform everywhere all at once,” said Adrian Smith, Chief Executive of Nottinghamshire County Council, opening our recent Shared Learning Event.

The scale and pace of change facing councils present significant challenges, but it also creates a rare opportunity to embed prevention at scale. Realising that opportunity will require councils to think differently about service design, workforce models, local intelligence, and leadership.

These themes were at the heart of the discussion, as senior leaders from Nottinghamshire, North Lincolnshire, and Coventry councils joined Professor Toby Lowe to explore what it will take to turn reform ambitions into lasting preventative change.

Building the data and insights to inform how and where to target resources 

It’s a cliché, but “one size fits all” models for prevention won’t work. Speakers reflected that knowing your people and place is essential for taking the right approach locally to prevent or delay crisis and avoid the significant costs that follow.  Coventry spoke about using data and insights to align on cohorts for targeted prevention, based on where it might be possible to avoid or delay need,  if support and outreach were better joined up across multiple services.  North Lincolnshire spoke about building a sophisticated understanding of neighbourhood needs, using an ice-cream analogy: “not every neighbourhood is the same flavour”. Successfully targeting preventative investment requires a shared understanding of where need can be prevented, delayed, or reduced, particularly when resources are limited.

Reform offers an opportunity, but we must widen the scope for service design 

The temptation when implementing statutory reforms is to focus on immediate core services in scope. However, as both Coventry and North Lincolnshire are showing through their models, the real benefits will come from casting the net wider. Universal services offer huge potential in achieving preventative outcomes. Advice services, libraries, leisure, and so on, are well placed to identify and help people access support early. Embedding integrated neighbourhood models through these services creates the opportunity for residents to thrive independently. North Lincolnshire is championing this approach, establishing integrated neighbourhood hubs within community facilities that provide easy access to help and smooth, supported pathways into community-led, targeted, or specialist support,  a simple front door that serves as an ‘extension of people’s living rooms’.  

We must be intentional about the workforce model that will really help people 

Prevention requires a workforce enabled and set up to support it. In our experience, this means a workforce enabled with the right tools, multi-skilled and confident to make decisions based on people’s needs. At the event, leaders discussed different viewpoints on the balance of organisation design versus culture change and new ways of working. The former is not without the risk of disruption while changes are embedded. However, it can also be a way to clearly signal intent and mission to your workforce and ensure resources are directed more effectively.  Moving to fewer role types across front-line services, as described by North Lincolnshire,  while respecting professional disciplines, can support collective ambition.  The challenge for leaders is to ensure that organisation design is used as an enabler, rather than as the end product. The real prize will come from enabling frontline teams to see their role in a new light, not simply managing scarce resources, but using their judgement to do the right thing to help the person in front of them.  

The best models for prevention won’t be driven from the “top down”  

Professor Toby Lowe challenged traditional approaches to public service reform with a simple observation: “You can’t deliver a relationship”. He argued that many public services remain organised around performance frameworks, statutory duties, and risk management rather than the relationships that help people thrive. Instead, he advocated for organisational models built around learning, adaptation and trust.

This chimes with our work at IMPOWER, where much of our focus is on embedding strengths-based, relational approaches that support people across a continuum of preventative, targeted, and complex services, driving better outcomes that ultimately cost less. 

Speakers shared the need to work collectively as one council and with partners to truly embed prevention. Discussions recognised the multiple, interconnected root causes of need, and the need for multidisciplinary, person-centred approaches. To achieve preventative outcomes, we need to cut across service delivery silos with a shared vision and narrative, driven by collective leadership.  

Finally, the business case is best made across a continuum of need & cost 

Prevention is a critical part of councils’ approach to long-term financial sustainability. Three-year funding settlements are enabling councils to take a longer-term view; however, with tight resources and multiple competing reforms, councils need certainty that they are investing in the right approaches to reduce spending down the line. Speakers reflected on the different ways they are thinking about the business case, whether this is unlocking savings through more joined-up service design, or aligning programmes with broader transformational savings such as from their commercial strategies. With 70-80% of spend on complex services, the business case is best made against a continuum of need and demand, with short, medium and longer term benefits. IMPOWER is working with organisations to do exactly this; setting out a three-year ambition for prevention, and identifying savings through preventative service design and demand management. If you are interested in hearing more, please contact Ruth Luscombe [email protected].