Prevention and self-care
What is this and how does it work?
A goal of integrated care is to enable people to maintain or regain independence and improve their quality of life. Prevention and self-care are as essential to meeting this goal as the coordination of health and social care services.
With prevention support, people should be able to make informed decisions about their care and wellbeing; develop skills and knowledge to self-manage their long-term conditions; remain active in their communities and not socially isolated.
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Video transcript Open
Prevention and self-care. What is this and how does it work?
One of the goals of integrated care is to enable people to maintain or regain independence and improve their quality of life. Prevention and self-care are as essential to meeting this goal as is the coordination of health and social care services.
With prevention support, people can make informed decisions about their care and wellbeing.
How does prevention support integrated care?
An individual's prevention goals and interventions should be identified as part of the joint needs assessment and care planning process. Prevention then becomes integrated to care coordination and provision.
Supporting people to live healthy lives and preventing or delaying the deterioration of their conditions requires a broad spectrum of interventions. Interventions might include:
- health education and coaching for self-care
- social prescribing
- information and advice services
- telehealth
- telecare.
This expands the range of services that can be used to support individuals' needs. Examples include the coordination of care with a housing association or the local fire service to provide a falls prevention service.
Who are prevention interventions aimed at?
Simply anyone who has deteriorating health or a growing dependency on Health and Social Care. There are great benefits to having services that add to more traditional health and social care.
What do preventive interventions need to succeed?
Strategies include improving people's skills and education, providing an easily navigated service environment, encouraging participation and others.
What is the evidence for outcomes and impact?
There is a growing body of evidence for prevention interventions although their outcomes and impact are varied. With older adults, interventions that support self care effectively increase self-rated health and wellbeing. And research around health coaching programs indicates that they lead to improved self-management and confidence, healthier behaviours and better health outcomes.
By supporting people's understanding of their conditions, encouraging activation and improving overall health outcomes, preventive and self-care programs may result in a reduction in demand for hospital care.
Explore prevention and self-care
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Guidance Open
- NHS RightCare: frailty toolkit: optimising a frailty system (NHSE, 2019)
- The role of technology in combating loneliness and social isolation (Housing LIN 2018)
- Adding extra years to life and extra life to those years: local government guide to healthy ageing (LGA 2018)
- Technology-enabled services for older people living at home independently (European Commission 2015)
- The anatomy of resilience: toolkit (Social Care Wales 2017)
- Staying on my feet: a practice guide for care homes (My Home Live Cymru 2018)
- Prevention is better than cure: our vision to help you live well for longer (DHSC 2018)
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Practice examples Open
- Prevention research and practice: service examples (SCIE)
- Self care: councils helping people look after themselves (LGA 2018)
- Adapting for ageing: good practice and innovation in home adaptations (Centre for Ageing Better 2018)
- Adding extra years to life and extra life to those years: local government guide to healthy ageing (LGA 2018)
- TEC stories: how technology enabled care has transformed people's lives (TSA et al. 2018)
- Helping people look after themselves (LGA 2016)
- Beyond fighting fires: The role of the fire and rescue service in improving the public's health (LGA 2015)
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Measuring success Open
- NHS RightCare: frailty toolkit: self-assessment questionnaire (NHSE, 2019)
- A return on investment tool for the assessment of falls prevention programmes for older people living in the community (Public Health England 2018)
- Outcomes against which the success of prevention should be monitored (Centre for Policy on Aging 2014)
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Research Open
- Prevention research and practice: research (SCIE)
- The (cost‐)effectiveness of preventive, integrated care for community‐dwelling frail older people: a systematic review (Health and Social Care in the Community 2019)
- Raising the bar on strength and balance: the importance of community-based provision (Centre for Ageing Better 2019)
- “It was the whole picture” a mixed methods study of successful components in an integrated wellness service in North East England (BMC Health Services Research 2018)
- "Economic evaluations of falls prevention programs for older adults: a systematic review (Journal of the American Geriatrics Society 2018)
- Preventive interventions for the second half of life: a systematic review (American Journal of Health Promotion 2018)
- Prevention in action: how prevention and integration are being understood and prioritised locally in England (British Red Cross 2017)
- The effect of complex interventions on supporting self-care among community-dwelling older adult (Age and Ageing 2018)
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Latest evidence Open
These are the latest resources from Social Care Online, the UK’s largest database of care knowledge and research.
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Reducing preventable admissions to hospital and long-term care: a high impact change model
- Local Government Association, 2021 -
Learning from each other in the context of personalisation and self-build social care
- Taylor and Francis, 2021 -
Greater Manchester falls prevention: delivering integration and reconditioning
- University of Manchester, 2022 -
Interactional practices in person-centred care: conversation analysis of nurse-patient disagreement during self-management support
- Wiley, 2021 -
The state of health and care 2022
- Institute for Public Policy Research, 2022 -
Health and social care reform in Scotland: what next?
- International Foundation for Integrated Care, 2021 -
Barriers and facilitators to person-centred infection prevention and control: results of a survey about the Dementia Isolation Toolkit
- BioMed Central Ltd, 2022 -
Places of living and places of dying: the case for preventing suicide in residential long-term care
- Cambridge University Press, 2021
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Reducing preventable admissions to hospital and long-term care: a high impact change model
How does prevention support integrated care?
An individual’s prevention goals and interventions should be identified as part of the joint needs assessment and care planning process. Prevention then becomes integrated to care coordination and provision. This recognises that supporting people to live healthy lives, and preventing or delaying their conditions deteriorating, requires a broad spectrum of interventions, services and approaches – not only traditional health and care services. These interventions might include:
- self-care and self-management
- patient activation
- health education and coaching
- social prescribing
- information and advice services
- housing and home adaptations services
- telehealth and telecare.
Prevention approaches should also address the wider determinants of health and wellbeing. When health and care professionals work cooperatively with other public services and the voluntary sector, prevention effects can be amplified. This expands the notion of which services can be integrated to support individuals’ needs. Good examples include the coordination of care with a housing association and the commissioning of the local fire service to provide a falls prevention service.
Who are prevention interventions aimed at?
Preventive interventions and the promotion of self-care are suitable for anyone receiving integrated care, based on personal needs, skills and preferences. Anyone who is at risk of deteriorating health or greater dependency on health and care services would benefit from having access to services that augment or complement more traditional health and social care.
What do preventive interventions need to succeed?
Successful interventions for prevention need to:
- target people at higher risk (through risk stratification)
- improve people’s skills and education (through health coaching, self-care, and self-management education)
- encourage activation and participation (through social prescribing and asset-based approaches)
- create a supportive, easily navigated service environment (through single points of access, community navigators and community links)
- ensure partners beyond statutory health and care services are considered as part of prevention service design (including housing support services and the voluntary and community sector)
What is the evidence for outcomes and impact?
There is a growing body of evidence for prevention interventions, although their outcomes and impact are varied because of different study design:
- The evidence suggests that a comprehensive approach to supporting older adults in the community effectively increases self-rated health, reduces the occurrence of falls and improves the mental sub-scale of quality of life.’
- Self-management education has been shown to increase self-efficacy, patient understanding of their condition, activation and overall health outcomes, resulting in reduction in A&E attendances and emergency admissions.
- Similarly, the emerging evidence around health coaching programmes indicates that they lead to improved self-management and confidence, the adoption of healthier behaviour and better health outcomes.
- Finally, the evidence shows that patient activation, which describes the knowledge, skills and confidence a person has in managing their own health and care, is a good predictor of health outcomes and can be improved through targeted interventions.