Preventative Spend: How can preventative spend in this area be mapped and quantified?
One of the core aims as part of our work was to describe how much is being spent on delivering preventative activities. This first section describes our approach to do this and then highlights our findings on quantifying spend which aims to prevent parent-baby separation in RCT.
The Chartered Institute of Public Finance and Accountancy (CIPFA) and the Health Foundation have recently partnered with three Local Authorities in England to better understand the practices required to track and measure prevention spend, and the extent to which local authorities’ spending on preventative action can be quantified (Roy and Finch, 2023). CIPFA’s exploratory work with partner councils and wider stakeholders sought to build consensus on a definition and scope for preventative action, against which services/programmes could be mapped to identify current levels of spending against those criteria. RCT HDRC partnered with CIPFA to draw on their expertise and learning to inform efforts to map preventative spend in RCT.
As part of their work, CIPFA co-produced a four-step approach to mapping and measuring prevention, providing a consistent process that could be used across different policy areas, to develop a shared understanding of prevention throughout the organisation (Scott, 2025). The four steps involve:
Setting the scope and defining a clear focus area
Identifying all services and activities within the scope, regardless of whether they are preventative or not
Applying the definitions of prevention to classify each service based on its target population and primary purpose
Collecting financial information to understand how much is being spend in each area
(Scott, 2025)
It is important to note that the CIPFA tool only attempts to map where and how much is spent on prevention, rather than measuring outcomes or effectiveness, providing clarity and creating the foundation for other work, such as in the other questions within this report (Scott, forthcoming). The remainder of this section outlines the findings from our use of the CIPFA mapping tool, attempting to quantify how much money in RCT is spent on services aiming to prevent parent-baby separation.
Mapping services in Rhondda Cynon Taf
Table 3 provides a summary of spend in Rhondda Cynon Taf on services that aim to prevent parent-baby separation. Many services identified as contributing to the purpose of preventing parent-baby separation also provide services aimed at older children as well, with Magu targeted exclusively at infants.
This meant that budgets needed to be apportioned in order to track the spend for those classified as infants. To do this, we used the proportion of cases under one year old for that service, which proved challenging to gather. Multiple different teams held this data, meaning that a very considerable amount of time and labour was required to obtain it.
Table 3: Summary of preventative spend on services in RCT which aim to prevent parent-baby separation
Stage of Prevention | Core Funding | Grant Funding | TOTAL |
Foundational | £0 | £0 | £0 |
Primary | £0 | £139,698 | £139,698 |
Secondary | £7,394 | £371,861 | £379,255 |
Tertiary | £306,599 | £340,000 | £646,599 |
TOTAL | £313,993 | £851,559 | £1,165,552 |
Predominantly, the services identified as preventing parent-baby separation are grant funded, with this amounting to 73% of total spend. Given the high proportion of the current investment funded by short-term grants, RCT CBC may want to consider the reallocation of core funding at the primary and secondary stages to mitigate the potential risk to upstream interventions, should this funding reduce or cease.
Preventative activity was mainly concentrated on the tertiary stage, which in practice terms would be cases open to statutory services. This comprised around 55% of preventative activity, based on value. No money is spent on foundational prevention in this area. The Council provides the majority of the identified services, although some funding is provided to the local health board through joint contracts for midwifery and health visiting for vulnerable families.
Council ledgers do not allow this type of information to be easily extracted. It took time to discuss and agree how stages of prevention could be applied to services, based on how they were budgeted for. This was overcome by simplifying the definitions of prevention to those which appear at the start of this report and focusing on the target population of primary service users, whether that be the entire population, or at specific groups at risk or, or currently experiencing a specific problem.
In theory, it should become easier to track preventative spend in future years once initial decisions have been made, as it requires services to simply consider whether the judgements for the stage of prevention activity falls within have been changed, and the budget allocation to be updated. However, when a significant amount of apportioning is required, as we found in our application of the tool, this becomes highly labour-intensive if the apportioning is dependent on data which is not easily available. Changes to data structure would be required to make the process more seamless, but this may still remain difficult depending on the exact data required. Moreover, apportioning using caseloads makes it possible to only retrospectively track preventative spend, unless these are used to make predictive estimates for future years. This poses challenges for future financial forecasting.
Key Points
RCT HDRC partnered with The Chartered Institute of Public Finance and Accountancy (CIPFA) to draw on their work mapping preventative spend.
The majority of services identified as preventing parent-baby separation in RCT were grant funded and focused on tertiary prevention.
Council ledgers do not currently allow preventative spend information to be easily extracted.
Establishing the type of prevention and associated costs for each service required lengthy discussion and significant effort due to the need for apportioning.
Retrospectively tracking preventative spend poses challenges for future financial forecasting.