Learning from 25 years of preventative interventions in Scotland

(Part 1: Overview) 1. Executive Summary

This report includes 15 case studies of preventative interventions introduced in Scotland in the period since devolution. Cross-cutting observations relating to these case studies are set out below:

• There are a large number of post devolution examples of preventative interventions that have been shown to improve outcomes, reduce costs and reduce demands on public services.
• There is evidence to suggest that some of these interventions have been successful at reducing socio-economic disadvantage and health inequalities.
• There are several examples where Scotland has led the way in introducing new and innovative approaches to prevention. There are also examples of successful international interventions being adopted and adapted in Scotland. Many of these are in public health.
• There are a wide range of preventative ‘levers’ that policy makers have at their disposal. Those discussed within the case studies include population level policies and regulations, cash transfers, vaccination programmes, financial incentives, intensive support programmes, community engagement, changes to the physical environment, and income maximisation advice and support.
• Investment in the evaluation of preventative interventions has been mixed. It appears that there is a stronger culture of evaluating these interventions in some policy areas than in others. There are a limited number of evaluations that include full economic analysis or examine longer term impacts.
• The lack of investment in evaluation means there is insufficient evidence to assess the impact or value for money associated with some preventative interventions.
• Introducing preventative interventions can be challenging. These approaches often require organisations to work together in new ways, involving closer multi-agency working that closely aligns with current priorities relating to public service reform.
• There is evidence that preventative interventions have been successfully targeted to meet the needs of particular groups and provide more intensive support to those with greater need.
• There are examples of preventative interventions being informed by behavioural research, resulting in changes in behaviours and attitudes.