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.

Explore prevention and self-care

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.