Preventative Spend: Magu Report Introduction

Cliciwch yma am y Gymraeg

Local Authorities across the UK are under increasing financial pressure. The Welsh Local Government Association (2024) estimated a budget gap of £559 million in 2025-26 for Council services in Wales. In response to these fiscal constraints, attention is returning to the role of ‘preventative spend’ in reducing future demand for services across the UK.

Preventative spend interventions that reduce demand for acute services are widely recognised as being cost-effective. However, these ‘savings’ are often realised over the longer term, and political cycles can lead decision makers to prioritise short-term results, ‘overlooking the profound and lasting advantages of preventative activity’ (Scott, 2024: 9). Increases in acute demand and significant financial pressures have also led to a decrease in preventative spending (Hoddinott, Davies and Kim, 2024).

The area of focus for preventative efforts varies between different public bodies. Those falling within the remit of Local Authorities often have a positive impact on the social determinants, or ‘building blocks’ of health, including areas such as transport, employment, housing, education, clean air and safe surroundings. Any savings achieved can accrue to other parts of the public sector (e.g. investment by a Local Authority may lead to reduced costs for the police or health boards). In Wales, there is potential for collective savings to be recognised and realised. The Wellbeing of Future Generations (Wales) Act places a legal duty on public services to prioritise long-term thinking and prevent problems from becoming worse, and offers the opportunity to appraise the value of collective preventative efforts.

Identifying which preventative interventions are effective and where the benefit may accrue is a complex task. First, it is difficult to define what constitutes a preventive activity; the Institute for Government concluded that ‘there is not an obvious, objective way of distinguishing between acute and preventative services, policies and programmes’ (Hoddinott, Davies and Kim, 2024: 9). Second, Local Authority ledgers are not currently set up to enable easy assessment of levels of preventative investment (Roy, 2024). Lastly, the long-term nature of preventative efforts can make measuring impact challenging. Demonstrating causality and cost-effectiveness of specific interventions may require large scale research studies and costly economic evaluations that enable assessment over long periods of time, and even then, it may be difficult to attribute an outcome to a specific service.

Rhondda Cynon Taf County Borough Council (RCT CBC) and RCT Health Determinants Research Collaboration are working together to develop a process to 1 enable the Council to map preventative spend and better understand potential outcomes. To achieve this, we set out to:

• Define different types of prevention for a Local Authority context;

• Describe how much is being spent on delivering preventative activities; and

• Assess the potential impact of spend in terms of outcomes for residents and communities and return on investment.

If gaps in evidence or impact measurement are identified, we aim to support skills and capacity development for impact measurement and/or support development of research funding proposals.

Given resource and capacity constraints within local authorities, the aim was to explore how to map spend and outcomes for three selected areas, drawing on existing evidence and expertise. This report focuses on the first of those areas: preventing parent-baby separation.

In undertaking this work, we adapted definitions of prevention for use in local authority settings (see section below). We also partnered with the Chartered Institute of Public Finance and Accountancy (CIPFA) to describe how much is being spent, drawing on their efforts and expertise in supporting local authorities to map preventative spend (Scott, 2025). More information on CIPFA’s work can be found in Section 1. To explore potential service outcomes, we examined those achieved by similar services elsewhere, drawing on existing evaluations.

Defining prevention

Table 1: Categories of prevention

In this report, we draw on definitions of prevention outlined by CIPFA and the Office for the Future Generations Commissioner (FGC), as demonstrated in Table 1 above. More information can be found in our briefing note on defining preventative spend (Notman, Bryan and Lloyd, 2025).

Preventing parent-baby separation: review questions

This report focuses on one area of prevention: preventing parent-baby separation. An evaluation of whether services in RCT prevent children from needing care and safely support children to leave statutory care, conducted in 2020, concluded that more needed to be done to reduce the number of infants (children aged under 12 months) becoming looked after (Institute of Public Care, unpublished). The evaluators highlighted a growing trend of local authorities to issue care proceedings at or soon after the birth of a child, providing a ‘typically short window for pre-birth assessment’. This results in prospective parents, who are known to be vulnerable, not having sufficient opportunity to work purposefully on their parenting skills before the child is removed from their care.

As a consequence of the IPC report, funding streams were reconfigured to deliver Magu, “an integrated care pathway for pregnant women and their families across early intervention and edge of care services, that focuses on building skills and resilience and reducing risk” (Rhondda Cynon Taf County Borough Council, 2021). The term ‘Magu’ translates from Welsh as ‘to bring up, rear, nurture, raise, gain’ and promotes the ongoing long-term nature of the support required to deliver better outcomes.

Although a variety of services contribute to preventing parent-baby separation in RCT (and are included in the financial assessment in section 1), only Magu has this preventative aim as its primary purpose. The focus on the impact of services, and therefore the other sections on this report, is therefore on the outcomes and impacts of Magu and similar services set up elsewhere.

Table 2 below highlights the research questions, methods and types of evidence used. We focus on describing and tracking preventative spend in section 1, with the remainder of the report focusing predominantly on impact. Section 2 then examines population data to enable a better understanding of the extent of the problem.

In sections 3 and 4, we explore academic evidence on the outcomes for children and families resulting from parent-baby separation, including parents’ experience of statutory care proceedings. This provides some understanding of what services aim to prevent.

We then reviewed services similar to Magu that have been formally evaluated to identify good practice (section 5), and the beneficial outcomes identified as a result of these services (section 6). In section 7, we compare Magu to models of good practice to understand shared features, and how these may contribute to beneficial outcomes. Finally, the information is brought together to make an assessment of Magu in terms of return on investment (section 8).

It is important to note that while we focus on preventing parent-baby separation, this outcome will not always be possible nor desirable in every case. The quality of the family environment in which a child is raised has a significant influence on their experiences and long-term outcomes (Clements and Birch, 2023). Whilst the benefits of children remaining with their birth families are well documented, it is equally important to consider the associated risks. Negative experiences within the home or wider community can increase the likelihood of poorer outcomes and engagement in harmful behaviours as children grow older (Public Health England, 2020). When it is not beneficial for a child to remain with their birth parents, statutory service interventions can mitigate risks and promote positive trajectories for vulnerable children (Public Health England, 2020). Services often work with vulnerable parents and aim to reduce risk to prevent parent-baby separation, where suitable. However, it is recognised that sometimes this is not the best option for the child, and sometimes separation is necessary due to the risk involved. It is important to recognise that not all cases are preventable.

Table 2: Methods and evidence used for each review question

Read the next section: How can preventative spend in this area be mapped and quantified?