Abstract

The UK population is ageing rapidly and the extent of comorbidities will continue to increase. This greater demand for support and care will need to be met within an environment of continued economic restraint. One policy response to mitigate such demand has been the reinvigorated focus on prevention and early intervention in health, social and third sector care. Prevention is broadly defined to include a wide range of services that promote independence; prevent or delay the deterioration of health and well-being resulting from ageing, illness or disability; and delay the need for more costly and intensive services. In exploring the existing evidence base around effective and cost-effective preventative services, our typology of prevention includes the accepted discourse of primary, second and tertiary prevention, while placing those ‘upstream’ well-being interventions at the core of any prevention strategy.

In particular, we recommend that a Care Navigator (CN) model is universally adopted as a central intervention in ensuring the development of a ‘seamless’ pathway for users and carers. CNs, often employed by the voluntary sector, but with a core role in multidisciplinary teams, identify available services, signpost and support access and facilitate appropriate service integration through their role as ‘link worker’ . While the CN role has been implemented in many different ways, the identified core tasks consist of assessment of need, education, collaboration, communication, support, coordination and follow-up of care across the relevant pathway. Outcomes from previous (albeit limited) evaluations have demonstrated reduced use of out of hours GP services and A&E; fewer repeat attendances at GP surgeries by patients for non-clinical matters; improved take-up of outpatient clinics; and improved health-related quality of life.